Abstract 17370: Multiple Pregnancy Factors and Later Hypertension in Swedish Women From the Vasterbotten Intervention Programme

Abstract

Introduction: Pregnancy is considered a maternal cardiometabolic stress test. However, it is uncertain when considered together, which set of pregnancy characteristics independently relate to later hypertension (HTN) in women. Methods: We used Swedish Medical Birth Register data linked with the Vasterbotten Intervention Programme cohort from Northern Sweden. Using logistic regression analysis in crude and multivariable adjusted models, we related pregnancy factors in any prior pregnancy with HTN at age 40 years in parous women free of prepregnancy HTN. Pregnancy factors included parity, age at first delivery, infertility ≥ 5 years, preeclampsia, delivering a small for gestational age baby (SGA, < 3rd percentile for birthweight), gestational age (shortest), placental abruption and gestational diabetes. We defined HTN as systolic BP ≥ 140 and/or DBP ≥ 90 mmHg and/or antihypertensive use. Multivariable models were adjusted for all pregnancy factors as well as for potential confounders including household income, education, smoking, alcohol intake and body mass index. Results: Among n=15,900 women, 1,535 women (9.6%) had HTN at age 40 years. In multivariable models, younger age at first birth, preeclampsia, gestational age < 32 weeks and SGA, were associated with HTN (Table). Gestational diabetes and stillbirth were related to HTN in unadjusted models but not in multivariable models. Parity, infertility and placental abruption were not related to HTN at age 40 years in crude or multivariable models. Conclusions: Younger age at first birth, preeclampsia and delivering a very preterm or small for gestational age baby were independently associated with maternal hypertension at age 40 years upon accounting for sociodemographic and lifestyle factors. Our findings, if confirmed, raise the possibility that earlier and more frequent BP screening may be desirable in women with these pregnancy characteristics.