Hypertensive Disorder in Pregnancy & Gestation Length at Delivery Status | |||||||
---|---|---|---|---|---|---|---|
Term (≥37 weeks) | Preterm (<37 weeks) | ||||||
Normotensive Pregnancy 49,099 (83.7%) | Gestational Hypertension 1,566 (2.7%) | Preeclampsia 3,112 (5.3%) | Hypertensive Disorder of Pregnancy 4,678 (8.0%) | Gestational Hypertension 133 (0.2%) | Preeclampsia 575 (1.0%) | Hypertensive Disorder of Pregnancy 708 (1.2%) | |
Chronic Hypertension | |||||||
Cases/Person-years | 15,234/1,347,395 | 903/32,892 | 1,624/72,261 | 2,527/105,153 | 76/2,676 | 298/12,056 | 374/14,732 |
Excess cases per 10,000 person-years | --- | 161 | 112 | 127 | 171 | 134 | 141 |
Model 1 | 1.00 (ref) | 3.19 (2.98, 3.41) | 2.42 (2.30, 2.55) | 2.65 (2.54, 2.76) | 3.36 (2.68, 4.21) | 2.78 (2.48, 3.12) | 2.88 (2.60, 3.19) |
Model 2 | 1.00 (ref) | 2.82 (2.63, 3.01) | 2.18 (2.07, 2.29) | 2.37 (2.27, 2.47) | 2.70 (2.15, 3.39) | 2.51 (2.24, 2.82) | 2.54 (2.29, 2.82) |
Type 2 Diabetes Mellitus | |||||||
Cases/Person-years | 2,836/1,560,189 | 171/46,261 | 379/95,969 | 550/142,230 | 16/3,687 | 56/16,375 | 72/20,062 |
Excess cases per 10,000 person-years | --- | 19 | 21 | 20 | 25 | 16 | 18 |
Model 1 | 1.00 (ref) | 2.15 (1.84, 2.51) | 2.26 (2.03, 2.51) | 2.22 (2.03, 2.44) | 2.49 (1.52, 4.07) | 2.03 (1.56, 2.64) | 2.11 (1.67, 2.67) |
Model 2 | 1.00 (ref) | 1.66 (1.42, 1.94) | 1.80 (1.62, 2.01) | 1.76 (1.60, 1.93) | 1.79 (1.09, 2.93) | 1.60 (1.23, 2.09) | 1.64 (1.29, 2.07) |
Hypercholesterolemia | |||||||
Cases/Person-years | 26,877/1,246,593 | 992/35,235 | 1,928/73,179 | 2,920/108,414 | 82/2,810 | 351/12,199 | 433/15,009 |
Excess cases per 10,000 person-years | --- | 66 | 48 | 54 | 76 | 72 | 73 |
Model 1 | 1.00 (ref) | 1.43 (1.34, 1.52) | 1.33 (1.27, 1.39) | 1.36 (1.31, 1.41) | 1.52 (1.22, 1.89) | 1.52 (1.37, 1.69) | 1.52 (1.38, 1.67) |
Model 2 | 1.00 (ref) | 1.36 (1.28, 1.45) | 1.29 (1.23, 1.35) | 1.31 (1.26, 1.36) | 1.46 (1.18, 1.82) | 1.49 (1.34, 1.66) | 1.49 (1.35, 1.63) |
Tests for effect modification by preterm delivery: p=0.08 for chronic hypertension, p=0.68 for type 2 diabetes mellitus, and p=0.03 for hypercholesterolemia.
Model 1 is adjusted for age at first birth (years), age in 1989 (years), race/ethnicity (African-American, Latina, Asian, Caucasian (ref), other), and parental education (<9, 9–11, 12, 13–15, ≥16 years (ref)).
Model 2 is additionally adjusted for 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).
These results are drawn from 6 different models—one model with hypertensive disorders in pregnancy and normotensive first pregnancies split out by term and preterm delivery (i.e. 4 exposure categories) and another model with preeclamptic, gestational hypertensive, and normotensive first pregnancies split out by term and preterm deliveries (i.e. 6 exposure categories) for each of the 3 CVD risk factor outcomes; normotensive term served as the reference group for all contrasts. Results for women with normotensive preterm are not shown above but were obtained within the same models: fully-adjusted chronic hypertension HR=1.10 (95% CI: 1.04, 1.16); type 2 diabetes mellitus HR=1.20 (1.06, 1.35); hypercholesterolemia HR=1.08 (1.03, 1.12).