Faculty of Medicine University of Montreal Montreal QC Canada.
University of Montreal Hospital Research Centre Montreal QC Canada.
J Am Heart Assoc. 2023 Jun 6;12(11):e029298. doi: 10.1161/JAHA.122.029298. Epub 2023 Jun 1.
Background Hyperemesis gravidarum is associated with preeclampsia, but it is unclear whether hyperemesis gravidarum is a risk factor for cardiovascular disease. We assessed the long-term risk of cardiovascular disease in women who experienced hyperemesis gravidarum with or without preeclampsia. Methods and Results We analyzed a longitudinal cohort of 1 413 166 pregnant women in Quebec between 1989 and 2021. Women were followed from their first pregnancy up to 3 decades later. We computed hazard ratios (HRs) and 95% CIs for the association of hyperemesis gravidarum, preeclampsia, or both conditions with subsequent risk of cardiovascular hospitalization using Cox regression models adjusted for baseline characteristics. Among 1 413 166 women, 16 288 (1.2%) had hyperemesis gravidarum only, 69 645 (4.9%) preeclampsia only, and 1103 (0.08%) had both conditions. After 32 years of follow-up, cardiovascular disease incidence was 17.7 per 100 women with hyperemesis gravidarum only, 28.2 per 100 women with preeclampsia only, 30.9 per 100 women with both exposures, and 14.0 per 100 women with neither exposure. Compared with no exposure, women with both hyperemesis and preeclampsia had the greatest risk of cardiovascular hospitalization (HR, 3.54 [95% CI, 3.03-4.14]), followed by women with preeclampsia only (HR, 2.58 [95% CI, 2.51-2.64]) and hyperemesis only (HR, 1.46 [95% CI, 1.38-1.54]). Having both hyperemesis gravidarum and preeclampsia was strongly associated with valve disease (HR, 3.38 [95% CI, 1.69-6.75]), heart failure (HR, 3.43 [95% CI, 1.79-6.59]), and cardiomyopathy (HR, 4.17 [95% CI, 1.99-8.76]). Conclusions Hyperemesis gravidarum is associated with the development of cardiovascular disease, whether preeclampsia is present or not.
妊娠剧吐与子痫前期有关，但妊娠剧吐是否是心血管疾病的危险因素尚不清楚。我们评估了患有妊娠剧吐伴有或不伴有子痫前期的女性发生心血管疾病的长期风险。
我们分析了魁北克省 1989 年至 2021 年间 1413166 名孕妇的纵向队列。从第一次妊娠开始对女性进行随访，随访时间长达 30 年。我们使用 Cox 回归模型，根据基线特征调整后，计算了妊娠剧吐、子痫前期或两者与随后心血管住院风险的关联的风险比（HR）和 95%置信区间。在 1413166 名女性中，16288 名（1.2%）仅有妊娠剧吐，69645 名（4.9%）仅有子痫前期，1103 名（0.08%）同时患有这两种疾病。在 32 年的随访后，仅有妊娠剧吐的女性心血管疾病发生率为每 100 名女性中 17.7 例，仅有子痫前期的女性发生率为每 100 名女性中 28.2 例，同时暴露于这两种疾病的女性发生率为每 100 名女性中 30.9 例，而未暴露于这两种疾病的女性发生率为每 100 名女性中 14.0 例。与无暴露相比，同时患有妊娠剧吐和子痫前期的女性发生心血管住院的风险最高（HR，3.54[95%CI，3.03-4.14]），其次是仅患有子痫前期的女性（HR，2.58[95%CI，2.51-2.64]）和仅患有妊娠剧吐的女性（HR，1.46[95%CI，1.38-1.54]）。同时患有妊娠剧吐和子痫前期与瓣膜疾病（HR，3.38[95%CI，1.69-6.75]）、心力衰竭（HR，3.43[95%CI，1.79-6.59]）和心肌病（HR，4.17[95%CI，1.99-8.76]）的发生密切相关。
无论是否存在子痫前期，妊娠剧吐均与心血管疾病的发生有关。
