Cardiovascular sequelae of toxaemia of pregnancy.

Hannaford, Philip Christopher; Ferry, Susan; Hirsch, Sybil

doi:10.1136/hrt.77.2.154

Cited by 225 publications

(133 citation statements)

References 16 publications

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“…In a study of 374 women with a history of hypertensive complications in pregnancy, the risk of dying from CHD (risk ratio 2.61; 95% CI 1.11-6.12) was significantly higher among women who had had eclampsia or pre-eclampsia (risk ratio 1.90; 95% CI 1.02-3.52) than among those with hypertension alone [17]. The Royal College of General Practitioners' oral contraceptive study also reported that a history of preeclampsia increased the risk of cardiovascular conditions in later life (relative risk for future ischaemic heart disease 1.7; 95% CI 1.3-2.2) [18], and a record linkage study from Scotland has also recently reported an association between pre-eclampsia and later ischaemic heart disease in the mother (risk ratio 2.0; 95% CI 1.5-2.5) [19]. An important clinical implication of our findings and these other studies linking pre-eclampsia to future ischaemic heart disease is whether this finding can identify women 'at risk' who otherwise might not have been identified, or whether the use of established risk factors such as hypertension and obesity would have identified these 'at risk' women and offered an opportunity for primary prevention.…”

Section: Discussionmentioning

confidence: 85%

Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort

et al. 2006

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Aims/hypothesis Studies have shown a relationship between pre-eclampsia and later coronary artery disease. This study investigated whether there is a relationship between pre-eclampsia and the development of type 2 diabetes in mothers and their babies and how this is affected by infant birthweight. Subjects and methods This was an intergenerational cohort study. The study population comprised 7,187 mothers who gave birth and 8,648 babies who were born in Dundee, Scotland between 1952 and 1958. Their later diabetic status was defined from 1980 to 2003 by linkage to populationbased datasets.Results There were 810 (11.3%) mothers with preeclampsia and 745 (10.4%) who subsequently developed type 2 diabetes. Logistic regression showed an increased risk of developing type 2 diabetes for mothers with preeclampsia, unadjusted odds ratio (OR) 1.37 (95% CI 1.10-1.71), p=0.005. This relationship persisted after adjustment for infant birthweight, OR 1.40 (95% CI 1.12-1.75), p=0.003. Of the babies born between 1952 and 1958, 221 (2.6%) had developed type 2 diabetes, 137 of them male (2.9% of male subjects in study population) and 84 female (2.2% of female subjects). The relationship between preeclampsia in the mother and the risk of type 2 diabetes in the offspring did not reach statistical significance, OR 1.38 (95% CI 0.90-2.10). Babies with birthweight in the lowest quintile (adjusted for sex, gestation and birth order) had an increased risk of developing type 2 diabetes, OR for lowest quintile vs highest quintile 1.84 (95% CI 1.24-2.72), p=0.002. Conclusions/interpretation Pre-eclampsia is associated with increased risk of developing type 2 diabetes in the mother, but birthweight is a more important determinant of future risk for the offspring.

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Section: Discussionmentioning

confidence: 85%

Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort

et al. 2006

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“…The lower endogenous estrogen level is consistent with a lower HDL cholesterol level and with heart disease [18]. Hypertensive disorders of pregnancy have been reported to be more common in younger mothers [19] who have a known risk of long-term CVD [20][21][22]. Further studies are needed to explain the mechanisms behind the increasing risk of CVD with earlier age at first delivery.…”

Section: Discussionmentioning

confidence: 87%

Maternal Age at First Delivery and Risk of Cardiovascular Disease Later in Life

2013

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Background. To elucidate the association between maternal age at first delivery and cardiovascular health in women. Material and Method. A nationally representative survey, comprising 3,937 Finnish women aged 30-99 years with information on most of the potential cardiovascular disease (CVD) risk factors. Weighting survey analyses and logistic regression were performed. Results. Women who had their first delivery at age 25 or less had about five times higher odds ratio for myocardial infarction (fully adjusted OR: 4.82; 95% CI: 1.39-16.75) and about 2-fold higher odds ratio of arrhythmia (fully adjusted OR: 1.82; 95% CI: 1.13-2.92) compared to those who were 31-35 years at their first delivery. Each one year younger maternal age at first delivery predicted a higher risk of myocardial infarction (age-adjusted OR = 1.12; 95% CI: 1.06-1.18), hypertension (age-adjusted OR = 1.05; 95% CI: 1.03-1.07), arrhythmia (age-adjusted OR = 1.03; 95% CI: 1.01-1.05), angina pectoris (age-adjusted OR = 1.06; 95% CI: 1.02-1.10), and heart failure (age-adjusted OR = 1.05; 95% CI: 1.01-1.10). Conclusion. Maternal earlier age at first delivery is related to subsequent development of CVD, especially myocardial infarction. Our findings suggest a need for additional care and monitoring for CVD and its risk factors in women who had their first delivery at young ages.

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“…Women who develop HDP have an increased risk of ischemic heart disease (11-16), hypertension (12,15), stroke (14,15), venous thromboembolism (13,17), and mortality (14,16,18) over the long term. Greater weight gain, and the increased risk of overweight and obesity in middle age, is associated with an increased risk of cardiovascular disease, diabetes, cancers, and overall mortality (19)(20)(21)).…”

Section: Discussionmentioning

confidence: 99%

The Association of Hypertensive Disorders of Pregnancy with Weight Gain over the Subsequent 21 Years: Findings from a Prospective Cohort Study

Callaway

McIntyre

O’Callaghan

et al. 2007

American Journal of Epidemiology

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Obesity is an important risk factor for hypertensive disorders of pregnancy, but most cases of hypertensive disorders of pregnancy occur in women of normal weight. There may be predisposing factors to both hypertensive disorders of pregnancy and obesity. To test this hypothesis, the authors compared changes in body mass index (weight (kg)/height (m) 2 ) over time in women with and without hypertensive disorders of pregnancy. They used data from 3,572 women who received antenatal care at a major public hospital in Brisbane, Australia, between 1981 and 1984 and who were followed up for 21 years. A total of 318 women (8.9%) had experienced hypertensive disorders in the index pregnancy, and 233 of them (73.3%) had a baseline body mass index of 25 kg/m 2 . After the authors adjusted for all potential confounding factors, they found that women with hypertensive disorders of pregnancy gained on average 1.35 kg/m 2 more (95% confidence interval: 0.80 kg/m 2 , 1.89 kg/m 2 ) in body mass index over 21 years than women without hypertensive disorders of pregnancy. The odds of gaining 5 kg/m 2 were 59% greater for women who experienced hypertensive disorders of pregnancy compared with those who did not (odds ratio = 1.59, 95% confidence interval: 1.24, 2.04). The authors concluded that hypertensive disorders of pregnancy are associated with increased weight gain over 21 years. body mass index; body weight; hypertension; pre-eclampsia; pregnancy; prospective studies; weight gain; women Abbreviations: BMI, body mass index; HDP, hypertensive disorders of pregnancy

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Cardiovascular sequelae of toxaemia of pregnancy.

Abstract: Objective-To determine whether the rate of cardiovascular disease is different among parous women with a general practitioner reported history of toxaemia of pregnancy than among those not reported to have experienced toxaemia, or among nuliparous women.

Cited by 225 publications

References 16 publications

Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort

Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort

Maternal Age at First Delivery and Risk of Cardiovascular Disease Later in Life

The Association of Hypertensive Disorders of Pregnancy with Weight Gain over the Subsequent 21 Years: Findings from a Prospective Cohort Study

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