Does Developing Interpregnancy Hypertension Affect the Recurrence Risk of Preeclampsia? A Population-Based Cohort Study.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Inger Björk Ragnarsdóttir, Tansim Akhter, Katja Junus, Linda Lindström, Susanne Lager, Anna-Karin Wikström
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Abstract

Background: Preeclampsia in a first pregnancy is a strong risk factor for preeclampsia in a second pregnancy. Whether chronic hypertension developed after a first pregnancy (interpregnancy hypertension) affects the recurrence risk of preeclampsia is unknown.

Methods: This is a population-based cohort study of 391,645 women with their first and second singleton births between 2006 and 2017. Exposure groups were women with preeclampsia in their first pregnancy, interpregnancy hypertension, or both risk factors. Women with neither risk factor were used as a reference group. We calculated the adjusted relative risk (aRR) with 95% confidence intervals (CIs) for overall preeclampsia in the second pregnancy as well as preterm (<37 gestational weeks) and term (≥37 gestational weeks) subgroups of the disease.

Results: Women with preeclampsia in their first pregnancy who did or did not develop interpregnancy hypertension had rates of preeclampsia in their second pregnancy of 21.5% and 13.6%, respectively. In the same population, the corresponding rates of preterm preeclampsia were 5.5% and 2.6%, respectively. After adjusting for maternal factors, women with preeclampsia in their first pregnancy who developed interpregnancy hypertension and those who did not have almost the same risk of overall preeclampsia in their second pregnancy (aRRs with 95% CIs: 14.51; 11.77-17.89 and 12.83; 12.09-13.62, respectively). However, preeclampsia in the first pregnancy and interpregnancy hypertension had a synergistic interaction on the outcome of preterm preeclampsia (aRR with 95% CI 26.66; 17.44-40.80).

Conclusions: Women with previous preeclampsia who developed interpregnancy hypertension had a very high rate of preterm preeclampsia in a second pregnancy, and the two risk factors had a synergistic interaction.

孕中期高血压会影响子痫前期的复发风险吗?一项基于人群的队列研究。
背景:首次妊娠子痫前期是再次妊娠子痫前期的一个重要风险因素。首次妊娠后出现的慢性高血压(孕期高血压)是否会影响子痫前期的复发风险,目前尚不清楚:这是一项基于人群的队列研究,研究对象是 2006 年至 2017 年间第一次和第二次单胎分娩的 391,645 名妇女。暴露组为首次妊娠患有子痫前期、妊娠期高血压或同时患有两种风险因素的妇女。不存在任何风险因素的妇女作为参照组。我们计算了第二次妊娠子痫前期总体以及早产(37 孕周)亚组的调整后相对风险(aRR)及 95% 置信区间(CI):第一次妊娠时患有子痫前期的妇女,无论是否出现孕中期高血压,第二次妊娠时子痫前期的发病率分别为21.5%和13.6%。在同一人群中,相应的先兆子痫发生率分别为 5.5%和 2.6%。在对母体因素进行调整后,第一次妊娠时患有子痫前期且出现孕中期高血压的妇女与未出现孕中期高血压的妇女在第二次妊娠时发生子痫前期的总体风险几乎相同(95% CI 的 aRR 分别为 14.51;11.77-17.89 和 12.83;12.09-13.62)。然而,首次妊娠子痫前期和孕中期高血压对子痫前期的结果有协同作用(95% CI 的 aRR 为 26.66;17.44-40.80):曾患子痫前期的妇女如果出现孕期高血压,再次妊娠时发生先兆子痫前期的比例非常高,这两个风险因素之间存在协同作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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