Key result
First-pregnancy preeclampsia is linked to ~294% higher 15-year risk of MI and CV death.
Why the study?
Preeclampsia can lead to severe complications and maternal and infant mortality, making it important to understand its future short- and long-term cardiovascular outcomes.
Does preeclampsia during first pregnancy increase the risk of myocardial infarction, stroke, cardiovascular death, and all-cause death in women?
Case-Control (n=331,707)
Does preeclampsia during first pregnancy increase the risk of myocardial infarction, stroke, cardiovascular death, and all-cause death in women?
Hazard Ratio: 3.94 (95% CI 1.25–12.4)
p-value: p=0.0196
Preeclampsia during a first pregnancy is associated with a significantly increased long-term risk of myocardial infarction, cardiovascular death, and all-cause death over a 15-year follow-up.
Background: Preeclampsia (PE) may lead to maternal and infant mortality and severe medical complications. Understanding future short- and long-term cardiovascular (CV) outcomes of PE is important to women's health. Materials and Methods: A retrospective matched case–control study assessed the risks of CV outcomes over a 15-year period (1999–2013) in pregnant case women, with gravidity and parity of one, diagnosed with PE, compared to pregnant primiparous control women who were not diagnosed with PE. The New Jersey Electronic Birth Certificate (EBC) database and the Myocardial Infarction Data Acquisition System (MIDAS), a database of all hospital admissions in New Jersey with longitudinal follow-up, were used to conduct the analysis. Participants were 18 years and older with demographics consistent with New Jersey, a state with a range of racial and ethnic diversity. Main outcome measures postpregnancy and over this 15-year period were myocardial infarction (MI), stroke, CV death, and all-cause death. Results: Women with PE ( N = 6,360) were more likely to suffer MI, stroke, CV death, and all-cause death than controls ( N = 325,347). After matching cases to controls for demographics and comorbidities, hazard ratios of PE cases for the outcomes of MI ( p adjusted for comorbidities and demographics = 0.0196), CV death (adjusted p = 0.007), and all-cause death (adjusted p = 0.0026) were significantly higher than 1 compared to matched controls. Women with PE had 3.94 (95% CI: 1.25–12.4) times higher hazard for MI, 4.66 (95% CI: 1.52–14.26) times higher hazard of CV death, and 2.32 (95% CI: 1.34–4.02) times higher hazard for all-cause death than matched controls. Conclusions: This 15-year study indicates that women who have PE with their first pregnancy have a significantly higher risk of adverse CV outcomes compared to controls and suggest a heightened and continued CV monitoring after birth for this population of women.
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Gastrich et al. (2019) conducted a case-control in Preeclampsia (n=331,707). Preeclampsia vs. No preeclampsia was evaluated on Myocardial infarction (HR 3.94, 95% CI 1.25-12.4, p=0.0196). Preeclampsia in first pregnancy was associated with a significantly higher risk of myocardial infarction (HR 3.94; 95% CI 1.25-12.4; P=0.0196) and cardiovascular death over a 15-year period.
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