Kathrin Haßdenteufel1, Mitho Müller2, Raphael Gutsfeld2, Maren Goetz3, Armin Bauer4, Markus Wallwiener5, Sara Y Brucker4, Stefanie Joos6, Miriam Giovanna Colombo6, Sabine Hawighorst-Knapstein7, Ariane Chaudhuri7, Gudula Kirtschig7, Frauke Saalmann7, Stephanie Wallwiener5. 1. Department of Obstetrics and Gynecology, Heidelberg University, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany. Kathrin.hassdenteufel@med.uni-heidelberg.de. 2. Department of Psychology, Ludwig Maximilian University, Munich, Germany. 3. Department of General Pediatrics, University Children's Hospital, Heidelberg, Germany. 4. Department of Women's Health, University Hospital Tuebingen, Tuebingen, Germany. 5. Department of Obstetrics and Gynecology, Heidelberg University, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany. 6. Institute for General Practice and Interprofessional Healthcare, Eberhardt-Karls-University, Tuebingen, Germany. 7. Department of Health Promotion, AOK Baden-Wuerttemberg, Stuttgart, Germany.
Abstract
PURPOSE: Preeclampsia occurs in up to 15% of pregnancies and constitutes a major risk factor for cardiovascular disease. This observational cohort study aimed to examine the association between preeclamptic pregnancies and cardiovascular outcomes as well as primary and specialized care utilization after delivery. METHODS: Using statutory claims data we identified women with singleton live births between 2010 and 2017. Main outcomes included the occurrence of either hypertension or cardiovascular disease after one or more preeclamptic pregnancies, number of contacts to a general practitioner or cardiologist after delivery and prescribed antihypertensive medication. Data were analyzed using Cox proportional hazard regression models adjusted for maternal age, diabetes, dyslipidemia, and obesity. RESULTS: The study cohort consisted of 181,574 women with 240,698 births. Women who experienced preeclampsia once had an increased risk for cardiovascular (hazard ratio, HR = 1.29) or hypertensive (HR = 4.13) events. In women affected by recurrent preeclampsia, risks were even higher to develop cardiovascular disease (HR = 1.53) or hypertension (HR = 6.01). In the following years after delivery, general practitioners were seen frequently, whereas cardiologists were consulted rarely (0.3 and 2.4%). CONCLUSION: Women affected by preeclampsia experience an increased risk of developing chronic hypertension and cardiovascular disease, especially those with recurrent preeclampsia. Future medical guidelines should take this potential risk into account.
PURPOSE: Preeclampsia occurs in up to 15% of pregnancies and constitutes a major risk factor for cardiovascular disease. This observational cohort study aimed to examine the association between preeclamptic pregnancies and cardiovascular outcomes as well as primary and specialized care utilization after delivery. METHODS: Using statutory claims data we identified women with singleton live births between 2010 and 2017. Main outcomes included the occurrence of either hypertension or cardiovascular disease after one or more preeclamptic pregnancies, number of contacts to a general practitioner or cardiologist after delivery and prescribed antihypertensive medication. Data were analyzed using Cox proportional hazard regression models adjusted for maternal age, diabetes, dyslipidemia, and obesity. RESULTS: The study cohort consisted of 181,574 women with 240,698 births. Women who experienced preeclampsia once had an increased risk for cardiovascular (hazard ratio, HR = 1.29) or hypertensive (HR = 4.13) events. In women affected by recurrent preeclampsia, risks were even higher to develop cardiovascular disease (HR = 1.53) or hypertension (HR = 6.01). In the following years after delivery, general practitioners were seen frequently, whereas cardiologists were consulted rarely (0.3 and 2.4%). CONCLUSION: Women affected by preeclampsia experience an increased risk of developing chronic hypertension and cardiovascular disease, especially those with recurrent preeclampsia. Future medical guidelines should take this potential risk into account.
Authors: A L Tranquilli; G Dekker; L Magee; J Roberts; B M Sibai; W Steyn; G G Zeeman; M A Brown Journal: Pregnancy Hypertens Date: 2014-02-15 Impact factor: 2.899
Authors: Elisabeth Balstad Magnussen; Lars Johan Vatten; Tom Ivar Lund-Nilsen; Kjell Asmund Salvesen; George Davey Smith; Pål Richard Romundstad Journal: BMJ Date: 2007-11-01