Table 2.
Comparison of the incidence of chronic conditions first occurring after the index date, between women with hypertensive disorders of pregnancy and 1:2 age- and parity-matched referent women
| HDP (N=571) | Referent (N=1,142) | Unadjusted models | Adjusted models* | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Individual Condition | N at risk† | Person-years | N events | N at risk‡ | Person-years | N events | HR (95% CI) | P‡ | HR (95% CI) | P‡ |
| Cardiac Arrhythmias | 563 | 13803 | 214 | 1138 | 26840 | 315 | 1.35 (1.13–1.61) | <0.001 | 1.33 (1.11–1.60) | 0.002 |
| Coronary Artery Disease | 570 | 15765 | 101 | 1141 | 29246 | 111 | 1.73 (1.32–2.28) | <0.001 | 1.59 (1.19–2.12) | 0.002 |
| Congestive Heart Failure | 570 | 16530 | 34 | 1142 | 30287 | 24 | 2.72 (1.60–4.64) | <0.001 | 2.11 (1.19–3.76) | 0.011 |
| Stroke | 570 | 16333 | 65 | 1142 | 29834 | 65 | 1.87 (1.32–2.63) | <0.001 | 1.76 (1.24–2.49) | 0.023 |
| Chronic Kidney Disease | 565 | 15861 | 79 | 1138 | 29755 | 86 | 1.78 (1.31–2.43) | <0.001 | 1.75 (1.28–2.41) | <0.001 |
| Dementia | 571 | 16630 | 28 | 1142 | 30237 | 28 | 1.85 (1.10–3.12) | 0.021 | 1.86 (1.10–3.15) | 0.020 |
| Depression | 555 | 12463 | 213 | 1112 | 23582 | 345 | 1.16 (0.98–1.38) | 0.078 | 1.15 (0.97–1.37) | 0.12 |
| Substance abuse | 568 | 15587 | 84 | 1134 | 28877 | 121 | 1.30 (0.98–1.71) | 0.068 | 1.37 (1.04–1.82) | 0.028 |
| Hyperlipidemia | 568 | 11695 | 324 | 1133 | 23045 | 513 | 1.31 (1.14–1.51) | <0.001 | 1.22 (1.05–1.41) | 0.008 |
| Hypertension | 470 | 9763 | 247 | 1120 | 26061 | 319 | 2.45 (2.06–2.91) | <0.001 | 2.31 (1.93–2.75) | <0.001 |
| Diabetes | 561 | 13982 | 248 | 1138 | 27191 | 292 | 1.77 (1.50–2.10) | <0.001 | 1.62 (1.36–1.94) | <0.001 |
| Arthritis | 569 | 13184 | 304 | 1138 | 24868 | 486 | 1.20 (1.04–1.39) | 0.014 | 1.17 (1.00–1.36) | 0.024 |
| Cancer | 566 | 15392 | 124 | 1132 | 27827 | 224 | 0.97 (0.78–1.21) | 0.81 | 0.99 (0.79–1.24) | 0.91 |
| Asthma | 562 | 14505 | 100 | 1123 | 27463 | 155 | 1.22 (0.94–1.57) | 0.13 | 1.19 (0.92–1.53) | 0.20 |
| COPD | 526 | 9695 | 236 | 1075 | 19153 | 422 | 1.11 (0.94–1.31) | 0.22 | 1.07 (0.90–1.27) | 0.45 |
| Osteoporosis | 571 | 15857 | 95 | 1142 | 28647 | 204 | 0.81 (0.63–1.03) | 0.085 | 0.83 (0.64–1.08) | 0.17 |
| Accumulation of Multimorbidity | ||||||||||
| Considering all of the above | 400 | 11722 | - | 987 | 26225 | - | 1.22 (1.15–1.30) | <0.001 | 1.19 (1.11–1.27) | <0.001 |
| All of the above, except HTN | 479 | 14102 | - | 1001 | 26509 | - | 1.18 (1.11–1.26) | <0.001 | 1.15 (1.08–1.22) | <0.001 |
Abbreviations: CAD, coronary artery disease; CHF, congestive heart failure; CI, confidence interval; COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease, HR, hazard ratio.
P-values in bold denote statistical significance at the 0.05 alpha level.
Age was used as the time scale for all models in the table.
Adjusted for education (categories include: <high school, high school or GED; some college; ≥college; or unknown), smoking (y/n), and obesity (defined as BMI based on weight taken closest to conception date within 6 months prior and up to 20 gestational weeks, categorized as: <25; 25–29; 30+; or unknown)
The number of women at risk varied across conditions because we excluded women with that specific condition prior to the index date, based on the diagnosis codes considered for each condition. For hypertension, we also excluded those who had hypertension prior to pregnancy based on chart review or chronic hypertension based on algorithm. For diabetes, we also excluded those who had diabetes prior to pregnancy based on chart review. For multimorbidity, we excluded those with any of the 16 chronic conditions prior to pregnancy.
Using a Bonferroni correction, all primary endpoints except dementia were statistically significant in unadjusted analyses; cardiac arrhythmia, CAD, and CKD were significant in adjusted analyses.