429: Risk for developing chronic hypertension, dyslipidemia, and diabetes after preeclampsia

Abstract

Pregnancy complications can be a ‘window’ into future health. The objective of this study was to analyze risk for development of chronic health conditions after preeclampsia. A retrospective cohort study using the MarketScan database from 12/2008 to 1/2015 was performed. Marketscan is a claims-based data source that includes privately insured and Medicaid patients. We identified delivery hospitalizations complicated by preeclampsia and determined subsequent risk for three outcomes: (i) chronic hypertension, (ii) diabetes, and (iii) dyslipidemia. Women with these three chronic conditions during or before pregnancy were excluded. Risk was then determined at 6 months, 1, 2, and 5 years after delivery for women with continuous insurance enrollment through these time points. If >1 delivery occurred, the index delivery was included as the study start point. Risk for outcomes based on preeclampsia at delivery was analyzed with the chi-square test. 2,038,726 deliveries followed by 6 months of coverage, 1,698,082, 1,278,667, and 458,572 deliveries followed by 1, 2, and 5 years of coverage respectively met inclusion criteria for the analysis. Among women without preeclampsia, 1.4% of women had a diagnosis of chronic hypertension at 6 months compared to 6.8% of women at 5 years (Figure 1). In comparison, chronic hypertension diagnoses among women with preeclampsia increased from 11.8% at 6 months to 26.8% at 5 years (p< 0.01 for comparisons at each time point). Risk for diabetes and hyperlipidemia (Figure 2A and 2B respectively) were also significantly higher at 6 months, and 1, 2, and 5 years postpartum for women with compared to without preeclampsia at delivery (p< 0.01 for all time points). This analysis found that risk for developing chronic hypertension was high in the immediate years following preeclampsia. Risk for diabetes and dyslipidemia was also increased for women with preeclampsia. These findings support the importance of subsequent health screening for women with preeclampsia.View Large Image Figure ViewerDownload Hi-res image Download (PPT)