118 Cardiovascular disease following hypertensive disorders of pregnancy
نویسندگان
چکیده
To determine whether hypertensive disorders of pregnancy (HDP) are associated with cardiovascular (CV) morbidity and mortality within 10-20 years following delivery. Retrospective cohort study including all women who delivered ≥1 at ≥20 weeks’ gestation a single health system from 1996-2008. Women were excluded if they had CV risk factors prior to their first delivery or no follow-up the after The exposure interest was any HDP. primary outcome composite ICD codes for coronary artery disease (CAD), peripheral vascular disease, events (myocardial infarction, stroke, death). A nested underwent cardiac catheterization angiographic CAD. Cox proportional hazards estimated hazard ratios outcomes among exposed versus unexposed women, adjusting maternal age, race, marital status, family history CVD, smoking, substance use, spontaneous vs induced labor, preterm birth, low birthweight, abruption, parity. Of 33,959 included, 2,385 HDP (7.0%, 1,205 pre-eclampsia, 23 eclampsia, 1,452 gestational hypertension). 49 (2.1%) 435 without (1.4%, p=0.003). (Table). There significant difference in event-free survival between groups (Figure). Parity >0 index not outcomes, effect modification by parity found (p-interaction= 0.81). 592 catheterization, 90 (15.2%) 502 20 CAD (22.2%) on angiography (9.8%, p<0.001). is Because twice incidence compared parous HDP, obstetric may be informative when deciding proceed catheterization.View Large Image Figure ViewerDownload Hi-res image Download (PPT)
منابع مشابه
Cardiac Disease and Hypertensive Disorders in Pregnancy
Hypertension during pregnancy has been classified by the American College of Obstetricians and Gynecologists into four distinct categories: (a) pre-eclampsia and eclampsia, (b) chronic hypertension (hypertension that was present before pregnancy), (c) chronic hypertension with superimposed preeclampsia or eclampsia, and (d) latent or transient hypertension of the third trimester (1). Most chron...
متن کاملHypertensive Disorders of Pregnancy.
Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks' gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks' gestation), preeclampsia, or preeclampsia superimposed on chronic hypertension. Preeclampsia is defined as hypertension and either proteinuria or thrombocytopenia, renal insufficiency...
متن کاملAll Hypertensive Disorders of Pregnancy Increase the Risk of Future Cardiovascular Disease.
Hypertensive disorders of pregnancy are associated with vascular dysfunction in the pregnancy and an increased risk of long-term cardiovascular disease (CVD) in the mother. What remains to be understood is whether the length, severity of the disease, the treatment of hypertension in pregnancy, or the subtype of hypertensive disorders of pregnancy are significant predictors of future CVD. We und...
متن کاملHypertensive disorders in pregnancy
Hypertensive disorders in pregnancy (HDP) affect 10% of pregnant patients and are the second most common cause of maternal mortality and adverse fetal outcomes in developed countries. HDP is a group of diseases that includes preeclampsia, eclampsia, pregnancy induced hypertension and HELLP syndrome. Inadequate placentation, immune intolerance and genetics are accounted as possible etiological f...
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ژورنال
عنوان ژورنال: American Journal of Obstetrics and Gynecology
سال: 2021
ISSN: ['1097-6868', '0002-9378', '1085-8709']
DOI: https://doi.org/10.1016/j.ajog.2020.12.140