Abstract
Hypertensive disorders of pregnancy (HDP) comprise 4 subtypes. Previous studies have not investigated the relationship between stroke risk, different HDP subtypes, and follow-up time, which was the purpose of this study. Data of 17 588 women aged 18 to 45 years who had a history of HDP in Taiwan from 2000 to 2017 was retrospectively reviewed. After matching with confounders, 13 617 HDP women and 54 468 non-HDP women were recruited. HDP women had an adjusted hazard ratio (aHR) of 1.71 (95% CI, 1.46-2.00) for stroke, and 1.60 (1.35-1.89) and 2.98 (2.13-4.18) for ischemic and hemorrhagic stroke, respectively (P<0.001 for all). The overall stroke risk in the HDP group was still 2.04 times 10 to 15 years after childbirth (1.47-2.83, P<0.001). Although the risks of both ischemic and hemorrhagic stroke persisted, their risk time trends were different. The risk of ischemic stroke reached peak during 1 to 3 years after childbirth with an aHR of 2.14 (1.36-3.38), while hemorrhagic stroke risk gradually increased and had an aHR of 4.64 (2.47-8.73) after 10 to 15 years of childbirth (both P<0.001). Among the 4 HDP subtypes, chronic hypertension with superimposed preeclampsia had the highest stroke risk (aHR=3.86, 1.91-7.82, P<0.001), followed by preeclampsia-eclampsia (aHR=2.00, 1.63-2.45, P<0.001), and gestational hypertension (aHR=1.68, 1.13-2.52, P<0.05); chronic preexisting hypertension had the lowest stroke risk (aHR=1.27, 0.97-1.68, P>0.05). Furthermore, multiple HDP combined with preeclampsia had aHR of 5.48 (1.14-26.42, P<0.05). The effect of HDP on the risk of future stroke persisted for up to 17 years, both for ischemic and hemorrhagic strokes. The presence of multiple HDP and preeclampsia further increase the stroke risk.
Highlights
AND PURPOSE: Hypertensive disorders of pregnancy (HDP) comprise 4 subtypes
Multiple HDP combined with preeclampsia had adjusted hazard ratio (aHR) of 5.48 (1.14−26.42, P
5% to 10% of pregnancies are complicated by hypertensive disorders of pregnancy (HDP),[1,2] with an incidence of around 15.83 million worldwide in 2017.3 HDP is divided into 4 subtypes: chronic hypertension (HTN), chronic HTN with superimposed preeclampsia, preeclampsia/eclampsia, and gestational HTN.[4]
Summary
Data of 588 women aged to 45 years who had a history of HDP in Taiwan from 2000 to 2017 was retrospectively reviewed. 13 617 HDP women and 54 468 non-HDP women were recruited. We used the Taiwan National Health Insurance Research Database (NHIRD). The information contained within the database was released for research purposes by the Health and Welfare Data Science Center (HWDC), Ministry of Health and Welfare, Taiwan. The raw data from the NHIRD is available to the research community; the data must be analyzed within the HWDC after the study proposal is approved (https:// dep.mohw.gov.tw/dos/np-2497-113.html). The confidentiality assurances were addressed by following the data regulations of the HWDC. The study protocol, analytic methods, and statistical programming codes are available from the corresponding author on reasonable request.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
