Abstract 4139455: Do Congenital Heart Defects in Offspring Signal Early Signs of Maternal Cardiometabolic Dysregulation and Increased Risk of Cardiovascular Disease Later in Life?

Introduction: A recent study suggested an association between a history of delivering a child with congenital heart defects (CHDs) and development of cardiovascular diseases (CVDs) later in life; however, little is known about this possible association. Research Question: Do women with a CHD-affected pregnancy have a higher risk of CVD compared to women who had a pregnancy unaffected by a structural birth defect? Goals: To determine the CVD risk among women with a history of a CHD-affected pregnancy. Methods: A total of 1,423 women who delivered an infant with at least one of selected CHDs, and 1,020 women who delivered a live-born infant with no structural birth defects were identified from the Arkansas site of the National Birth Defects Prevention Study (August 1997 – December 2011) and linked to the Arkansas All-Payers Claims Database (2000-2022) to identify cases of CVD. CVD was identified using International Classification Diagnostic Ninth (ICD-9) and Tenth (ICD-10) codes and was categorized as ischemic, cerebrovascular, essential hypertension, other heart diseases, other CVDs, and any CVDs. Women were followed from the estimated date of delivery of their offspring (in years) until the date of the first CVD event, death, or the end of the study (January 1, 2023), whichever occurred first. Unadjusted and adjusted hazard ratios (aHR) with corresponding 95% confidence intervals (CIs) were calculated from Cox Proportional Hazard regression analyses. Results: Both adjusted and unadjusted models showed women with CHD-affected pregnancies had a higher risk of developing any type of CVD than those with no structural birth defects. Women with CHD-affected children had a 1.40 times risk of developing any type of CVD (aHR=1.4, 95% CI: 1.1, 1.8) after adjusting for potential confounders. For specific types of CVD, the risk was (aHR=3.7, 95% CI: 1.1, 13.1) for developing ischemic heart disease. Conclusion: Women with CHD-affected pregnancies have an increased risk of developing CVD in later life. CHD-affected pregnancies may be early signs of cardiometabolic dysregulation and CVD in later life. Additional studies are needed to further investigate this possible association.