Prior placental bed disorders and later dementia: a retrospective Swedish register-based cohort study
Prior placental bed disorders and later dementia: a retrospective Swedish register-based cohort study
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DOI：
10.1111/1471-0528.16201
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发表时间：
2020-03-31
影响因子：
5.8
通讯作者：
Sydsjo, G.
中科院分区：
文献类型：
--
作者：
Andolf, E.;Bladh, M.;Sydsjo, G.
目的探讨胎盘床疾病史与晚期痴呆之间的关系。设计：回顾性人群队列研究。背景：瑞典。样本：1973年至1993年在瑞典分娩的所有妇女（1128709）.方法对有和无胎盘床疾病的妇女进行比较（妊娠高血压疾病，包括先兆子痫、胎儿生长受限、自发性早产和分娩、早产胎膜早破、胎盘早剥，晚期流产）和其他妊娠并发症通过瑞典医疗出生登记进行确认。使用国际疾病分类。数据与其他国家登记册相关联。参与者被随访至2013年。采用考克斯比例风险模型计算有和无妊娠并发症妇女的风险比，并对可能的混杂因素进行调整。主要结果测量血管性痴呆和非血管性痴呆的诊断。结果调整心血管疾病和社会人口因素后，既往妊娠高血压妇女血管性痴呆的风险增加（风险比[HR] 1.88，95% CI 1.32-2.69）、先兆子痫（HR 1.63，95% CI 1.23-2.16）、自发性早产和分娩（HR 1.65，95% CI 1.12-2.42）或早产胎膜早破（HR 1.60，95% CI 1.08-2.37）。其他妊娠并发症或非血管性痴呆的风险无统计学显着增加，即使许多点估计表明风险增加。结论胎盘床疾病的妇女有较高的风险血管疾病。异常胎盘形成背后的机制仍然难以捉摸，虽然母体体质因素，异常植入以及受损的血管生成已被提出。Tweetable abstract胎盘床综合征与血管性痴呆相关，即使在调整心血管疾病后。
Objective To investigate the association between a history of placental bed disorders and later dementia.Design Retrospective population-based cohort study.Setting Sweden.Sample All women giving birth in Sweden between 1973 and 1993 (1 128 709).Methods Women with and without placental bed disorders (hypertensive disorders of pregnancy including pre-eclampsia, fetal growth restriction, spontaneous preterm labour and birth, preterm premature rupture of membranes, abruptio placenta, late miscarriages) and other pregnancy complications were identified by means of the Swedish Medical Birth Register. International classification of disease was used. Data were linked to other National Registers. Participants were followed up until 2013. The Cox proportional hazards model was used to calculate hazard ratios for women with and without pregnancy complications and were adjusted for possible confounders.Main outcome measures Diagnosis of vascular dementia and non-vascular dementia.Results Adjusted for cardiovascular disease and socio-demographic factors, an increased risk of vascular dementia was shown in women with previous pregnancy-induced hypertension (Hazard ratio [HR] 1.88, 95% CI 1.32-2.69), pre-eclampsia (HR 1.63, 95% CI 1.23-2.16), spontaneous preterm labour and birth (HR 1.65, 95% CI 1.12-2.42) or preterm premature rupture of membranes (HR 1.60, 95% CI 1.08-2.37). No statistically significant increased risk was seen for other pregnancy complications or non-vascular dementia even though many of the point estimates indicated increased risks.Conclusions Women with placental bed disorders have a higher risk for vascular disease. Mechanisms behind the abnormal placentation remain elusive, although maternal constitutional factors, abnormal implantation as well as impaired angiogenesis have been suggested.Tweetable abstract Placental bed syndromes associated with vascular dementia even after adjusting for cardiovascular disease.