What question did this study set out to answer?

To evaluate whether hypertensive disorders of pregnancy are associated with an increased risk of cardiomyopathy beyond the peripartum period.

March 8, 2016JAMAOpen Access

Association Between Hypertensive Disorders of Pregnancy and Later Risk of Cardiomyopathy

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Why the study?

Does a history of hypertensive disorders of pregnancy increase the risk of cardiomyopathy beyond the peripartum period in women?

Key Points

To evaluate whether hypertensive disorders of pregnancy are associated with an increased risk of cardiomyopathy beyond the peripartum period.
Nationwide register-based cohort study of 1,075,763 women with 2,067,633 eligible pregnancies in Denmark between 1978 and 2012, followed through December 31, 2012.
Used Cox proportional hazards regression to evaluate exposures of severe preeclampsia, moderate preeclampsia, and gestational hypertension.
Tracked incident cardiomyopathy diagnosed more than 5 months after delivery for up to 34 years and 7 months.
Compared with normotensive pregnancies (7.7 events/100,000 person-years), cardiomyopathy rates were significantly elevated following severe preeclampsia (15.6/100,000; adjusted HR, 2.20 [95% CI, 1.50-3.23]), moderate preeclampsia (14.6/100,000; adjusted HR, 1.89 [95% CI, 1.55-2.23]), and gestational hypertension (17.3/100,000; adjusted HR, 2.06 [95% CI, 1.50-2.82]).
Increased cardiomyopathy risks persisted more than 5 years after the latest pregnancy, with mediation analyses indicating only about 50% of the association was mediated through chronic postpregnancy hypertension.

Structured PICO

Does a history of hypertensive disorders of pregnancy increase the risk of cardiomyopathy beyond the peripartum period in women?

Population

1,075,763 women with at least 1 pregnancy ending in live birth or stillbirth in Denmark, 1978-2012.

Intervention

Hypertensive disorder of pregnancy (severe or moderate preeclampsia or gestational hypertension)

Comparator

Normotensive pregnancies

Outcome

Cardiomyopathy more than 5 months after delivery (outside the peripartum period) up to 34 years 7 monthshard clinical

A history of hypertensive disorders of pregnancy is associated with an approximately twofold increased risk of developing cardiomyopathy later in life, beyond the peripartum period.

Discussion

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Implication

May warrant long-term cardiomyopathy vigilance after hypertensive pregnancy disorders; hypothesis-generating for screening or prevention trials.

Cite This Study

Behrens et al. (2016) studied this question.

synapsesocial.com/papers/69fd56575c6eda218801915f https://doi.org/10.1001/jama.2016.1869

Topics

Cardiomyopathy

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Implication

May warrant long-term cardiomyopathy vigilance after hypertensive pregnancy disorders; hypothesis-generating for screening or prevention trials.

Association Between Hypertensive Disorders of Pregnancy and Later Risk of Cardiomyopathy

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Association Between Hypertensive Disorders of Pregnancy and Later Risk of Cardiomyopathy

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider