TY - JOUR
T1 - Preterm delivery and risk of subsequent cardiovascular morbidity and type-II diabetes in the mother
AU - Lykke, J A
AU - Paidas, M J
AU - Damm, P
AU - Triche, E W
AU - Kuczynski, E
AU - Langhoff-Roos, J
PY - 2010/2/1
Y1 - 2010/2/1
N2 - Objective Preterm delivery has been shown to be associated with subsequent maternal cardiovascular morbidity. However, the impact of the severity and recurrence of preterm delivery on the risk of specific cardiovascular events and the metabolic syndrome in the mother, have not been investigated. Design National registry-based retrospective cohort study. Setting Women delivering in Denmark from 1978 to 2007. Population Women with a first singleton delivery (n = 782 287), and with a first and second singleton delivery (n = 536 419). Methods Cox proportional hazard models, with the gestational age stratified into four groups as primary exposure. We made adjustments for maternal age, year of delivery, hypertensive pregnancy disorders, fetal growth deviation, placental abruption and stillbirth. Main outcome measures Subsequent maternal hypertension, ischaemic heart diseases, thromboembolism and type-II diabetes. Results After a first delivery at 32-36 completed weeks of gestation, the adjusted risk of subsequent type-II diabetes increased 1.89-fold (1.69-2.10) and the risk of thromboembolism increased 1.42-fold (1.24-1.62). Women having a preterm delivery in the first pregnancy and a term delivery in the second had a 1.58-fold (1.34-1.86) increased risk of type-II diabetes and a 1.18-fold (0.96-1.44) increased risk of thromboembolism. Women having two preterm deliveries had a 2.30-fold (1.71-3.10) increased risk of type-II diabetes and a 1.80-fold (1.29-2.50) increased risk of thromboembolism. Conclusions Preterm delivery is independent of other pregnancy complications associated with subsequent maternal overt type-II diabetes and thromboembolism. The recurrence of preterm delivery will augment these risks.
AB - Objective Preterm delivery has been shown to be associated with subsequent maternal cardiovascular morbidity. However, the impact of the severity and recurrence of preterm delivery on the risk of specific cardiovascular events and the metabolic syndrome in the mother, have not been investigated. Design National registry-based retrospective cohort study. Setting Women delivering in Denmark from 1978 to 2007. Population Women with a first singleton delivery (n = 782 287), and with a first and second singleton delivery (n = 536 419). Methods Cox proportional hazard models, with the gestational age stratified into four groups as primary exposure. We made adjustments for maternal age, year of delivery, hypertensive pregnancy disorders, fetal growth deviation, placental abruption and stillbirth. Main outcome measures Subsequent maternal hypertension, ischaemic heart diseases, thromboembolism and type-II diabetes. Results After a first delivery at 32-36 completed weeks of gestation, the adjusted risk of subsequent type-II diabetes increased 1.89-fold (1.69-2.10) and the risk of thromboembolism increased 1.42-fold (1.24-1.62). Women having a preterm delivery in the first pregnancy and a term delivery in the second had a 1.58-fold (1.34-1.86) increased risk of type-II diabetes and a 1.18-fold (0.96-1.44) increased risk of thromboembolism. Women having two preterm deliveries had a 2.30-fold (1.71-3.10) increased risk of type-II diabetes and a 1.80-fold (1.29-2.50) increased risk of thromboembolism. Conclusions Preterm delivery is independent of other pregnancy complications associated with subsequent maternal overt type-II diabetes and thromboembolism. The recurrence of preterm delivery will augment these risks.
U2 - 10.1111/j.1471-0528.2009.02448.x
DO - 10.1111/j.1471-0528.2009.02448.x
M3 - Journal article
SN - 0140-7686
VL - 117
SP - 274
EP - 281
JO - The Journal of obstetrics and gynaecology of the British Commonwealth
JF - The Journal of obstetrics and gynaecology of the British Commonwealth
IS - 3
ER -
