title: Subsequent risk of gout for women with hypertensive disorders in pregnancy: a retrospective cohort study.
abstract: BACKGROUND
  The association between the risk of subsequent gout and hypertensive disorders in pregnancy (HDP), including gestational hypertension and preeclampsia has not been well investigated. We investigated the risk of gout in later life for women with a history of HDP.
  
  
  METHODS
  We identified 1133 newly diagnosed HDP women aged 14-40 years from Taiwan insurance claims data from the period of 2000-2010. From the same database, 9064 women without HDP were randomly selected as the control cohort, with frequency matched by age and diagnosis year. Those with a baseline history of hypertension or gout were excluded from this study. All study participants were followed until the development of gout, withdrawal from the insurance program, or the end of 2011. Cox proportional hazards regression was used to assess the risk for gout in the HDP cohort compared with the controls.
  
  
  RESULTS
  The incidence of gout was 2.83 folds higher in the HDP cohort than in the control cohort (2.66 vs. 0.94 per 1000 person-years) with an adjusted hazard ratio of 2.34 (95% confidence interval = 1.36-4.02) and 1.84 (95% confidence interval = 1.03-3.32) after controlling for comorbidities prior to and after pregnancy, respectively. In addition, the risk for gout increased as the severity of HDP increased.
  
  
  CONCLUSIONS
  Women with HDP are at higher risk of developing gout in their later life. Close surveillance for hyperuricemia and lifestyle intervention should be considered for these high risk women. Further prospective study is needed for investigating the relationship between HDP and subsequent gout.
authors.affiliation: aGraduate Institute of Clinical Medical Science bDepartment of Internal Medicine, College of Medicine cDivision of Nephrology dDivision of Rheumatology eManagement Office for Health Data, China Medical University Hospital, Taichung, Taiwan fDivision of Nephrology, Chang Gung Memorial Hospital, Taipei gChang Gung University College of Medicine, Taoyuan hDepartment of Health Services Administration, China Medical University, Taichung, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Jiunn-Horng
authors.initials: JH
authors.lastname: Chen
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Liu
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006073:Gout / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced; D015994:Incidence; D011225:Pre-Eclampsia; D011247:Pregnancy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult