Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Am J Hypertens. 2024 Jun 14;37(7):523-530. doi: 10.1093/ajh/hpae034.
Preeclampsia in a first pregnancy is a strong risk factor for preeclampsia in a second pregnancy. Whether chronic hypertension developed after a first pregnancy (interpregnancy hypertension) affects the recurrence risk of preeclampsia is unknown.
This is a population-based cohort study of 391,645 women with their first and second singleton births between 2006 and 2017. Exposure groups were women with preeclampsia in their first pregnancy, interpregnancy hypertension, or both risk factors. Women with neither risk factor were used as a reference group. We calculated the adjusted relative risk (aRR) with 95% confidence intervals (CIs) for overall preeclampsia in the second pregnancy as well as preterm (<37 gestational weeks) and term (≥37 gestational weeks) subgroups of the disease.
Women with preeclampsia in their first pregnancy who did or did not develop interpregnancy hypertension had rates of preeclampsia in their second pregnancy of 21.5% and 13.6%, respectively. In the same population, the corresponding rates of preterm preeclampsia were 5.5% and 2.6%, respectively. After adjusting for maternal factors, women with preeclampsia in their first pregnancy who developed interpregnancy hypertension and those who did not have almost the same risk of overall preeclampsia in their second pregnancy (aRRs with 95% CIs: 14.51; 11.77-17.89 and 12.83; 12.09-13.62, respectively). However, preeclampsia in the first pregnancy and interpregnancy hypertension had a synergistic interaction on the outcome of preterm preeclampsia (aRR with 95% CI 26.66; 17.44-40.80).
Women with previous preeclampsia who developed interpregnancy hypertension had a very high rate of preterm preeclampsia in a second pregnancy, and the two risk factors had a synergistic interaction.
初产妇子痫前期是再次妊娠发生子痫前期的一个强危险因素。初产妇妊娠后发生的慢性高血压（interpregnancy hypertension）是否会影响子痫前期的复发风险尚不清楚。
这是一项基于人群的队列研究，纳入了 2006 年至 2017 年间首次分娩的 391645 名单胎产妇。暴露组为初产妇子痫前期、interpregnancy hypertension 或两种危险因素。无危险因素的产妇作为对照组。我们计算了第二胎妊娠总体子痫前期、早产（<37 孕周）和足月（≥37 孕周）亚组的调整相对风险（aRR）及 95%置信区间（CI）。
初产妇子痫前期且妊娠后发生 interpregnancy hypertension 的产妇第二胎妊娠子痫前期的发生率为 21.5%，初产妇子痫前期且妊娠后未发生 interpregnancy hypertension 的产妇第二胎妊娠子痫前期的发生率为 13.6%。在同一人群中，相应的早产子痫前期发生率分别为 5.5%和 2.6%。调整了产妇因素后，初产妇子痫前期且妊娠后发生 interpregnancy hypertension 的产妇与未发生 interpregnancy hypertension 的产妇，第二胎妊娠总体子痫前期的风险几乎相同（aRRs 及其 95%CI：14.51；11.77-17.89 和 12.83；12.09-13.62）。然而，初产妇子痫前期和 interpregnancy hypertension 对早产子痫前期的结局有协同作用（aRR 及其 95%CI：26.66；17.44-40.80）。
初产妇子痫前期且妊娠后发生 interpregnancy hypertension 的产妇在第二胎妊娠中发生早产子痫前期的风险非常高，且两种危险因素有协同作用。
