Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Neurology, Medical University of South Carolina, Charleston, SC 29425, USA.
Int J Environ Res Public Health. 2024 Jan 12;21(1):89. doi: 10.3390/ijerph21010089.
Hypertensive disorders of pregnancy (HDP) and pre-pregnancy hypertension contribute to maternal morbidity and mortality. We examined the association of HDP and pre-pregnancy hypertension with subsequent venous thromboembolic (VTE) events. The retrospective cohort study included 444,859 women with ≥1 live, singleton birth in South Carolina (2004-2016). Hospital and emergency department visit and death certificate data defined incident VTE, HDP, and pre-pregnancy hypertension. Birth certificate data also defined the exposures. Adjusted Cox proportional hazards methods modeled VTE events risk. Of the cohort, 2.6% of women had pre-pregnancy hypertension, 5.8% had HDP, 2.8% had both pre-pregnancy hypertension and HDP (both conditions), and 88.8% had neither condition. The risk of incident VTE events within one year of delivery was higher in women with HDP (hazard ratio [HR] = 1.62, 95% confidence interval [CI]: 1.15-2.29) and both conditions (HR = 2.32, 95% CI: 1.60-3.35) compared to those with neither condition as was the risk within five years for women with HDP (HR = 1.35, 95% CI: 1.13-1.60) and for women with both conditions (HR = 1.82, 95% CI: 1.50-2.20). One- and five-year risks did not differ in women with pre-pregnancy hypertension compared to women with neither condition. Compared to non-Hispanic White (NHW) women with neither condition, the incident VTE event risk was elevated within five years of delivery for NHW (HR = 1.29, 95% CI: 1.02-1.63; HR = 1.59, 95% CI: 1.16-2.17) and non-Hispanic Black (NHB; HR = 1.51, 95% CI: 1.16-2.96; HR = 2.08, 95% CI: 1.62-2.66) women with HDP and with both conditions, respectively, and for NHB women with pre-pregnancy hypertension (HR = 1.50, 95% CI: 1.09-2.07). VTE event risk was highest in women with HDP, and the event rates were higher in NHB women than in NHW women in the same exposure group.
妊娠高血压疾病（HDP）和孕前高血压与产妇发病率和死亡率有关。我们研究了 HDP 和孕前高血压与随后静脉血栓栓塞（VTE）事件的关系。这项回顾性队列研究纳入了南卡罗来纳州≥1 次活产、单胎分娩的 444859 名妇女（2004-2016 年）。医院和急诊就诊以及死亡证明数据定义了 VTE、HDP 和孕前高血压的发病情况。出生证明数据还定义了暴露情况。采用校正的 Cox 比例风险模型来分析 VTE 事件的风险。在该队列中，2.6%的妇女患有孕前高血压，5.8%患有 HDP，2.8%同时患有孕前高血压和 HDP（两种情况），88.8%的妇女没有这两种情况。与无上述两种情况的妇女相比，HDP 组（风险比[HR] = 1.62，95%置信区间[CI]：1.15-2.29）和同时患有两种情况的妇女（HR = 2.32，95%CI：1.60-3.35）在分娩后一年内发生 VTE 事件的风险更高，HDP 组（HR = 1.35，95%CI：1.13-1.60）和同时患有两种情况的妇女（HR = 1.82，95%CI：1.50-2.20）在五年内发生 VTE 事件的风险也更高。与无上述两种情况的妇女相比，孕前高血压妇女在五年内的风险没有差异。与无上述两种情况的非西班牙裔白人（NHW）妇女相比，在分娩后五年内，HDP 组的 NHW 妇女（HR = 1.29，95%CI：1.02-1.63；HR = 1.59，95%CI：1.16-2.17）和非西班牙裔黑人（NHB；HR = 1.51，95%CI：1.16-2.96；HR = 2.08，95%CI：1.62-2.66）的 VTE 事件风险升高，HDP 组的 NHB 妇女（HR = 1.50，95%CI：1.09-2.07）和孕前高血压的 NHB 妇女（HR = 1.50，95%CI：1.09-2.07）的 VTE 事件风险也升高。HDP 妇女的 VTE 事件风险最高，而在相同暴露组中，NHB 妇女的事件发生率高于 NHW 妇女。
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