Table 3:
Risk of CVD disease in first 24 months’ postpartum for women with hypertensive disorders of pregnancy (HDP), deliveries in Maine 2007–2019, n=119,422
| Unadjusted HR (95% CI) | Adjusted HR (95% CI) a | |
|---|---|---|
|
| ||
| Heart failure | ||
| No-HDP | Reference | Reference |
| HDP | 4.40 ( 3.32, 5.84) | 2.81 ( 1.90, 4.15) |
| Ischemic heart disease | ||
| No-HDP | Reference | Reference |
| HDP | 2.34 ( 1.56, 3.52) | 0.92 ( 0.55, 1.54) |
| Cerebrovascular disease/stroke | ||
| No-HDP | Reference | Reference |
| HDP | 2.06 ( 1.64, 2.58) | 1.43 ( 1.07, 1.91) |
| Arrhythmia/cardiac arrest | ||
| No-HDP | Reference | Reference |
| HDP | 1.21 ( 0.77, 1.91) | 0.90 ( 0.52, 1.57) |
| Cardiomyopathy | ||
| No-HDP | Reference | Reference |
| HDP | 4.13 ( 3.11, 5.48) | 2.90 ( 1.96, 4.27) |
| Severe cardiac disease (heart failure, stroke, or cardiomyopathy) | ||
| No-HDP | Reference | Reference |
| HDP | 2.69 (2.28, 3.16) | 1.90 (1.54, 2.36) |
| New chronic hypertension (43+ days after delivery)b | ||
| No-HDP | Reference | Reference |
| HDP | 7.30 ( 6.61, 8.06) | 7.29 ( 6.57, 8.09) |
Data source: Maine Health Data Organization’s All Payer Claims Data
CI=confidence interval; CVD= cardiovascular disease; HR= hazard ratio; HDP=hypertensive disorders of pregnancy
Adjusted for maternal age at time of delivery (continuous), pre-pregnancy depression (yes/no), pre-existing chronic hypertension (yes/no; for chronic hypertension models, these observations were excluded), pre-pregnancy diabetes (yes/no), obesity (yes/no), smoking (yes/no), nulliparity (yes/no), pregnancy number in dataset (continuous), year of delivery (continuous), Medicaid coverage during pregnancy (months covered, continuous), county-level measures (ratio of population to primary care physicians [continuous]; percentage uninsured adults [continuous]; percentage smoking adults [continuous]; percentage of adults with obesity [continuous]), ZIP-code level measures (percentage of non-white residents [continuous], percentage of adults with no Bachelor’s degree [continuous], percentage of persons living below poverty level [continuous]), prenatal depression (yes/no), and gestational diabetes (yes/no).
Hypertension diagnoses in the first 42 days’ postpartum were not included as chronic hypertension outcomes, as these were included in the definition of hypertensive disorders of pregnancy.