Table 3.
Hazard ratios (95% confidence intervals) for hypertensive disorders in first pregnancy and cardiovascular disease risk factors by years since first birth within five-year intervals, compared to normotensive first pregnancy (reference)
| Hypertensive Disorder in First Pregnancy Status | |||
|---|---|---|---|
| Cases/Person-years | Gestational Hypertension | Preeclampsia | |
| Chronic Hypertension | |||
| ≤5 years | 371/292,788 | 4.29 (3.16, 5.84) | 3.96 (3.07, 5.11) |
| 6–10 years | 1,228/287,252 | 3.62 (3.01, 4.34) | 3.59 (3.11, 4.15) |
| 11–15 years | 2,390/273,710 | 2.92 (2.51, 3.38) | 2.62 (2.33, 2.95) |
| 16–20 years | 3,570/248,421 | 2.87 (2.51, 3.28) | 2.04 (1.83, 2.27) |
| 21–25 years | 4,290/205,778 | 2.18 (1.86, 2.54) | 1.94 (1.75, 2.16) |
| 26–30 years | 3,899/144,421 | 2.08 (1.72, 2.51) | 1.78 (1.57, 2.00) |
| 31–35 years | 2,382/81,124 | 1.81 (1.34, 2.43) | 1.85 (1.57, 2.18) |
| 36–40 years | 1,029/35,295 | 2.04 (1.26, 3.30) | 1.39 (1.03, 1.88) |
| Type 2 Diabetes Mellitus | |||
| ≤5 years | 11/284,750 | *** | *** |
| 6–10 years | 72/287,619 | 2.08 (0.97, 4.49) | 2.64 (1.43, 4.87) |
| 11–15 years | 220/290,780 | 1.29 (0.77, 2.17) | 1.51 (1.01, 2.25) |
| 16–20 years | 472/283,769 | 0.86 (0.54, 1.37) | 2.06 (1.61, 2.65) |
| 21–25 years | 756/260,885 | 1.77 (1.30, 2.41) | 2.03 (1.64, 2.50) |
| 26–30 years | 863/207,632 | 1.93 (1.44, 2.60) | 1.59 (1.27, 1.99) |
| 31–35 years | 754/134,730 | 1.67 (1.13, 2.46) | 1.62 (1.26, 2.07) |
| 36–40 years | 454/67,523 | 2.55 (1.62, 4.00) | 1.85 (1.34, 2.56) |
| Hypercholesterolemia | |||
| ≤5 years | 1,642/291,114 | 1.37 (1.09, 1.72) | 1.44 (1.22, 1.70) |
| 6–10 years | 3,050/279,052 | 1.26 (1.05, 1.51) | 1.53 (1.35, 1.72) |
| 11–15 years | 4,583/259,806 | 1.18 (1.01, 1.38) | 1.30 (1.17, 1.45) |
| 16–20 years | 5,999/229,863 | 1.38 (1.20, 1.57) | 1.21 (1.09, 1.34) |
| 21–25 years | 6,356/185,154 | 1.41 (1.23, 1.62) | 1.30 (1.18, 1.43) |
| 26–30 years | 5,590/125,494 | 1.33 (1.13, 1.57) | 1.16 (1.04, 1.30) |
| 31–35 years | 3,483/67,843 | 1.28 (1.02, 1.62) | 1.29 (1.12, 1.49) |
| 36–40 years | 1,566/27,832 | 1.77 (1.28, 2.45) | 1.13 (0.88, 1.43) |
Models are adjusted for age at first birth (years), age in 1989 (years), race/ethnicity (African-American, Latina, Asian, Caucasian (ref), other), parental education (<9, 9–11, 12, 13–15, ≥16 years (ref)), physical activity at ages 18–22 (never, 1–3 (ref), 4–6, 7–9, 10–12 mo/yr), pre-pregnancy smoking (never (ref), past, current), pre-pregnancy BMI (<18.5, 18.5–24.9 (ref), 25–29.9, ≥30 kg/m2), pre-pregnancy alcohol consumption (none (ref), ≤1 drink/week, 2–6/week, ≥1/day), pre-pregnancy Alternative Healthy Eating Index (AHEI) score (quintiles with the fifth quintile (ref) representing the healthiest diet category), pre-pregnancy oral contraceptive use (never (ref), <2, 2-<4, ≥4 years), and family history of chronic hypertension (yes/no; chronic hypertension model only) and family history of type 2 diabetes mellitus (yes/no; type 2 diabetes mellitus model only). Due to small cell counts, for the type 2 diabetes mellitus model from 6–10 years, women with missing pre-pregnancy smoking (n=352), strenuous physical activity from 18–22 (n=348), and pre-pregnancy alcohol consumption (n=249) were excluded from the analysis.
Small case numbers resulted in unstable estimates for type 2 diabetes mellitus ≤5 years after first birth, as there was n=1 case among women with gestational hypertension and no cases among women with preeclampsia.