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Association between pregravid physical activity and family history of stroke and risk of stillbirth: population-based cohort study.

ABSTRACT: OBJECTIVES:To evaluate whether family history of disease and pregravid lifestyle and cardiovascular risk factors are associated with subsequent stillbirth delivery. DESIGN:Prepregnancy cohort study. SETTING:Cohort Norway regional health surveys (1994-2003) linked to Medical Birth Registry of Norway for deliveries through 2012. PARTICIPANTS:13 497 singleton births (> 22 weeks gestation) in 8478 women. MAIN OUTCOME MEASURE:Risk of stillbirth evaluated by Poisson regression. RESULTS:Mean (SD) length of follow-up was 5.5 (3.5) years. In analyses adjusting for baseline age and length of follow-up, ?3 hours of baseline past-year vigorous physical activity per week (resulting in shortness of breath/sweating) was associated with increased risk of stillbirth compared with <1?hour/week of vigorous activity (incidence rate ratio, IRR 2.46; 95%?CI 1.23 to 4.90). In contrast, baseline past-year light physical activity of ?3 hours per week associated with reduced risk of stillbirth compared with <3?hours of light physical activity per week (IRR 0.53; 95%?CI 0.30 to 0.93). A family history of stroke associated with increased risk of stillbirth delivery (IRR 2.53; 95%?CI 1.06 to 6.01). Because overweight/obese women may experience shortness of breath and sweating with less physical exertion than normal weight women, a sensitivity analysis was conducted limited to women with a normal BMI (> 18.5?and <25?kg/m2). Vigorous activity of ?3 hours per week (IRR of 4.50; 95%?CI 1.72 to 11.79) and a family history of stroke (IRR of 3.81; 95%?CI 1.31 to 11.07) were more strongly related to stillbirth risk among women with a normal BMI than that observed for all women combined. Established risk factors also associated with stillbirth risk. CONCLUSIONS:The study identified physical activity and family history of stroke as potential new risk factors for stillbirth delivery.

SUBMITTER: Egeland GM

PROVIDER: S-EPMC5724104 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Association between pregravid physical activity and family history of stroke and risk of stillbirth: population-based cohort study.

Egeland Grace M GM Tell Grethe S GS Næss Øyvind Ø Igland Jannicke J Klungsøyr Kari K

BMJ open 20170811 8

<h4>Objectives</h4>To evaluate whether family history of disease and pregravid lifestyle and cardiovascular risk factors are associated with subsequent stillbirth delivery.<h4>Design</h4>Prepregnancy cohort study.<h4>Setting</h4>Cohort Norway regional health surveys (1994-2003) linked to Medical Birth Registry of Norway for deliveries through 2012.<h4>Participants</h4>13 497 singleton births (<u>></u> 22 weeks gestation) in 8478 women.<h4>Main outcome measure</h4>Risk of stillbirth evaluated by ...[more]

PMID: 28801430

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Project description:ObjectiveTo assess the prospective associations of baseline and long term trajectories of physical activity on mortality from all causes, cardiovascular disease, and cancer.DesignPopulation based cohort study.SettingAdults from the general population in the UK.Participants14 599 men and women (aged 40 to 79) from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort, assessed at baseline (1993 to 1997) up to 2004 for lifestyle and other risk factors; then followed to 2016 for mortality (median of 12.5 years of follow-up, after the last exposure assessment).Main exposurePhysical activity energy expenditure (PAEE) derived from questionnaires, calibrated against combined movement and heart rate monitoring.Main outcome measuresMortality from all causes, cardiovascular disease, and cancer. Multivariable proportional hazards regression models were adjusted for age, sex, sociodemographics, and changes in medical history, overall diet quality, body mass index, blood pressure, triglycerides, and cholesterol levels.ResultsDuring 171 277 person years of follow-up, 3148 deaths occurred. Long term increases in PAEE were inversely associated with mortality, independent of baseline PAEE. For each 1 kJ/kg/day per year increase in PAEE (equivalent to a trajectory of being inactive at baseline and gradually, over five years, meeting the World Health Organization minimum physical activity guidelines of 150 minutes/week of moderate-intensity physical activity), hazard ratios were: 0.76 (95% confidence interval 0.71 to 0.82) for all cause mortality, 0.71 (0.62 to 0.82) for cardiovascular disease mortality, and 0.89 (0.79 to 0.99) for cancer mortality, adjusted for baseline PAEE, and established risk factors. Similar results were observed when analyses were stratified by medical history of cardiovascular disease and cancer. Joint analyses with baseline and trajectories of physical activity show that, compared with consistently inactive individuals, those with increasing physical activity trajectories over time experienced lower risks of mortality from all causes, with hazard ratios of 0.76 (0.65 to 0.88), 0.62 (0.53 to 0.72), and 0.58 (0.43 to 0.78) at low, medium, and high baseline physical activity, respectively. At the population level, meeting and maintaining at least the minimum physical activity recommendations would potentially prevent 46% of deaths associated with physical inactivity.ConclusionsMiddle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors. Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life.

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Association between pregravid physical activity and family history of stroke and risk of stillbirth: population-based cohort study.

Publications

Association between pregravid physical activity and family history of stroke and risk of stillbirth: population-based cohort study.

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