Hypertensive disorders of pregnancy and future health and mortality: A record linkage study |
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| Authors: | S Bhattacharya GJ Prescott L Iversen DM Campbell WCS Smith PC Hannaford |
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| Institution: | 1. Section of Population Health, School of Medicine and Dentistry, University of Aberdeen, United Kingdom;2. Centre of Academic Primary Care, School of Medicine and Dentistry, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, United Kingdom;3. Obstetrics and Gynaecology, Aberdeen Maternity Hospital, AB25 2ZL, United Kingdom;1. Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, 5252 boul de Maisonneuve, H4A 3S5 Montreal, Quebec, Canada;2. Department of Medicine, McGill University Health Center, 1001 DecarieBoulevard, H4A 3J1 Montreal, Quebec, Canada;1. Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, 333 City Boulevard West, 14th Floor, Suite 1400, Orange, CA 92868, USA;2. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of California, Irvine Medical Center, 333 City Boulevard West, 14th Floor, Suite 1400, Orange, CA 92868, USA;1. Department of Epidemiology, University of Washington, Seattle, USA;2. Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya;3. Department of Medicine, Division of Metabolism, Endocrinology and Nutrition, Diabetes Institute, University of Washington, Seattle, USA;4. Department of Biostatistics, University of Washington, Seattle, USA;5. Department of Global Health, University of Washington, Seattle, USA;6. Vaccine and Infectious Disease Division, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, USA;7. Department of Research and Programs and Department of Reproductive Health, Kenyatta National Hospital, Nairobi, Kenya;8. Department of Laboratory Medicine, University of Washington, Seattle, USA;9. Department of Medicine (Allergy and Infectious Diseases), University of Washington, Seattle, USA;1. Division of Nephrology Ospedale Maggiore, Milano, Italy (retired);2. Unita'' Operativa di Nefrologia e Dialisi Fondazione IRCCS Ca'' Granda Ospedale Maggiore di Milano, Italy;1. Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal;2. Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal |
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| Abstract: | The objective of this register-based cohort study was to examine the relationship between hypertensive disorders of pregnancy and future hospital discharges from specified causes including cardiovascular disease, incident cancer registrations and mortality. From the Aberdeen Maternity and Neonatal Databank we identified 34,854 women who were born on or before 31st December 1967 and who had (i) preeclampsia/eclampsia, (ii) gestational hypertension or (iii) normal blood pressure in their first pregnancy. Hospital discharges from selected causes including cardiovascular disease, cancer registrations and deaths in these women were identified from the Scottish Morbidity Records.There were 2026 women who had preeclampsia, 8891 who had gestational hypertension and 23,937 who were normotensive during their first pregnancy. Compared to normotensive women, women with preeclampsia had a higher mortality from ischaemic heart disease (adj. IRR 1.38, 95% CI 1.03, 1.84) and circulatory disease (adj. IRR 1.30, 95% CI 1.06, 1.60). Similar trends were seen with gestational hypertension. There was no difference in all cause mortality in the three groups. The odds of a hypertensive episode were higher in women with preeclampsia (adj. OR 1.79, 95% CI 1.55, 2.05) and gestational hypertension (adj. OR 1.68, 95% CI 1.55, 1.82) compared to normotensives. Compared to normotensives, women with gestational hypertension (adj. IRR 0.91, 95% CI 0.85, 0.96) or preeclampsia (adj. IRR 0.86, 95% CI 0.77, 0.97) had lower incidences of cancer.Women with pregnancy induced hypertension are at a higher risk of incidence and mortality from ischaemic heart disease and a lower risk of cancer. |
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