The association of maternal chronic hypertension with perinatal death in male and female offspring: a record linkage study of 866,188 women.
OBJECTIVE
The purpose of this study was to determine whether there is a difference, by gender, in perinatal mortality in chronically hypertensive women compared with normotensive women.


METHODS
Population-based prospective cohort study.


METHODS
Sweden.


METHODS
A total of 866,188 women with singleton pregnancies registered in the Swedish Medical Birth Registry 1992-2004, of which 4749 were diagnosed with chronic hypertension.


METHODS
Multivariate logistic regression analysis was performed. In a first step, we adjusted for maternal characteristics and in a second step for mild and severe pre-eclampsia, gestational diabetes, placental abruption and small for gestational age. An effect modification by gender was included in the model.


METHODS
Odds ratios (OR) for intrauterine death, neonatal death and post-neonatal death with respect to gender of offspring.


RESULTS
The unadjusted OR of intrauterine death was 4.12 (95% CI: 2.84-5.96) and 1.29 (95% CI: 0.67-2.48) for male and female offspring, respectively, and of neonatal death, it was 3.45 (95% CI: 2.13-5.59) and 2.17 (95% CI: 1.08-4.35) for male and female offspring, respectively. After multivariate analysis, the OR of intrauterine death was 3.07 (95% CI: 2.12-4.46) and neonatal death was 2.99 (95% CI: 1.84-4.85) for male offspring. For female offspring, the OR of intrauterine death was 0.98 (95% CI: 0.51-1.89) and neonatal death was 1.88 (95% CI: 0.93-3.79).


CONCLUSIONS
Mothers with chronic hypertension have an increased risk of perinatal mortality of their male offspring.
Zetterström
K
K
Department of Gynecology and Obstetrics, Orebro University Hospital, Orebro, Sweden. karin.zetterstrom@orebroll.se
Lindeberg
S N
SN
Haglund
B
B
Hanson
U
U
D000037:Abruptio Placentae / Q000401:mortality; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D016640:Diabetes, Gestational / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D054238:Perinatal Mortality; D011225:Pre-Eclampsia / Q000401:mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality*; D012737:Sex Factors; D050497:Stillbirth / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult