Long-term mortality after preeclampsia
Long-term mortality after preeclampsia
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DOI：
10.1097/01.ede.0000152912.02042.cd
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发表时间：
2005-03-01
期刊：
影响因子：
5.4
通讯作者：
Harlap, S
中科院分区：
文献类型：
--
作者：
Funai, EF;Friedlander, Y;Harlap, S
背景：许多人认为先兆子痫与未来的发病率或死亡率无关。我们试图调查子痫前期妇女的长期死亡风险，重点关注那些已知随后血压正常的妇女。研究设计：我们对37,061名1964-1976年在耶路撒冷分娩的妇女进行了24-36年的随访，确定了死亡人数，其中包括1,070名先兆子痫妇女。我们使用Cox比例风险模型来估计与子痫前期相关的死亡风险，同时控制妇女的年龄和教育程度、糖尿病史、心脏病史和低出生体重、丈夫的社会阶层和随访开始时的日历年。结果：与未诊断为子痫前期的妇女相比，子痫前期的相对死亡风险为2.1（95%可信区间= 1.8-2.5）。心血管疾病死亡对这一增长贡献最大。在有子痫前期的妇女中，如果她们的后代没有子痫前期，那么在20年后，死亡的额外风险才变得明显。结论：这些发现与近期其他队列研究一起，将先兆子痫定义为心血管疾病死亡的风险标志。他们建议，观察到子痫前期血压正常不应阻止寻找其他心血管危险因素或取消其他预防措施的需要。
Background: Many believe that preeclampsia is not associated with future morbidity or mortality. We sought to investigate the long-term risk of mortality in women with preeclampsia, focusing on those known to be subsequently normotensive.Study Design: We ascertained deaths during 24-36 years' follow-up in a cohort of 37,061 women who delivered in Jerusalem in 1964-1976, including 1,070 women with preeclampsia. We used Cox proportional hazard models to estimate the risk of mortality associated with preeclampsia while controlling for the woman's age and education, history of diabetes, heart disease and low birth weight birth, the husband's social class, and the calendar year at the start of follow-up.Results: Compared with women who were not diagnosed with preeclampsia, the relative risk of death after preeclampsia was 2.1 (95% confidence interval = 1.8-2.5). Deaths from cardiovascular disease contributed most strongly to this increase. Among women with preeclampsia who had subsequent births without preeclampsia, the excess risk of mortality became manifest only after 20 years.Conclusions: These findings, together with other recent cohort studies, define preeclampsia as a risk marker for mortality from cardiovascular disease. They suggest that the observation of a normal blood pressure after preeclampsia should not discourage the search for other cardiovascular risk factors or abrogate the need for other preventive measures.