Do Pregnant Women ≥40 Years have Higher Stroke and MI Risk Postmenopause?
This study by Qureshi et al. (AJOG, 2017) sought to determine the cardiovascular effects in postmenopausal women following pregnancy at an advanced age (≥40 years), a question that has become increasingly important in the age of ART.
Retrospective Cohort Study
The investigators used the data collected in the Women’s Health Initiative Study. Outcome measures were ischemic stroke, myocardial infarction, hemorrhagic stroke, and cardiovascular death in the postmenopausal period. 4.6% of the participants (3,306) reported a pregnancy at ≥40 years. When multivariate analysis was applied, women who were ≥40 years at the time of last pregnancy were 50% more likely to have a hemorrhagic stroke, compared with women with pregnancy at younger ages (hazard ratio 1.5; 95% CI, 1.0-2.1). No such statistically significant difference was found for other cardiovascular effects after adjusting for confounders. The authors conclude that pregnancy at ≥40 years increases the risk for hemorrhagic stroke in the postmenopausal period.
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