History of
preeclampsia in first pregnancy doubles the risk for Major Cardiac Event (MACEs)
subsequently later in life for mothers, the risk is 2.8 times if the
preeclamptic pregnancy resulted in SGA and/or preterm delivery. If the
preeclampsia recurs in subsequent pregnancy the risk is 2.2 times while if it
is combined again with in SGA and/or preterm delivery the risk increases nearly
5 times compared with women without preeclampsia according to new research study
published in March issue of Journal of American Medical Association( JAMA).[1]
In this large
register based prospective follow up study, the researchers linked the data
from Medical Birth Registry of Norway(MBRN) with Cardiovascular Disease in
Norway 1994–2009 (CVDNOR) project and the Norwegian Cause of Death Registry.
Of 708 614 women
registered with MBRN from 1980–2009, 506 350 women between 16-49 years of age
with parity <5 met the study inclusion criteria’s. The exposure of interest was preeclampsia defined
according to the criteria by American Congress of Obstetrician and
Gynecologists (ACOG).
The outcome of interest in the study was nonfatal acute
myocardial infarction or coronary death, CVD or all-cause mortality.
Further the
analyses was stratified by parity, assessing whether the exposure and outcome
differed according to number of children born. Women with more than 1 births
were grouped as no preeclampsia (control), women with preeclampsia in first pregnancy, women with preeclampsia in subsequent pregnancy or preeclampsia in later but not
first pregnancy.
The
incidence of preeclampsia was 6% (29 917) in at least one pregnancy with 75% of
these preeclamptic pregnancy (21 635) being the first pregnancy. Preeclamptic
women were 2 times more likely to have a child born with SGA and 3 times more
like to have a preterm labor as compared to women with no preeclampsia.
Women with only
preeclampsia had 1.6 times increased risk of all-cause mortality which further
increased to 3.7 with a child born with SGA and 2.8 times with preterm delivery
as compared to women without preeclampsia.
After adjusting
for confounders, the risk of MACE was highest in preeclamptic women who had
SGA/ preterm delivery (4.7 times) and the risk was highest if preeclampsia occurs
in first 2 pregnancy with SGA/ preterm birth.
During follow up 1275 (0.3%) women experienced MACEs
and 468 (0.1%) mothers died due to CVD and 5411 (1.1%) due to any cause with majority
of cardiac events occurred after the age of 50 years.
The study
provide evidence to monitor these high-risk women who are at increased risk for
coronary artery disease in future.
The full
text of the article can be accessed here
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