The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review

Aims: Pregnancy-related factors are associated with an increased risk of cardiovascular disease (CVD) and may help identify women at high cardiovascular risk. This study aims to provide an overview of prediction models for CVD which included pregnancy-related factors and to evaluate the impact of th...

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Main Authors: Zhixun Yang, Hendrikus J.A. van Os, Janet M. Kist, Rimke C. Vos, Hedwig M.M. Vos, Niels H. Chavannes, Annelieke H.J. Petrus
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:International Journal of Cardiology. Cardiovascular Risk and Prevention
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772487525001217
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author Zhixun Yang
Hendrikus J.A. van Os
Janet M. Kist
Rimke C. Vos
Hedwig M.M. Vos
Niels H. Chavannes
Annelieke H.J. Petrus
author_facet Zhixun Yang
Hendrikus J.A. van Os
Janet M. Kist
Rimke C. Vos
Hedwig M.M. Vos
Niels H. Chavannes
Annelieke H.J. Petrus
author_sort Zhixun Yang
collection DOAJ
description Aims: Pregnancy-related factors are associated with an increased risk of cardiovascular disease (CVD) and may help identify women at high cardiovascular risk. This study aims to provide an overview of prediction models for CVD which included pregnancy-related factors and to evaluate the impact of these factors on model performance. Methods: PubMed and Embase were systematically searched until March 2023 for studies reporting on the development or validation of prediction models for CVD which included pregnancy-related factors. Data extraction was performed using the CHARMS checklist. Risk of bias was assessed using PROBAST. Results: Seven studies were included. C-indices ranged between 0.63 and 0.79. Adding pregnancy-related factors resulted in improved C-index in four studies, ranging from 0.0033 (95 % confidence interval [CI]: 0.0022–0.0051) to 0.004 (95 % CI: 0.002–0.006). Net reclassification improvement (NRI) for events was improved in two studies, ranging from 0.01 (95 % CI: 0.003–0.02) to 0.038 (95 % CI: 0.003–0.074). NRI for non-events was improved in three studies, ranging from 0.002 (95 % CI: 0.0001–0.005) to 0.02 (95 % CI: 0.001–0.04). Two studies showed both low risk of bias and low concern regarding applicability. Subgroup analyses by age in three studies indicated larger improvements in model performance in younger women. Conclusion: Addition of pregnancy-related factors results in limited improvements in performance of CVD prediction models, with relatively larger improvements in younger women.
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spelling doaj-art-b9fc0d631cc042c2aa1ff1356c96c94f2025-08-20T04:02:31ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-12-012720048310.1016/j.ijcrp.2025.200483The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic reviewZhixun Yang0Hendrikus J.A. van Os1Janet M. Kist2Rimke C. Vos3Hedwig M.M. Vos4Niels H. Chavannes5Annelieke H.J. Petrus6Department of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Health Campus The Hague, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Health Campus The Hague, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Health Campus The Hague, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Health Campus The Hague, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Health Campus The Hague, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; National eHealth Living Lab, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the NetherlandsDepartment of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Health Campus The Hague, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands; Corresponding author. Department of Public Health & Primary Care, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333, ZA, the Netherlands.Aims: Pregnancy-related factors are associated with an increased risk of cardiovascular disease (CVD) and may help identify women at high cardiovascular risk. This study aims to provide an overview of prediction models for CVD which included pregnancy-related factors and to evaluate the impact of these factors on model performance. Methods: PubMed and Embase were systematically searched until March 2023 for studies reporting on the development or validation of prediction models for CVD which included pregnancy-related factors. Data extraction was performed using the CHARMS checklist. Risk of bias was assessed using PROBAST. Results: Seven studies were included. C-indices ranged between 0.63 and 0.79. Adding pregnancy-related factors resulted in improved C-index in four studies, ranging from 0.0033 (95 % confidence interval [CI]: 0.0022–0.0051) to 0.004 (95 % CI: 0.002–0.006). Net reclassification improvement (NRI) for events was improved in two studies, ranging from 0.01 (95 % CI: 0.003–0.02) to 0.038 (95 % CI: 0.003–0.074). NRI for non-events was improved in three studies, ranging from 0.002 (95 % CI: 0.0001–0.005) to 0.02 (95 % CI: 0.001–0.04). Two studies showed both low risk of bias and low concern regarding applicability. Subgroup analyses by age in three studies indicated larger improvements in model performance in younger women. Conclusion: Addition of pregnancy-related factors results in limited improvements in performance of CVD prediction models, with relatively larger improvements in younger women.http://www.sciencedirect.com/science/article/pii/S2772487525001217PregnancyCardiovascular diseaseWomenFemalePrediction model
spellingShingle Zhixun Yang
Hendrikus J.A. van Os
Janet M. Kist
Rimke C. Vos
Hedwig M.M. Vos
Niels H. Chavannes
Annelieke H.J. Petrus
The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review
International Journal of Cardiology. Cardiovascular Risk and Prevention
Pregnancy
Cardiovascular disease
Women
Female
Prediction model
title The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review
title_full The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review
title_fullStr The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review
title_full_unstemmed The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review
title_short The value of pregnancy-related factors in the prediction of cardiovascular disease: a systematic review
title_sort value of pregnancy related factors in the prediction of cardiovascular disease a systematic review
topic Pregnancy
Cardiovascular disease
Women
Female
Prediction model
url http://www.sciencedirect.com/science/article/pii/S2772487525001217
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