Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 København Ø, Denmark.
Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 København Ø, Denmark.
Eur J Prev Cardiol. 2024 Sep 20;31(13):1621-1630. doi: 10.1093/eurjpc/zwae176.
Pre-eclampsia (PE), a pregnancy-induced hypertensive disorder, affects 4-5% of pregnancies worldwide. It is well known that hypertension is associated with an increased risk of arrhythmias; however, data on the association between PE and arrhythmias are sparse.
In this observational cohort study, we identified all primiparous women who gave birth in Denmark (1997-2016) using Danish nationwide registries. The women were stratified on whether they developed PE during primiparous pregnancy and followed from primiparous pregnancy to incident arrhythmia, emigration, death, or end of study (31 December 2018). A total of 523 271 primiparous women with a median age of 28 years were included, and 23 367 (4.5%) were diagnosed with PE. During a median follow-up of 10.1 years, women with and without PE were associated with a higher incidence of arrhythmias (1.42 vs. 1.02%): (i) composite of cardiac arrest, ventricular tachycardia/fibrillation, or implantable cardioverter defibrillator implantation [adjusted hazard ratio (HR) 1.60, 95% confidence interval (CI) 1.14-2.24], (ii) composite of advanced second- or third-degree atrioventricular block, sinoatrial dysfunction, or pacemaker implantation [adjusted HR 1.48 (95% CI 0.97-2.23)], (iii) composite of supraventricular tachyarrhythmias or extra systoles [adjusted HR 1.34 (95% CI 1.19-1.51)], and (iv) composite of all the above-mentioned arrhythmias [adjusted HR 1.37 (95% CI 1.23-1.54)].
Pre-eclamptic women were associated with a significantly and at hitherto unknown long-term increased rate of arrhythmias. This finding suggests that women with PE may benefit from cardiovascular risk assessment, screening, and preventive education.
子痫前期（PE）是一种妊娠高血压疾病，影响全球 4-5%的妊娠。众所周知，高血压与心律失常风险增加有关；然而，PE 与心律失常之间关联的数据较为匮乏。
在这项观察性队列研究中，我们使用丹麦全国性登记册，确定了所有在丹麦分娩的初产妇（1997-2016 年）。根据她们在初产妇妊娠期间是否发生 PE 进行分层，并随访至初产妇妊娠后出现心律失常、移民、死亡或研究结束（2018 年 12 月 31 日）。共纳入 523271 名初产妇，中位年龄为 28 岁，其中 23367 人（4.5%）被诊断为 PE。中位随访 10.1 年后，患有和未患有 PE 的女性心律失常发生率更高（1.42%对 1.02%）：（i）心搏骤停、室性心动过速/颤动或植入式心脏复律除颤器植入的复合终点[校正后的危险比（HR）1.60，95%置信区间（CI）1.14-2.24]；（ii）房室传导阻滞Ⅱ度或Ⅲ度、窦房结功能障碍或起搏器植入的复合终点[校正 HR 1.48（95% CI 0.97-2.23）]；（iii）室上性心动过速或期外收缩的复合终点[校正 HR 1.34（95% CI 1.19-1.51）]；（iv）上述所有心律失常的复合终点[校正 HR 1.37（95% CI 1.23-1.54）]。
患有子痫前期的女性心律失常发生率显著且在以前未知的长期增加。这一发现表明，PE 女性可能受益于心血管风险评估、筛查和预防教育。
