Spangler, J. (Johanna) (2017) Association of maternal early-onset hypertensive disorders of pregnancy and foetal growth restriction followed by iatrogenic preterm birth with the mother’s health status 10-13 years after delivery. thesis, Medicine.
Full text available on request.Abstract
Introduction: Women with a history of early-onset hypertensive disorders of pregnancy (HDP) have an increased risk of developing future cardiovascular diseases (CVD). Most research focused on the identification of risk factors shortly after pregnancy or ≥20 years post-partum; less is known about the fourth and fifth decade of life when the first signs of CVD are expected. The aim of this study was to investigate if women with a history of early-onset HDP and foetal growth restriction (FGR) followed by iatrogenic preterm-birth are at an increased risk for CVD one decade after delivery and if this timing is suitable for screening and prevention measures of CVD. Methods: We conducted a cross-sectional study with help of the PETRA and HELIUS databases. In our study we included 101 women with a history of early-onset HDP (<34 weeks ‘gestation) and FGR followed by iatrogenic preterm birth from the PETRA trial and 405 women with normotensive pregnancies were matched from the HELIUS study. One decade postpartum the health status of these women was compared. It was assessed by a questionnaire addressing the presence of CVD as well as risk factors and determinants of it. The window of opportunity of preventive measures was defined by the presence of cardiovascular risk factors and the absence of CVD. Results: 39% of the women with a history of early-onset HDP had hypertension at a mean age of 44 years (SD ± 7.0) compared to 17% of the women with a normotensive pregnancy at a mean age of 42 years (SD ± 5.1) one decade after the index pregnancy (p<0.001). These women still had significant higher rates of hypertension after adjustment for maternal age, maternal BMI, smoking, physical activity, parity and ethnicity (95% CI 2.29-8.75). One decade postpartum, 42% of the women with a history of early-onset HDP were still in the window of opportunity for preventive measures. Conclusion: Women with a history of early-onset HDP had almost two times higher rates of hypertension compared to women with a normotensive pregnancy and almost halve of these women are still in the window of opportunity for preventive measures one decade after the index pregnancy. Further studies are necessary to analyse women with a history of HDP in their 4th and 5th decade of life concerning suitable timing for screening and implementation of preventive measures in order to prohibit development of CVD.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisors: and Ganzevoort Dr. J.W. MD PhD and Horen, E. van and Linden Dr. P.J.Q. van der ; and Department of Obstetrics & Gynaecology, Academic Medical Cen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/785 |
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