Adverse pregnancy outcomes may lead to hypertension
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Pregnancy outcomes including hypertensive disorders of pregnancy, small-for-gestational-age birth, preterm birth and stillbirth may indicate the development of hypertension 2 to 7 years postpartum, according to a study published in the Journal of the American Heart Association.
An analysis of women following their first pregnancy found an overall incidence of hypertension of 5.4% (95% CI, 4.7-6.1), however women with adverse pregnancy outcomes experienced a significantly higher adjusted risk for hypertension at follow-up compared with women who did not have adverse pregnancy outcomes (RR = 2.4; 95% CI, 1.83.1).
“We used to think it took years and years to develop high blood pressure,” David Haas, MD, professor of obstetrics and gynecology at Indiana University School of Medicine, Indianapolis, said in a press release. “We found that it can occur much sooner than expected ... in as little as three years.”
Moreover, elevated risk for hypertension was associated with several specific adverse pregnancy outcomes:
- any hypertensive disorders of pregnancy (RR = 2.7; 95% CI, 23.6);
- preeclampsia (RR = 2.8; 95% CI, 24);
- preterm birth (RR = 2.7; 95% CI 1.93.8); and
- preterm birth plus hypertensive disorders of pregnancy (RR = 4.3; 95% CI, 2.76.7).
“[These findings] may mean asking more details about the health history of women during pregnancy. It may mean closer health monitoring and more counseling about possible lifestyle modifications to prevent high blood pressure,” Haas said in the release. “A lot of the women tested during this study didn’t have any idea that they had high BP.”
Using data from the observational Nulliparous Pregnancy Outcomes Study Monitoring Motherstobe Heart Health Study, researchers analyzed 4,484 women (mean age, 27 years; 62% white; 2.8% with pregestational hypertension) who were followed up 2 to 7 years (mean, 3.2 years) after their first pregnancy to determine if adverse pregnancy outcomes were associated with hypertension. The primary outcome was development of hypertension and risk ratios were adjusted for age, smoking, BMI, insurance type and race/ethnicity.
“The take-home message for pregnant women is to get prenatal care early, talk to your obstetric provider about your current health conditions, and make sure your health is as good as it can be,” Haas said in the release. “For women who had complications during their first pregnancy, routine health care — watching BP, weight and cholesterol — is just as critical.” – by Scott Buzby
Disclosures: The authors report no relevant financial disclosures.
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