{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:01:31Z","timestamp":1791925291901,"version":"4.3.4"},"reference-count":100,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,1,23]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Preterm delivery (&lt;37\u00a0weeks gestational age) affects 11% of all pregnancies, but data are conflicting whether preterm birth is associated with long\u2010term adverse maternal cardiovascular outcomes. We aimed to systematically evaluate and summarize the evidence on the relationship between preterm birth and future maternal risk of cardiovascular diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A systematic search of\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">MEDLINE<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">EMBASE<\/jats:styled-content>\n                      was performed to identify relevant studies that evaluated the association between preterm birth and future maternal risk of composite cardiovascular disease, coronary heart disease, stroke, and death caused by cardiovascular or coronary heart disease and stroke. We quantified the associations using random effects meta\u2010analysis. Twenty\u2010one studies with over 5.8\u00a0million women, including over 338\u00a0000 women with previous preterm deliveries, were identified. Meta\u2010analysis of studies that adjusted for potential confounders showed that preterm birth was associated with an increased risk of maternal future cardiovascular disease (risk ratio [\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">RR<\/jats:styled-content>\n                      ] 1.43, 95% confidence interval [CI], 1.18, 1.72), cardiovascular disease death (\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">RR<\/jats:styled-content>\n                      1.78, 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 1.42, 2.21), coronary heart disease (\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">RR<\/jats:styled-content>\n                      1.49, 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 1.38, 1.60), coronary heart disease death (\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">RR<\/jats:styled-content>\n                      2.10, 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 1.87, 2.36), and stroke (\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">RR<\/jats:styled-content>\n                      1.65, 95%\n                      <jats:styled-content style=\"fixed-case\" toggle=\"no\">CI<\/jats:styled-content>\n                      , 1.51, 1.79). Sensitivity analysis showed that the highest risks occurred when the preterm deliveries occurred before 32\u00a0weeks gestation or were medically indicated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Preterm delivery is associated with an increase in future maternal adverse cardiovascular outcomes, including a 2\u2010fold increase in deaths caused by coronary heart disease. These findings support the assessment of preterm delivery in cardiovascular risk assessment in women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.117.007809","type":"journal-article","created":{"date-parts":[[2018,1,15]],"date-time":"2018-01-15T20:11:02Z","timestamp":1516047062000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":181,"title":["Preterm Delivery and Future Risk of Maternal Cardiovascular Disease: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"7","author":[{"given":"Pens\u00e9e","family":"Wu","sequence":"first","affiliation":[{"name":"University of Keele","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Gulati","sequence":"additional","affiliation":[{"name":"University of Arizona","place":["Phoenix"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Shing","family":"Kwok","sequence":"additional","affiliation":[{"name":"University of Keele","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Wai","family":"Wong","sequence":"additional","affiliation":[{"name":"University of Keele","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Narain","sequence":"additional","affiliation":[{"name":"University of Keele","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaughn","family":"O'Brien","sequence":"additional","affiliation":[{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"Keele University School of Medicine","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn A.","family":"Chew\u2010Graham","sequence":"additional","affiliation":[{"name":"Keele University","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"Keele University","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganga","family":"Verma","sequence":"additional","affiliation":[{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh T.","family":"Kadam","sequence":"additional","affiliation":[{"name":"University of Leicester","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"University of Keele","place":["Stoke\u2010on\u2010Trent, United Kingdom"]},{"name":"University Hospital of North Midlands","place":["Stoke\u2010on\u2010Trent, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1186\/1742-4755-10-S1-S2","article-title":"Born too soon: the global epidemiology of 15 million preterm births","volume":"10","author":"Blencowe H","year":"2013","unstructured":"Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, Kinney M, Lawn J. 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