Table 3.
Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for the risk of all-cause premature mortality (before age 70 y) according to the occurrence of HDP status across multiple pregnancies among 61,806 parous women (NHS-II, 1989-2017).
| HDP status | Deaths/PY | Crude Incidence per 1000 PY | HRs (95% CI) | ||
|---|---|---|---|---|---|
| Age-adjusted model* | Multivariable model 1† | Multivariable model 2‡ | |||
| Change in HDP status | |||||
| Normotension in the first birth | |||||
| Normotensive subsequent births or no additional births | 530/415,338 | 1.28 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| HDPs in subsequent births | 27/11,767 | 2.29 | 1.86 (1.26–2.74) | 1.78 (1.21–2.63) | 1.82 (1.22–2.69) |
| HDP in the first birth | |||||
| Normotensive subsequent births or no additional births | 39/35,717 | 1.09 | 0.92 (0.66–1.27) | 0.88 (0.63–1.22) | 0.81 (0.58–1.13) |
| HDPs in subsequent births | 16/10,272 | 1.56 | 1.33 (0.81–2.19) | 1.27 (0.77–2.09) | 1.23 (0.74–2.04) |
| Total number of pregnancies with HDPs | |||||
| No HDPs | 530/415,338 | 1.28 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| 1 | 61/46,371 | 1.32 | 1.09 (0.84–1.43) | 1.05 (0.80–1.37) | 0.99 (0.76–1.30) |
| ≥2 | 21/11,384 | 1.84 | 1.59 (1.02–2.46) | 1.51 (0.97–2.35) | 1.47 (0.94–2.30) |
| Co-exposure to HDPs and preterm birth | |||||
| No HDPs | 530/415,338 | 1.28 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| Only HDPs | 66/45,493 | 1.45 | 1.19 (0.92–1.54) | 1.14 (0.88–1.48) | 1.10 (0.84–1.42) |
| HDPs and preterm birth | 16/12,262 | 1.30 | 1.18 (0.72–1.94) | 1.13 (0.68–1.86) | 1.03 (0.62–1.69) |
| Co-exposure to HDPs and low birth weight | |||||
| No HDPs | 530/415,338 | 1.28 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| Only HDPs | 67/48,197 | 1.39 | 1.16 (0.90–1.50) | 1.11 (0.86–1.43) | 1.06 (0.82–1.37) |
| HDPs and low birth weight | 15/9,558 | 1.57 | 1.32 (0.79–2.21) | 1.30 (0.78–2.18) | 1.20 (0.72–2.02) |
In the age-adjusted model, age in months at the start of follow-up and calendar year of the current questionnaire cycle was included as a stratified variable.
Based on age-adjusted models, multivariable model 1 was further adjusted for White race/ethnicity (yes, no), pre-pregnancy BMI (<25, ≥25 kg/m2), and time-varying menopausal status (premenopausal, postmenopausal, unsure/biologically uncertain), current hormone therapy use (never, past, current), daily aspirin use (yes/no), and parental history of MI or stroke (yes, no).
Multivariable model 2 was further adjusted for time-varying breastfeeding duration (≤3.0, 3.1–12, >12 months), parity (≤1, 2, ≥3), alcohol intake (0, 1–14, ≥15 g/d), smoking status (never, former, current 1–34 cigarettes/day, current ≥35 cigarettes/day), physical activity (0, 0.1–1.0, 1.1–2.4, 2.5–5.9, or ≥6 h/wk), AHEI-2010 dietary score (quintiles), and current BMI (<18.5, 18.5–24.9, 25–29.9, ≥30 kg/m2). HDPs= Hypertensive disorders of pregnancy; PY=person year.