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. Author manuscript; available in PMC: 2019 Jul 1.
Published in final edited form as: Ann Intern Med. 2018 Jul 3;169(4):224–232. doi: 10.7326/M17-2740
Pregnancy History at Age 40 Chronic Hypertension Type 2 Diabetes Mellitus Hypercholesterolemia
First Pregnancy Second or Later Pregnancies Cases Person- years HR (95% CI) Cases Person- years HR (95% CI) Cases Person- years HR (95% CI)
Normotensive All Normotensive 9,504 554,504 1.00 (Ref) 1,428 659,537 1.00 (Ref) 16,209 526,278 1.00 (Ref)
Normotensive No further pregnancies 1,756 101,586 1.02 (0.97, 1.08) 289 122,653 1.01 (0.89, 1.15) 3,071 95,855 1.05 (1.01, 1.09)
Normotensive Any HDP 434 11,272 2.40 (2.18, 2.64) 90 16,224 2.12 (1.71, 2.63) 481 12,353 1.30 (1.19, 1.43)
HDP All Normotensive 896 29,288 1.85 (1.73, 1.98) 147 38,626 1.63 (1.38, 1.94) 1,071 30,384 1.21 (1.13, 1.28)
HDP No further pregnancies 357 9,682 2.24 (2.01, 2.49) 72 13,609 1.83 (1.44, 2.33) 420 10,121 1.45 (1.32, 1.60)
HDP Any HDP 357 6,628 3.53 (3.17, 3.93) 65 10,545 2.17 (1.69, 2.79) 319 8,159 1.32 (1.18, 1.48)

HDP = hypertensive disorders of pregnancy. The six exposure categories included in this table are: 1) Normotension in all pregnancies, 2) Normotension in first pregnancy, no additional pregnancies, 3) Normotension in first pregnancy, HDP (preeclampsia or gestational hypertension) in at least one later pregnancy, 4) HDP in first pregnancy, normotension in all subsequent pregnancies, 5) HDP in first pregnancy, no additional pregnancies, and 6) HDP in first pregnancy with recurrence in at least one later pregnancy. Women free from the endpoint at age 40 and with no births after age 40 contribute person-time to the models above from age 40 on.

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).