title: Preeclampsia in pregnancy and later use of antihypertensive drugs.
abstract: We explored the association between preeclampsia and later use of antihypertensive drugs in a population-based study with data from the Medical Birth Registry of Norway and the Norwegian Prescription Database. The study cohort consisted of 980,000 women having 2.1 million pregnancies during 1967-2012. Hazard ratios (HRs) with 95% confidence intervals (95% CI) were estimated in multivariate time-dependent Cox proportional hazards regression models. Overall, the HR of later use of antihypertensive drugs was 2.0 (95% CI 2.0-2.0) in women with one preeclamptic pregnancy compared to women without preeclamptic pregnancies. The HR increased by increasing number of preeclamptic pregnancies, both term and preterm pregnancies. In women with two or more preeclamptic pregnancies, the HR was 2.8 (2.7-3.0). The overall HR after 40 years of follow-up for women with one preeclamptic pregnancy was 1.3 (1.2-1.4) and for two or more preeclamptic pregnancies the HR was 1.6 (1.1-2.1). The first 5 years after the first birth, the HR of being dispensed antihypertensive drugs was higher in preterm [8.4 (7.7-9.1)] than term preeclamptic pregnancies [4.3(4.0-4.6)]. However, after 10 years, this difference was no longer present. The HR of later use of antihypertensive drugs increased with the number of preeclamptic pregnancies, and in the first 10 years the HR was higher after a preterm than a term preeclamptic pregnancy. Although the HR decreased with time since first birth, the risk was still elevated after 40 years.
authors.affiliation: Division of Epidemiology, Department of Pharmacoepidemiology, Norwegian Institute of Public Health, Oslo, Norway, anders.engeland@igs.uib.no.
authors.forename: Anders
authors.initials: A
authors.lastname: Engeland
authors.forename: Tone
authors.initials: T
authors.lastname: Bjørge
authors.forename: Kari
authors.initials: K
authors.lastname: Klungsøyr
authors.forename: Rolv
authors.initials: R
authors.lastname: Skjærven
authors.forename: Svetlana
authors.initials: S
authors.lastname: Skurtveit
authors.forename: Kari
authors.initials: K
authors.lastname: Furu
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D009664:Norway / Q000453:epidemiology; D011159:Population Surveillance; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents