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Maternal risk of hypertension 7-15 Years after pregnancy: clues from the placenta
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4 2021
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Source: BJOG. 128(5):827-836
[PDF-135.63 KB]
Details:
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Alternative Title:BJOG
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Personal Author:
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Description:Objective
To assess if pre-eclampsia (PE)-related placental/extraplacental membrane findings are linked to moderately-elevated blood pressure (BP) in pregnancy and later-life hypertension.
Design
Prospective Cohort
Setting
52 prenatal clinics, 5 Michigan communities
Sample
The POUCH Study recruited women at 16–27 weeks’ gestation (1998–2004) and studied a sub-cohort in-depth. This sample (n=490) includes sub-cohort women with detailed placental assessments and cardiovascular health evaluations 7–15 years later in the POUCHmoms follow-up study.
Methods
PE-related placental/extraplacental membrane findings (i.e. mural hyperplasia, unaltered/abnormal vessels, or atherosis in decidua; infarcts) were evaluated in relation to pregnancy BP and odds of Stage 2 hypertension at follow-up using weighted polytomous regression. Follow-up hypertension odds also were compared in 3 pregnancy BP groups, i.e. normotensives (referent), and moderately-elevated BP with or without PE-related placental/extraplacental membrane findings.
Main Outcome Measures
Stage 2 hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg, or using antihypertensive medications) at follow-up.
Results
After removing women with pregnancy hypertension (i.e. chronic, PE, gestational), mural hyperplasia and unaltered/abnormal decidual vessels were each associated with Stage 2 hypertension at follow-up, adjusted odds ratio (aOR)= 2.7 (95% CI 1.1,6.6), and 1.7 (95% CI 0.8, 3.4) respectively. Women with moderately-elevated BP in pregnancy and evidence of mural hyperplasia or unaltered/abnormal decidual vessels had greater odds of Stage 2 hypertension at follow-up, aOR= 4.5 (95% CI 1.6, 12.5) and 2.6 (95% CI 1.1, 5.9) respectively.
Conclusions
PE-related placental/extraplacental membrane findings help risk stratify women with moderately-elevated BP in pregnancy for later development of hypertension.
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Subjects:
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Source:
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Pubmed ID:32931608
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Pubmed Central ID:PMC10243612
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Document Type:
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Funding:
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Volume:128
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Issue:5
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