Incident Coronary Heart Disease After Preeclampsia: Role of Reduced Fetal Growth, Preterm Delivery, and Parity.
Incident Coronary Heart Disease After Preeclampsia: Role of Reduced Fetal Growth, Preterm Delivery, and Parity.
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DOI：
10.1161/jaha.116.004158
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发表时间：
2017-03-06
影响因子：
5.4
通讯作者：
Daltveit AK
中科院分区：
文献类型：
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作者：
Riise HK;Sulo G;Tell GS;Igland J;Nygård O;Vollset SE;Iversen AC;Austgulen R;Daltveit AK
先兆子痫是一种严重的妊娠期疾病，通常并发胎儿生长减少或早产，并与长期孕产妇发病率和死亡率相关。我们的目的是评估先兆子痫表型与随后的冠心病风险和孕产妇心血管死亡率之间的关系。对1980-2002年期间生育并在挪威医学出生登记处登记的16 - 49岁女性进行前瞻性随访（1-29年），通过与1994-2009年挪威心血管疾病（CVDNOR）项目和挪威死因登记处的联系，了解重大冠状动脉事件和死亡率。先兆子痫是细分的基础上存在的一个孩子出生小于胎龄或早产。在506350例单胎生育1 - 5个孩子的妇女中，有1275例（0.3%）发生了重大冠状动脉事件，468例（0.1%）心血管死亡，5411例（1.1%）死亡。与无先兆子痫的妇女相比，单独先兆子痫后主要冠状动脉事件的危险比（95% CI）为2. 1（1. 73 - 2. 65），先兆子痫合并小于胎龄儿后为3. 3（2. 37 - 4. 57），先兆子痫合并早产后为5. 4（3. 74 - 7. 74）。区分1次（n=61 352）或>1次（n=281 069）终身妊娠的妇女的分析和以心血管死亡率作为结局的分析遵循相同的模式。先兆子痫妇女中主要冠状动脉事件的发生率增加，先兆子痫合并小于胎龄儿和/或早产的发生率最高。
Preeclampsia is a severe pregnancy disorder often complicated by reduced fetal growth or preterm delivery and is associated with long‐term maternal morbidity and mortality. We aimed to assess the association between preeclampsia phenotypes and risk of subsequent coronary heart disease and maternal cardiovascular mortality. Women aged 16 to 49 years who gave birth during 1980–2002 and registered in the Medical Birth Registry of Norway were followed prospectively (1–29 years) for an incident major coronary event and mortality through linkage with the Cardiovascular Disease in Norway 1994–2009 (CVDNOR) project and the Norwegian Cause of Death Registry. Preeclampsia was subdivided based on the presence of a child born small for gestational age or preterm delivery. Among 506 350 women with 1 to 5 singleton births, there were 1275 (0.3%) occurrences of major coronary event, 468 (0.1%) cardiovascular deaths, and 5411 (1.1%) deaths overall. Compared with women without preeclampsia, the hazard ratio (95% CI) for major coronary event was 2.1 (1.73–2.65) after preeclampsia alone, 3.3 (2.37–4.57) after preeclampsia in combination with small for gestational age, and 5.4 (3.74–7.74) after preeclampsia in combination with preterm delivery. Analyses distinguishing women with 1 (n=61 352) or >1 (n=281 069) lifetime pregnancy and analyses with cardiovascular mortality as outcome followed the same pattern. The occurrence of major coronary events was increased among women with preeclampsia and highest for preeclampsia combined with a child born small for gestational age and/or preterm delivery.