OP 37 Familial co-aggregation of preeclampsia and cardiovascular disease

Abstract

Introduction Women with a history of preeclampsia (PE) have an increased risk of cardiovascular disease (CVD) later in life. To assess whether PE and CVD might share underlying, potentially heritable mechanisms, we examined the familial co-aggregation of PE and CVD. Objectives To determine whether PE in daughters is associated with CVD in parents, by timing of PE onset in the daughters and type of CVD in the parents. Material and methods Using Danish health and civil registers, we identified all women with pregnancies in 1978–2015, along with their parents (656,027 mothers and 581,035 fathers). We followed the parents from the first pregnancy in a daughter until registration of an ischemic event (myocardial infarction [MI], cerebrovascular infarction or ischemic heart disease), death, immigration or the end of follow-up (31 December 2015). Using Cox regression, we estimated hazard ratios (HRs) for ischemic events in parents by history of PE in daughters. Results Parents with one daughter with a history of PE had 1.15 (95% confidence interval [CI] 1.13–1.18) times the rate of ischemic events as parents whose daughters had no history of PE. Having two or more daughters with a history of PE yielded an HR of 1.28 (95% CI 1.13–1.45). The corresponding HRs for MI alone were 1.21 (95% CI 1.17–1.25, 1 daughter with PE) and 1.55 (95% CI 1.29–1.86, ⩾ 2 daughters with PE). Effect magnitudes did not differ for mothers and fathers. Early-onset (delivery Conclusion PE in daughters is associated with an increased risk of ischemic events, MI in particular, in parents. Increasing strength of association with increasing number of affected daughters, similar effect magnitudes for mothers and fathers, and stronger associations with early-onset PE than with term PE, all suggest that the association between PE and CVD can be explained by common heritable mechanisms, rather than shared behavioral risk factors.