Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease: a Danish cohort study

Shannon X. Chen, Kathleen M. Rasmussen, Julia Finkelstein, H. Støvring, Ellen Aa Nøhr, Helene Kirkegaard*

*Kontaktforfatter for dette arbejde

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Resumé

Objectives The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths. Design A prospective cohort study. Setting Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height. Participants A total of 44 552 first-time mothers in the Danish National Birth Cohort. Outcome measures Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles. Results After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m 2) was observed. Conclusions Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.

OriginalsprogEngelsk
Artikelnummer030702
TidsskriftBMJ Open
Vol/bind9
Udgave nummer11
Antal sider9
ISSN2044-6055
DOI
StatusUdgivet - 4. nov. 2019

Fingeraftryk

Reproductive History
Live Birth
Cohort Studies
Mothers
Body Mass Index
Stillbirth
Registries

Citer dette

Chen, Shannon X. ; Rasmussen, Kathleen M. ; Finkelstein, Julia ; Støvring, H. ; Nøhr, Ellen Aa ; Kirkegaard, Helene. / Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease : a Danish cohort study. I: BMJ Open. 2019 ; Bind 9, Nr. 11.
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abstract = "Objectives The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths. Design A prospective cohort study. Setting Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height. Participants A total of 44 552 first-time mothers in the Danish National Birth Cohort. Outcome measures Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles. Results After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95{\%} CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95{\%} CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m 2) was observed. Conclusions Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.",
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Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease : a Danish cohort study. / Chen, Shannon X.; Rasmussen, Kathleen M.; Finkelstein, Julia; Støvring, H.; Nøhr, Ellen Aa; Kirkegaard, Helene.

I: BMJ Open, Bind 9, Nr. 11, 030702, 04.11.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease

T2 - a Danish cohort study

AU - Chen, Shannon X.

AU - Rasmussen, Kathleen M.

AU - Finkelstein, Julia

AU - Støvring, H.

AU - Nøhr, Ellen Aa

AU - Kirkegaard, Helene

PY - 2019/11/4

Y1 - 2019/11/4

N2 - Objectives The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths. Design A prospective cohort study. Setting Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height. Participants A total of 44 552 first-time mothers in the Danish National Birth Cohort. Outcome measures Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles. Results After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m 2) was observed. Conclusions Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.

AB - Objectives The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths. Design A prospective cohort study. Setting Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height. Participants A total of 44 552 first-time mothers in the Danish National Birth Cohort. Outcome measures Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles. Results After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m 2) was observed. Conclusions Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.

KW - Cardiac Epidemiology

KW - Hypertension

KW - Maternal medicine

KW - PUBLIC HEALTH

KW - REPRODUCTIVE MEDICINE

U2 - 10.1136/bmjopen-2019-030702

DO - 10.1136/bmjopen-2019-030702

M3 - Journal article

C2 - 31690605

AN - SCOPUS:85074622824

VL - 9

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 11

M1 - 030702

ER -