Incident Coronary Heart Disease After Preeclampsia: Role of Reduced Fetal Growth, Preterm Delivery, and Parity

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Rigmor Austgulen¹  Ann‐Charlotte Iversen¹  Grethe S. Tell²  Anne Kjersti Daltveit²  Stein Emil Vollset²  Hilde Kristin Refvik Riise²  Jannicke Igland²  Gerhard Sulo²  Ottar Nygård³ 

[1] Department of Cancer Research and Molecular Medicine Centre of Molecular Inflammation Research Norwegian University of Science and Technology (NTNU) Trondheim Norway;Department of Global Public Health and Primary Care University of Bergen Norway;KG Jebsen Center for Diabetes Research Department of Clinical Science University of Bergen Norway;

关键词: cardiovascular disease;    fetal growth restriction;    major coronary events;    preeclampsia;    preterm delivery;   

DOI  :  10.1161/JAHA.116.004158

来源: DOAJ

【 摘 要 】

Background Preeclampsia is a severe pregnancy disorder often complicated by reduced fetal growth or preterm delivery and is associated with long‐term maternal morbidity and mortality. We aimed to assess the association between preeclampsia phenotypes and risk of subsequent coronary heart disease and maternal cardiovascular mortality. Methods and Results Women aged 16 to 49 years who gave birth during 1980–2002 and registered in the Medical Birth Registry of Norway were followed prospectively (1–29 years) for an incident major coronary event and mortality through linkage with the Cardiovascular Disease in Norway 1994–2009 (CVDNOR) project and the Norwegian Cause of Death Registry. Preeclampsia was subdivided based on the presence of a child born small for gestational age or preterm delivery. Among 506 350 women with 1 to 5 singleton births, there were 1275 (0.3%) occurrences of major coronary event, 468 (0.1%) cardiovascular deaths, and 5411 (1.1%) deaths overall. Compared with women without preeclampsia, the hazard ratio (95% CI) for major coronary event was 2.1 (1.73–2.65) after preeclampsia alone, 3.3 (2.37–4.57) after preeclampsia in combination with small for gestational age, and 5.4 (3.74–7.74) after preeclampsia in combination with preterm delivery. Analyses distinguishing women with 1 (n=61 352) or >1 (n=281 069) lifetime pregnancy and analyses with cardiovascular mortality as outcome followed the same pattern. Conclusions The occurrence of major coronary events was increased among women with preeclampsia and highest for preeclampsia combined with a child born small for gestational age and/or preterm delivery.

【 授权许可】

Unknown