Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts

Background: We hypothesized that there is an influence of socioeconomic status (SES) on association between pregnancy complications and premature coronary artery disease (PCAD) risk. Materials and Methods: This project involved a data linkage approach merging three databases of South Australian coho...

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Main Authors: Adeel Khoja, Prabha H. Andraweera, Rosanna Tavella, Tiffany K. Gill, Gustaaf A. Dekker, Claire T. Roberts, Suzanne Edwards, Margaret A. Arstall
Format: Article
Language:English
Published: Mary Ann Liebert 2024-04-01
Series:Women's Health Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/whr.2023.0092
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author Adeel Khoja
Prabha H. Andraweera
Rosanna Tavella
Tiffany K. Gill
Gustaaf A. Dekker
Claire T. Roberts
Suzanne Edwards
Margaret A. Arstall
author_facet Adeel Khoja
Prabha H. Andraweera
Rosanna Tavella
Tiffany K. Gill
Gustaaf A. Dekker
Claire T. Roberts
Suzanne Edwards
Margaret A. Arstall
author_sort Adeel Khoja
collection DOAJ
description Background: We hypothesized that there is an influence of socioeconomic status (SES) on association between pregnancy complications and premature coronary artery disease (PCAD) risk. Materials and Methods: This project involved a data linkage approach merging three databases of South Australian cohorts using retrospective, age-matched case–control study design. Cases (n = 721), that is, women aged <60 years from Coronary Angiogram Database of South Australia (CADOSA) were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain prior pregnancy outcomes and SES. Controls (n = 194) were selected from North West Adelaide Health Study (NWAHS), comprising women who were healthy or had health conditions unrelated to CAD, age matched to CADOSA (±5 years), and linked to SAPSC to determine prior pregnancy outcomes and SES. This project performed comparative analysis of SES using socioeconomic indexes for areas–index of relative socioeconomic advantage and disadvantage (SEIFA-IRSAD) scores across three databases. Results: Findings revealed that SEIFA-IRSAD scores at the time of pregnancy (p-value = 0.005) and increase in SEIFA-IRSAD scores over time (p-value = 0.040) were significantly associated with PCAD. In addition, when models were adjusted for SEIFA-IRSAD scores at the time of pregnancy and age, risk factors including placenta-mediated pregnancy complications such as preterm birth (odds ratio [OR] = 4.77, 95% confidence interval [CI]: 1.74–13.03) and history of a miscarriage (OR = 2.14, 95% CI: 1.02–4.49), and cardiovascular disease (CVD) risk factors including smoking (OR = 8.60, 95% CI: 3.25–22.75) were significantly associated with PCAD. When the model was adjusted for change in SEIFA-IRSAD scores (from CADOSA/NWAHS to SAPSC) and age, pregnancy-mediated pregnancy complications including preterm birth (OR = 4.40, 95% CI: 1.61–12.05) and history of a miscarriage (OR = 2.09, 95% CI: 1.00–4.35), and CVD risk factor smoking (OR = 8.75, 95% CI: 3.32–23.07) were significantly associated with PCAD. Conclusion: SES at the time of pregnancy and change in SES were not associated with PCAD risk.
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spelling doaj-art-d9470d0da9af41618915a449b2939ff62025-08-20T02:31:48ZengMary Ann LiebertWomen's Health Reports2688-48442024-04-015112013110.1089/whr.2023.0092Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three CohortsAdeel Khoja0Prabha H. Andraweera1Rosanna Tavella2Tiffany K. Gill3Gustaaf A. Dekker4Claire T. Roberts5Suzanne Edwards6Margaret A. Arstall7Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.Department of Medicine, Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.Department of Medicine, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, Australia.Department of Cardiology, Cardiology Unit, Northern Adelaide Local Health Network, Adelaide, Australia.Background: We hypothesized that there is an influence of socioeconomic status (SES) on association between pregnancy complications and premature coronary artery disease (PCAD) risk. Materials and Methods: This project involved a data linkage approach merging three databases of South Australian cohorts using retrospective, age-matched case–control study design. Cases (n = 721), that is, women aged <60 years from Coronary Angiogram Database of South Australia (CADOSA) were linked to South Australian Perinatal Statistics Collection (SAPSC) to ascertain prior pregnancy outcomes and SES. Controls (n = 194) were selected from North West Adelaide Health Study (NWAHS), comprising women who were healthy or had health conditions unrelated to CAD, age matched to CADOSA (±5 years), and linked to SAPSC to determine prior pregnancy outcomes and SES. This project performed comparative analysis of SES using socioeconomic indexes for areas–index of relative socioeconomic advantage and disadvantage (SEIFA-IRSAD) scores across three databases. Results: Findings revealed that SEIFA-IRSAD scores at the time of pregnancy (p-value = 0.005) and increase in SEIFA-IRSAD scores over time (p-value = 0.040) were significantly associated with PCAD. In addition, when models were adjusted for SEIFA-IRSAD scores at the time of pregnancy and age, risk factors including placenta-mediated pregnancy complications such as preterm birth (odds ratio [OR] = 4.77, 95% confidence interval [CI]: 1.74–13.03) and history of a miscarriage (OR = 2.14, 95% CI: 1.02–4.49), and cardiovascular disease (CVD) risk factors including smoking (OR = 8.60, 95% CI: 3.25–22.75) were significantly associated with PCAD. When the model was adjusted for change in SEIFA-IRSAD scores (from CADOSA/NWAHS to SAPSC) and age, pregnancy-mediated pregnancy complications including preterm birth (OR = 4.40, 95% CI: 1.61–12.05) and history of a miscarriage (OR = 2.09, 95% CI: 1.00–4.35), and CVD risk factor smoking (OR = 8.75, 95% CI: 3.32–23.07) were significantly associated with PCAD. Conclusion: SES at the time of pregnancy and change in SES were not associated with PCAD risk.https://www.liebertpub.com/doi/10.1089/whr.2023.0092coronary artery diseasesocioeconomic statuspregnancy complicationsprematuredata linkagedatabases
spellingShingle Adeel Khoja
Prabha H. Andraweera
Rosanna Tavella
Tiffany K. Gill
Gustaaf A. Dekker
Claire T. Roberts
Suzanne Edwards
Margaret A. Arstall
Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts
Women's Health Reports
coronary artery disease
socioeconomic status
pregnancy complications
premature
data linkage
databases
title Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts
title_full Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts
title_fullStr Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts
title_full_unstemmed Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts
title_short Influence of Socioeconomic Status on the Association Between Pregnancy Complications and Premature Coronary Artery Disease: Linking Three Cohorts
title_sort influence of socioeconomic status on the association between pregnancy complications and premature coronary artery disease linking three cohorts
topic coronary artery disease
socioeconomic status
pregnancy complications
premature
data linkage
databases
url https://www.liebertpub.com/doi/10.1089/whr.2023.0092
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