title: Cardiovascular disease risk factors after early-onset preeclampsia, late-onset preeclampsia, and pregnancy-induced hypertension.
abstract: Observational studies have shown an increased lifetime risk of cardiovascular disease (CVD) in women who experienced a hypertensive disorder in pregnancy. This risk is related to the severity of the pregnancy-related hypertensive disease and gestational age at onset. However, it has not been investigated whether these differences in CVD risk factors are already present at postpartum cardiovascular screening. We evaluated postpartum differences in CVD risk factors in 3 subgroups of patients with a history of hypertensive pregnancy. We compared the prevalence of common CVD risk factors postpartum among 448 women with previous early-onset preeclampsia, 76 women with previous late-onset preeclampsia, and 224 women with previous pregnancy-induced hypertension. Women with previous early-onset preeclampsia were compared with women with late-onset preeclampsia and pregnancy-induced hypertension and had significantly higher fasting blood glucose (5.29 versus 4.80 and 4.83 mmol/L), insulin (9.12 versus 6.31 and 6.7 uIU/L), triglycerides (1.32 versus 1.02 and 0.97 mmol/L), and total cholesterol (5.14 versus 4.73 and 4.73 mmol/L). Almost half of the early-onset preeclampsia women had developed hypertension, as opposed to 39% and 25% of women in the pregnancy-induced hypertension and late-onset preeclampsia groups, respectively. Our data show differences in the prevalence of common modifiable CVD risk factors postpartum and suggest that prevention strategies should be stratified according to severity and gestational age of onset for the hypertensive disorders of pregnancy.
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.). J.H.W.Veerbeek@umcutrecht.nl.
authors.forename: Jan H W
authors.initials: JH
authors.lastname: Veerbeek
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Wietske
authors.initials: W
authors.lastname: Hermes
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Anath Y
authors.initials: AY
authors.lastname: Breimer
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Bas B
authors.initials: BB
authors.lastname: van Rijn
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Steven V
authors.initials: SV
authors.lastname: Koenen
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Ben W
authors.initials: BW
authors.lastname: Mol
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Christianne J M
authors.initials: CJ
authors.lastname: de Groot
authors.affiliation: From the Division of Woman and Baby, Department of Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands (J.H.W.V., A.Y.B., B.B.v.R., S.V.K., A.F., M.P.H.K.); Department of Obstetrics and Gynecology, Medical Center Haaglanden, The Hague, The Netherlands (W.H.); Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands (W.H., C.J.M.d.G.); The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, South Australia, Australia (B.W.M.); and Academic Unit of Human Development and Health, Princess Anne Hospital, University of Southampton, Southampton, United Kingdom (B.B.v.R.).
authors.forename: Maria P H
authors.initials: MP
authors.lastname: Koster
mesh_terms: D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000503:physiopathology*; D008055:Lipids / Q000097:blood; D017063:Outcome Assessment, Health Care; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000503:physiopathology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D008055:Lipids
keywords: hypertension; prevention