Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease: a Danish cohort study

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Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease : a Danish cohort study. / Chen, Shannon X; Rasmussen, Kathleen M; Finkelstein, Julia; Støvring, H; Nøhr, Ellen Aa; Kirkegaard, Helene.

I: BMJ Open, Bind 9, Nr. 11, e030702, 04.11.2019.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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Chen, Shannon X ; Rasmussen, Kathleen M ; Finkelstein, Julia ; Støvring, H ; Nøhr, Ellen Aa ; Kirkegaard, Helene. / Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease : a Danish cohort study. I: BMJ Open. 2019 ; Bind 9, Nr. 11.

Bibtex

@article{85e2e00d2c624c45998d17456b96a94f,
title = "Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease: a Danish cohort study",
abstract = "OBJECTIVES: The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths.DESIGN: A prospective cohort study.SETTING: Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height.PARTICIPANTS: A total of 44 552 first-time mothers in the Danish National Birth Cohort.OUTCOME MEASURES: Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles.RESULTS: After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m2) was observed.CONCLUSIONS: Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.",
author = "Chen, {Shannon X} and Rasmussen, {Kathleen M} and Julia Finkelstein and H St{\o}vring and N{\o}hr, {Ellen Aa} and Helene Kirkegaard",
note = "{\textcopyright} Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2019",
month = nov,
day = "4",
doi = "10.1136/bmjopen-2019-030702",
language = "English",
volume = "9",
journal = "B M J Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "11",

}

RIS

TY - JOUR

T1 - Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease

T2 - a Danish cohort study

AU - Chen, Shannon X

AU - Rasmussen, Kathleen M

AU - Finkelstein, Julia

AU - Støvring, H

AU - Nøhr, Ellen Aa

AU - Kirkegaard, Helene

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/11/4

Y1 - 2019/11/4

N2 - OBJECTIVES: The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths.DESIGN: A prospective cohort study.SETTING: Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height.PARTICIPANTS: A total of 44 552 first-time mothers in the Danish National Birth Cohort.OUTCOME MEASURES: Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles.RESULTS: After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m2) was observed.CONCLUSIONS: Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.

AB - OBJECTIVES: The metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths.DESIGN: A prospective cohort study.SETTING: Mothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height.PARTICIPANTS: A total of 44 552 first-time mothers in the Danish National Birth Cohort.OUTCOME MEASURES: Risks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles.RESULTS: After adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m2) was observed.CONCLUSIONS: Premenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.

U2 - 10.1136/bmjopen-2019-030702

DO - 10.1136/bmjopen-2019-030702

M3 - Journal article

C2 - 31690605

VL - 9

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 11

M1 - e030702

ER -