title: Hypertensive disorders of pregnancy and future health and mortality: A record linkage study.
abstract: The objective of this register-based cohort study was to examine the relationship between hypertensive disorders of pregnancy and future hospital discharges from specified causes including cardiovascular disease, incident cancer registrations and mortality. From the Aberdeen Maternity and Neonatal Databank we identified 34,854 women who were born on or before 31st December 1967 and who had (i) preeclampsia/eclampsia, (ii) gestational hypertension or (iii) normal blood pressure in their first pregnancy. Hospital discharges from selected causes including cardiovascular disease, cancer registrations and deaths in these women were identified from the Scottish Morbidity Records. There were 2026 women who had preeclampsia, 8891 who had gestational hypertension and 23,937 who were normotensive during their first pregnancy. Compared to normotensive women, women with preeclampsia had a higher mortality from ischaemic heart disease (adj. IRR 1.38, 95% CI 1.03, 1.84) and circulatory disease (adj. IRR 1.30, 95% CI 1.06, 1.60). Similar trends were seen with gestational hypertension. There was no difference in all cause mortality in the three groups. The odds of a hypertensive episode were higher in women with preeclampsia (adj. OR 1.79, 95% CI 1.55, 2.05) and gestational hypertension (adj. OR 1.68, 95% CI 1.55, 1.82) compared to normotensives. Compared to normotensives, women with gestational hypertension (adj. IRR 0.91, 95% CI 0.85, 0.96) or preeclampsia (adj. IRR 0.86, 95% CI 0.77, 0.97) had lower incidences of cancer. Women with pregnancy induced hypertension are at a higher risk of incidence and mortality from ischaemic heart disease and a lower risk of cancer.
authors.affiliation: Section of Population Health, School of Medicine and Dentistry, University of Aberdeen, United Kingdom. Electronic address: sohinee.bhattacharya@abdn.ac.uk.
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharya
authors.affiliation: Section of Population Health, School of Medicine and Dentistry, University of Aberdeen, United Kingdom.
authors.forename: G J
authors.initials: GJ
authors.lastname: Prescott
authors.affiliation: Centre of Academic Primary Care, School of Medicine and Dentistry, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, United Kingdom.
authors.forename: L
authors.initials: L
authors.lastname: Iversen
authors.affiliation: Obstetrics and Gynaecology, Aberdeen Maternity Hospital, AB25 2ZL, United Kingdom.
authors.forename: D M
authors.initials: DM
authors.lastname: Campbell
authors.affiliation: Section of Population Health, School of Medicine and Dentistry, University of Aberdeen, United Kingdom.
authors.forename: W C S
authors.initials: WC
authors.lastname: Smith
authors.affiliation: Centre of Academic Primary Care, School of Medicine and Dentistry, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen AB25 2AY, United Kingdom.
authors.forename: P C
authors.initials: PC
authors.lastname: Hannaford
keywords: Cancer; Cardiovascular disease; Gestational hypertension; Mortality; Preeclampsia