Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Preterm Delivery and Cardiovascular Health in Women of Reproductive Age

Sun, Baiyang (2024) Preterm Delivery and Cardiovascular Health in Women of Reproductive Age. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

[img] PDF
Restricted to University of Pittsburgh users only until 19 August 2026.

Download (2MB) | Request a Copy

Abstract

Pregnancy is considered a stress test for cardiovascular risk in women of childbearing age. Women who experience preterm delivery are seen as failing to adapt to the dramatic physiological changes during pregnancy (i.e., increased insulin resistance, increased triglycerides, and increased cardiac output with accompanying reduced systemic vascular resistance and blood pressure) and have been found to have a higher risk of cardiovascular disease (CVD) later in life. However, the mechanisms linking these two conditions remain unclear. Accumulating evidence indicates that preterm delivery is associated with cardiometabolic risk factors before, during, and after pregnancy, suggesting a shared pathway between preterm delivery and CVD. My dissertation uses longitudinal data to explore why preterm delivery is associated with an elevated risk for CVD from a life course perspective, considering traditional cardiometabolic risk factors at different periods relative to pregnancy.
In the first paper, I investigated whether the unfavorable changes in the cardiometabolic profile associated with preterm delivery begin before, during, or after childbearing. I found that preterm delivery was associated with unfavorable patterns of change in diastolic blood pressure and adiposity that originate during the childbearing years and persist or worsen later in life.
In the second paper, I examined how cardiometabolic risk factors and preterm delivery relate to coronary artery calcification. Compared to women with term delivery, impaired fasting glucose and elevated blood pressure are more detrimental to the development of subclinical atherosclerosis among those with preterm delivery.
In the third paper, I tested the hypothesis that changes in blood lipids from during pregnancy to years after pregnancy may vary based on delivery outcomes. I found that women with spontaneous preterm delivery experience blunted changes in lipids from mid- to post-pregnancy, potentially reflecting impaired ability to adapt and recover from pregnancy.
By examining cardiometabolic risk factor changes across different periods relative to pregnancy, this dissertation enhances our understanding of the mechanistic pathways between preterm delivery and future maternal CVD. This is of public health significance because women with a history of preterm delivery could benefit from closer monitoring of cardiometabolic risk factors for better risk stratification and preventative intervention for early CVD.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sun, Baiyangbas154@pitt.edubas1540000-0001-6154-3787
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCatov, Janet M.jmcst43@pitt.edujmcst430000-0002-9551-851X
Committee MemberBertolet, Marniemhb12@pitt.edumhb120000-0002-5799-9033
Committee MemberBrooks, Maria M.mbrooks@pitt.edumbrooks0000-0002-2030-7873
Committee MemberHubel, Carl A.hubelc@pitt.eduhubelc0000-0003-2326-9902
Committee MemberGunderson, Erica P.Erica.Gunderson@kp.org0000-0002-2039-1964
Date: 19 August 2024
Date Type: Publication
Defense Date: 29 July 2024
Approval Date: 19 August 2024
Submission Date: 9 August 2024
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 159
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: cardiovascular disease risk factors; life course; longitudinal cohort study; preterm delivery; women
Date Deposited: 19 Aug 2024 17:19
Last Modified: 19 Aug 2024 17:19
URI: http://d-scholarship.pitt.edu/id/eprint/46846

Metrics

Monthly Views for the past 3 years

Plum Analytics


Actions (login required)

View Item View Item