Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566.
To investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not.
Population-based longitudinal open cohort study.
English primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases.
Women exposed to PPH during the study period matched for age and date of delivery, and unexposed.
We conducted an open cohort study using linked primary care THIN and HES Databases, from 1 January 1997 to 31 January 2018. A total of 42 327 women were included: 14 109 of them exposed to PPH during the study period and 28 218 matched for age and date of delivery, and unexposed to PPH. HRs for cardiovascular outcomes among women who had and did not have PPH were estimated after controlling for covariates using multivariate Cox regression models.
Risk of hypertensive disease, ischaemic heart disease, heart failure, stroke or transient ischaemic attack.
During a median follow-up of over 4 years, there was no significant difference in the risk of hypertensive disease after adjustment for covariates (adjusted HR (aHR): 1.03 (95% CI: 0.87 to 1.22); p=0.71). We also did not observe a statistically significant difference in the risk of composite CVD (ischaemic heart disease, heart failure, stroke or transient ischaemic attack) between the exposed and the unexposed cohort (aHR: 0.86 (95% CI: 0.52 to 1.43; p=0.57).
Over a median follow-up of 4 years, we did not observe an association between PPH and hypertension or CVD.
调查与未发生产后出血（PPH）的女性相比，发生 PPH 的女性发生高血压和心血管疾病（CVD）的长期风险。
基于人群的纵向开放队列研究。
英国初级保健（健康改善网络（THIN））和二级保健（住院事件统计（HES））数据库。
在研究期间发生 PPH 的女性与年龄和分娩日期相匹配且未发生 PPH 的女性。
我们使用链接的初级保健 THIN 和 HES 数据库进行了一项开放队列研究，时间范围为 1997 年 1 月 1 日至 2018 年 1 月 31 日。共纳入 42327 名女性：其中 14109 名女性在研究期间发生 PPH，28218 名女性与年龄和分娩日期相匹配且未发生 PPH。使用多变量 Cox 回归模型控制协变量后，估计发生 PPH 和未发生 PPH 的女性发生心血管结局的 HR。
高血压疾病、缺血性心脏病、心力衰竭、中风或短暂性脑缺血发作的风险。
在超过 4 年的中位随访期间，调整协变量后，高血压疾病的风险无显著差异（调整后的 HR（aHR）：1.03（95%CI：0.87 至 1.22）；p=0.71）。我们也未观察到暴露组与未暴露组之间复合 CVD（缺血性心脏病、心力衰竭、中风或短暂性脑缺血发作）风险存在统计学差异（aHR：0.86（95%CI：0.52 至 1.43；p=0.57）。
在中位随访 4 年期间，我们未观察到 PPH 与高血压或 CVD 之间存在关联。
