title: Incident Coronary Heart Disease After Preeclampsia: Role of Reduced Fetal Growth, Preterm Delivery, and Parity.
abstract: BACKGROUND
  Preeclampsia is a severe pregnancy disorder often complicated by reduced fetal growth or preterm delivery and is associated with long-term maternal morbidity and mortality. We aimed to assess the association between preeclampsia phenotypes and risk of subsequent coronary heart disease and maternal cardiovascular mortality.
  
  
  RESULTS
  Women aged 16 to 49 years who gave birth during 1980-2002 and registered in the Medical Birth Registry of Norway were followed prospectively (1-29 years) for an incident major coronary event and mortality through linkage with the Cardiovascular Disease in Norway 1994-2009 (CVDNOR) project and the Norwegian Cause of Death Registry. Preeclampsia was subdivided based on the presence of a child born small for gestational age or preterm delivery. Among 506 350 women with 1 to 5 singleton births, there were 1275 (0.3%) occurrences of major coronary event, 468 (0.1%) cardiovascular deaths, and 5411 (1.1%) deaths overall. Compared with women without preeclampsia, the hazard ratio (95% CI) for major coronary event was 2.1 (1.73-2.65) after preeclampsia alone, 3.3 (2.37-4.57) after preeclampsia in combination with small for gestational age, and 5.4 (3.74-7.74) after preeclampsia in combination with preterm delivery. Analyses distinguishing women with 1 (n=61 352) or >1 (n=281 069) lifetime pregnancy and analyses with cardiovascular mortality as outcome followed the same pattern.
  
  
  CONCLUSIONS
  The occurrence of major coronary events was increased among women with preeclampsia and highest for preeclampsia combined with a child born small for gestational age and/or preterm delivery.
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway hilde.riise@uib.no anne.daltveit@uib.no.
authors.forename: Hilde Kristin Refvik
authors.initials: HK
authors.lastname: Riise
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Sulo
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Grethe S
authors.initials: GS
authors.lastname: Tell
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.
authors.forename: Jannicke
authors.initials: J
authors.lastname: Igland
authors.affiliation: KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway.|Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ottar
authors.initials: O
authors.lastname: Nygård
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Centre for Disease Burden, Norwegian Institute of Public Health, Oslo/Bergen Bergen, Norway.
authors.forename: Stein Emil
authors.initials: SE
authors.lastname: Vollset
authors.affiliation: Department of Cancer Research and Molecular Medicine, Centre of Molecular Inflammation Research, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Iversen
authors.affiliation: Department of Cancer Research and Molecular Medicine, Centre of Molecular Inflammation Research, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
authors.forename: Rigmor
authors.initials: R
authors.lastname: Austgulen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Norway.|Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Anne Kjersti
authors.initials: AK
authors.lastname: Daltveit
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D002423:Cause of Death; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009026:Mortality; D009203:Myocardial Infarction / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D016016:Proportional Hazards Models; D055815:Young Adult
keywords: cardiovascular disease; fetal growth restriction; major coronary events; preeclampsia; preterm delivery