Rutgers Robert Wood Johnson Medical School, Cardiovascular Institute of New Jersey, New Brunswick, New Jersey.
Department of Ob/Gyn and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
J Womens Health (Larchmt). 2020 Jan;29(1):74-83. doi: 10.1089/jwh.2019.7671. Epub 2019 Aug 16.
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. 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. Women with PE ( = 6,360) were more likely to suffer MI, stroke, CV death, and all-cause death than controls ( = 325,347). After matching cases to controls for demographics and comorbidities, hazard ratios of PE cases for the outcomes of MI ( adjusted for comorbidities and demographics = 0.0196), CV death (adjusted = 0.007), and all-cause death (adjusted = 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. 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.
子痫前期 (PE) 可能导致母婴死亡和严重的医疗并发症。了解 PE 患者未来 15 年内的短期和长期心血管 (CV) 结局对女性健康非常重要。一项回顾性匹配病例对照研究评估了 1999 年至 2013 年间，患有 PE 的初产妇病例组和未被诊断为 PE 的初产妇对照组在 15 年内 CV 结局的风险。该研究使用了新泽西州电子出生证明 (EBC) 数据库和新泽西州所有住院患者的数据库 Myocardial Infarction Data Acquisition System (MIDAS) 进行分析，该数据库具有纵向随访功能。参与者为 18 岁及以上，人口统计学特征与新泽西州一致，该州具有多种种族和民族多样性。主要观察指标为产后和 15 年内的心肌梗死 (MI)、中风、CV 死亡和全因死亡。与对照组 ( = 325,347) 相比，患有 PE 的女性 ( = 6,360) 更易发生 MI、中风、CV 死亡和全因死亡。对病例和对照组进行人口统计学和合并症匹配后，PE 病例组 MI (合并症和人口统计学因素调整后 HR = 0.0196)、CV 死亡 (调整后 HR = 0.007) 和全因死亡 (调整后 HR = 0.0026) 的结局发生风险比 1 显著更高。患有 PE 的女性发生 MI 的风险比对照组高 3.94 倍 (95% CI: 1.25-12.4)，发生 CV 死亡的风险比对照组高 4.66 倍 (95% CI: 1.52-14.26)，发生全因死亡的风险比对照组高 2.32 倍 (95% CI: 1.34-4.02)。这项为期 15 年的研究表明，初产妇患有 PE 时发生不良 CV 结局的风险明显高于对照组，建议对该人群在产后进行强化和持续的 CV 监测。
