Cardiovascular Disease in Relation to Placental Abruption: A Population-Based Cohort Study from Denmark
Autor: | Anne-Marie Nybo Andersen, Cande V. Ananth, Michelle A. Williams, Anne Vinkel Hansen |
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Rok vydání: | 2017 |
Předmět: |
Adult
medicine.medical_specialty Epidemiology Denmark Pregnancy Complications Cardiovascular Mothers Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors Interquartile range Cause of Death Prevalence medicine Humans Prospective Studies Registries 030212 general & internal medicine Prospective cohort study Abruptio Placentae Proportional Hazards Models Cause of death 030219 obstetrics & reproductive medicine Placental abruption Proportional hazards model Obstetrics business.industry Hazard ratio medicine.disease Hypertensive heart disease Cardiovascular Diseases Population Surveillance Pediatrics Perinatology and Child Health Female business Follow-Up Studies Cohort study |
Zdroj: | Paediatric and Perinatal Epidemiology. 31:209-218 |
ISSN: | 0269-5022 |
Popis: | Background Cardiovascular (CVD) complications stemming from vascular dysfunction have been widely explored in the setting of preeclampsia. However, the impact of abruption, a strong indicator of microvascular disturbance, on the risk of CVD mortality and morbidity remains poorly characterised. Methods We designed a cohort analysis of 828 289 women who delivered singletons in Denmark between 1978 and 2010. We linked the National Patient Registry and the Registry of Causes of Death to the Danish Birth Registry to ascertain CVD events. We estimated CVD risks in relation to abruption from Cox proportional hazards regression following adjustments for confounders. Results With 13 231 562 person-years of follow-up of women with at least one delivery, 11 829 pregnancies were complicated by abruption. The median (interquartile range) follow-up in the non-abruption and abruption groups was 16 (8, 24) and 18 (10, 25) years, respectively. CVD mortality rates in women with and without abruption were 0.9 and 0.3 per 10 000 person-years, respectively (adjusted hazard ratio (HR) 2.7, 95% confidence interval (CI) 1.5, 5.0). The corresponding CVD morbidity complication rates were 16.7 and 10.0 per 10 000 person-years, respectively (HR 1.5, 95% CI 1.4, 1.8). The increased risks were evident for ischaemic heart disease, acute myocardial infarction, hypertensive heart disease, non-rheumatic valvular disease, and congestive heart failure. Conclusions This study shows increased hazards of CVD morbidity and mortality in relation to abruption. A better understanding of the pathogenesis of distorted placental microvasculature is needed as this appears to be a harbinger of CVD later in life. |
Databáze: | OpenAIRE |
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