Changes in the prevalence of pre‐eclampsia in Akershus County and the rest of Norway during the past 35 years

Dahlstrøm, Berit; Engh, Marie Ellstrøm; Bukholm, Geir; Øian, Pål

doi:10.1080/00016340500442449

Cited by 33 publications

(18 citation statements)

References 15 publications

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“…Our nationwide study population had a prevalence of 2.2% for PE and 4.3% for PPH, similar rates are seen internationally (United States [20], Canada [17], [40]–[42], Scandinavia [43]–[45], United Kingdom [46], Australia [47], [48]). A worrying finding is the rising trend of both PE and PPH.…”

Section: Discussionsupporting

confidence: 69%

Pre-Eclampsia Increases the Risk of Postpartum Haemorrhage: A Nationwide Cohort Study in The Netherlands

et al. 2013

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BackgroundPostpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide. Identifying risk indicators for postpartum haemorrhage is crucial to predict this life threatening condition. Another major contributor to maternal morbidity and mortality is pre-eclampsia. Previous studies show conflicting results in the association between pre-eclampsia and postpartum haemorrhage. The primary objective of this study was to investigate the association between pre-eclampsia and postpartum haemorrhage. Our secondary objective was to identify other risk indicators for postpartum haemorrhage in the Netherlands.MethodsA nationwide cohort was used, containing prospectively collected data of women giving birth after 19 completed weeks of gestation from January 2000 until January 2008 (n = 1 457 576). Data were extracted from the Netherlands Perinatal Registry, covering 96% of all deliveries in the Netherlands. The main outcome measure, postpartum haemorrhage, was defined as blood loss of ≥1000 ml in the 24 hours following delivery. The association between pre-eclampsia and postpartum haemorrhage was investigated with uni- and multivariable logistic regression analyses.ResultsOverall prevalence of postpartum haemorrhage was 4.3% and of pre-eclampsia 2.2%. From the 31 560 women with pre-eclampsia 2 347 (7.4%) developed postpartum haemorrhage, compared to 60 517 (4.2%) from the 1 426 016 women without pre-eclampsia (odds ratio 1.81; 95% CI 1.74 to 1.89). Risk of postpartum haemorrhage in women with pre-eclampsia remained increased after adjusting for confounders (adjusted odds ratio 1.53; 95% CI 1.46 to 1.60).ConclusionWomen with pre-eclampsia have a 1.53 fold increased risk for postpartum haemorrhage. Clinicians should be aware of this and use this knowledge in the management of pre-eclampsia and the third stage of labour in order to reach the fifth Millenium Developmental Goal of reducing maternal mortality ratios with 75% by 2015.

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Section: Discussionsupporting

confidence: 69%

Pre-Eclampsia Increases the Risk of Postpartum Haemorrhage: A Nationwide Cohort Study in The Netherlands

et al. 2013

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“…Most of these deaths are attributed to pre‐eclampsia, especially when the condition progresses into severe pre‐eclampsia or eclampsia 2 . With the improvement in the early diagnosis of pre‐eclampsia and better accessibility to antenatal care, diagnosis of pre‐eclampsia has increased during the last two decades in many developed countries, with a rate of approximately 3% of pregnancies in the USA, and more than 4% in Norway 3,4 . These improvements in diagnosis have not yet been accompanied by a substantial reduction in the case fatality rates, 5 and the etiology of this disease is still poorly understood.…”

Section: Introductionmentioning

confidence: 99%

“…2 With the improvement in the early diagnosis of pre-eclampsia and better accessibility to antenatal care, diagnosis of pre-eclampsia has increased during the last two decades in many developed countries, with a rate of approximately 3% of pregnancies in the USA, and more than 4% in Norway. 3,4 These improvements in diagnosis have not yet been accompanied by a substantial reduction in the case fatality rates, 5 and the etiology of this disease is still poorly understood. However, it is suspected that pre-eclampsia may result from changes in vascular ischaemic function, 6 which can be influenced by ABO blood group.…”

Section: Introductionmentioning

confidence: 99%

ABO and RhD blood groups and gestational hypertensive disorders: a population‐based cohort study

Lee

Zhang

Wikman

et al. 2012

BJOG

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Objective To examine the association between ABO and RhD blood groups and gestational hypertensive disorders in a large population-based cohort.Design Cohort study. Risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, estimated by odds ratios for maternal ABO blood group and RhD status.Setting National health registers of Sweden.Population All singleton deliveries in Sweden born to first-time mothers during the period 1987-2002 [total n = 641 926; any gestational hypertensive disorders, n = 39 011 (6.1%); preeclampsia cases, n = 29 337 (4.6%); severe pre-eclampsia cases, n = 8477 (1.3%)].Methods Using blood group O as a reference, odds ratios of gestational hypertensive disorders, pre-eclampsia, and severe preeclampsia were obtained from logistic regression models adjusted for potential confounding factors.Main outcome measures Gestational hypertensive disorders, preeclampsia, and severe pre-eclampsia.Results Compared with blood group O, all non-O blood groups had modest but statistically significantly higher odds of preeclampsia. Blood group AB had the highest risk for pre-eclampsia (OR = 1.10, 95% CI 1.04-1.16) and severe pre-eclampsia (OR = 1.18, 95% CI 1.07-1.30). RhD-positive mothers had a small increased risk for pre-eclampsia (OR = 1.07, 95% CI 1.03-1.10).Conclusions In the largest study on this topic to date, women with AB blood group have the highest risks of gestational hypertensive disorders, pre-eclampsia, and severe pre-eclampsia, whereas women with O blood group have the lowest risks of developing these disorders. Although the magnitude of increased risk is small, this finding may help improve our understanding of the etiology of pre-eclampsia.

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“…A diagnosis of preeclampsia in the Medical Birth Registry has not been directly validated, but consistency of rates has been demonstrated across counties and over time (22,23). Preeclampsia in "a man's pregnancy" implies preeclampsia in a pregnancy for which he was reported as the father.…”

Section: Explanatory Variablesmentioning

confidence: 99%

Familial Factors in the Association between Preeclampsia and Later ESRD

Vikse

Irgens

Karumanchi

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Women with preeclampsia have increased risk of developing ESRD. This study assessed whether this can be explained by preeclampsia itself or by familial aggregation of common risk factors.Design, setting, participants, & measurements Since 1967, the Medical Birth Registry of Norway has registered data on all births in the country. By linkage with the Norwegian Population Registry, different, but overlapping, cohorts were defined: the first and second cohorts included women and a sibling (first cohort) or child (second cohort) with a registered first birth between 1967 and 2008. Similar cohorts were defined for men. The Norwegian Renal Registry provided data on ESRD from 1980 to June 2009.Results Cohort 1 was used for the main analyses and included 570,675 women, 291 of whom developed ESRD after a median 18.2 years. Compared with women without preeclampsia and no siblings with preeclampsia, women without preeclampsia but a sibling with preeclampsia had a relative risk (RR) of ESRD of 0.96 (95% confidence interval, 0.59-1.6), women with preeclampsia but no siblings with preeclampsia had a RR of 6.0 (4.4-8.1), and women with preeclampsia and a sibling with preeclampsia had a RR of 2. 8 (0.88-8.6). Further analyses of women showed no increased risk of ESRD if a child had preeclampsia in first pregnancy.Conclusions Familial aggregation of risk factors does not seem to explain increased ESRD risk after preeclampsia. These findings support the hypothesis that preeclampsia per se may lead to kidney damage.

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Changes in the prevalence of pre‐eclampsia in Akershus County and the rest of Norway during the past 35 years

Cited by 33 publications

References 15 publications

Pre-Eclampsia Increases the Risk of Postpartum Haemorrhage: A Nationwide Cohort Study in The Netherlands

Pre-Eclampsia Increases the Risk of Postpartum Haemorrhage: A Nationwide Cohort Study in The Netherlands

ABO and RhD blood groups and gestational hypertensive disorders: a population‐based cohort study

Familial Factors in the Association between Preeclampsia and Later ESRD

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