title: Risk of pregnancy-related hypertension within 5 years of exposure to drinking water contaminated with Escherichia coli O157:H7.
abstract: The authors evaluated the risk for pregnancy-related hypertension among previously healthy women who conceived within 5 years of exposure to drinking water contaminated with Escherichia coli O157.H7 in Walkerton, Canada (2000). Chronic hypertension was defined as systolic/diastolic blood pressure >/=140/90 mm Hg before 20 weeks gestation; gestational hypertension was defined as new onset systolic/diastolic blood pressure >/=140/90 mm Hg >/=20 weeks gestation. The incidence of hypertension was compared between women who were asymptomatic during the outbreak to those who experienced acute gastroenteritis. Blood pressure data were available for 135 of 148 eligible pregnancies. The adjusted relative risks for chronic and gestational hypertension were 1.5 (95% confidence interval [CI]: 0.3-7.7) and 1.0 (95% CI: 0.4-2.5), respectively. Mean arterial pressure before 20 weeks gestation was 2.7 mm Hg higher in women who had acute gastroenteritis (95% CI: 0.05-5.4). A trend toward higher chronic hypertension and mean arterial pressure in early pregnancy was observed among women who experienced gastroenteritis after exposure to bacterially-contaminated drinking water.
authors.affiliation: Division of Nephrology, Department of Medicine, Victoria Hospital-London Health Sciences Centre, 800 Commissioners Road East, London, Ontario, Canada. louise.moist@lhsc.on.ca
authors.forename: Louise
authors.initials: L
authors.lastname: Moist
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sontrop
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
authors.forename: William F
authors.initials: WF
authors.lastname: Clark
authors.forename: Rita S
authors.initials: RS
authors.lastname: Suri
authors.forename: Robert
authors.initials: R
authors.lastname: Gratton
authors.forename: Marina
authors.initials: M
authors.lastname: Salvadori
authors.forename: Immaculate
authors.initials: I
authors.lastname: Nevis
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Macnab
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D002170:Canada; D015331:Cohort Studies; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D019453:Escherichia coli O157; D005260:Female; D005759:Gastroenteritis / Q000150:complications* / Q000382:microbiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D015994:Incidence; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014871:Water Microbiology