有妊娠高血压疾病史的妇女因多种原因导致早期死亡的风险增加。复发性妊娠高血压疾病对死亡风险和预期寿命的影响尚不清楚。
我们试图确定妊娠高血压疾病复发是否与死亡风险增加相关。
在这项回顾性队列研究中,我们使用出生证明数据来确定从1939年至2012年在犹他州分娩的每名女性的妊娠受妊娠期高血压疾病影响的妊娠次数.根据受影响的妊娠次数,我们将妇女分为3组中的1组:0、1或≥2。暴露妇女的单胎妊娠≥1,产后在犹他州生活≥1年。暴露女性与未暴露女性的年龄为1:2,分娩年份,和平价。根据死亡证明确定了死因。根据受影响的怀孕数量,比较了暴露和未暴露妇女之间潜在死亡原因的死亡风险。为婴儿性别控制的考克斯回归,胎龄,父母教育,种族,和婚姻状况。
我们确定了57,384名≥1次受累妊娠的妇女(49,598名1次受累妊娠的妇女和7786名≥2次受累妊娠的妇女)。这些女性与114,768名未暴露的女性相匹配。截至2016年,有11,894名妇女死亡:4722名(8.2%)暴露,7172名(6.3%)未暴露。受影响妊娠≥2次的妇女因各种原因死亡率增加(调整后的危险比,2.04;95%置信区间,1.76-2.36),糖尿病(调整后的危险比,4.33;95%置信区间,2.21-8.47),缺血性心脏病(调整后的风险比,3.30;95%置信区间,2.02-5.40),和中风(调整后的危险比,5.10;95%置信区间,2.62-9.92)。对于从1939年到1959年怀孕的妇女(n=10,488),与仅1或0例高血压妊娠的母亲相比,≥2例受影响妊娠的母亲的额外预期寿命较短(48.92vs51.91vs55.48岁,分别)。
妊娠高血压疾病与早期全因死亡率和某些特定原因死亡率的过高风险有关。这些风险随着疾病的复发而进一步增加。
Women with a history of hypertensive disease of pregnancy have increased risks for early mortality from multiple causes. The effect of recurrent hypertensive disease of pregnancy on mortality risk and life expectancy is unknown.
We sought to determine whether recurrent hypertensive disease of pregnancy is associated with increased mortality risks.
In this retrospective cohort study, we used birth certificate data to determine the number of pregnancies affected by hypertensive disease of pregnancy for each woman delivering in Utah from 1939 through 2012. We assigned women to 1 of 3 groups based on number of affected pregnancies: 0, 1, or ≥2. Exposed women had ≥1 affected singleton pregnancy and lived in Utah for ≥1 year postpartum. Exposed women were matched 1:2 to unexposed women by age, year of childbirth, and parity. Underlying cause of death was determined from death certificates. Mortality risks by underlying cause of death were compared between exposed and unexposed women as a function of number of affected pregnancies. Cox regressions controlled for infant sex, gestational age, parental education, ethnicity, and marital status.
We identified 57,384 women with ≥1 affected pregnancy (49,598 women with 1 affected pregnancy and 7786 women with ≥2 affected pregnancies). These women were matched to 114,768 unexposed women. As of 2016, 11,894 women were deceased: 4722 (8.2%) exposed and 7172 (6.3%) unexposed. Women with ≥2 affected pregnancies had increased mortality from all causes (adjusted hazard ratio, 2.04; 95% confidence interval, 1.76-2.36), diabetes (adjusted hazard ratio, 4.33; 95% confidence interval, 2.21-8.47), ischemic heart disease (adjusted hazard ratio, 3.30; 95% confidence interval, 2.02-5.40), and stroke (adjusted hazard ratio, 5.10; 95% confidence interval, 2.62-9.92). For women whose index pregnancy delivered from 1939 through 1959 (n = 10,488), those with ≥2 affected pregnancies had shorter additional life expectancies than mothers who had only 1 or 0 hypertensive pregnancies (48.92 vs 51.91 vs 55.48 years, respectively).
Hypertensive diseases of pregnancy are associated with excess risks for early all-cause mortality and some cause-specific mortality, and these risks increase further with recurrent disease.