Maternal risk of hypertension 7-15 Years after pregnancy: clues from the placenta

Details

• Alternative Title:
  BJOG
• Personal Author:
  Holzman, Claudia B. ; Senagore, Patricia ; Xu, Jia ; Dunietz, Galit L. ; Strutz, Kelly L. ; Tian, Yan ; Bullen, Bertha L. ; Eagle, Megan ; Catov, Janet M.
• 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.
  
  
• Subjects:
  Adult Article Epidemiology: General Obstetrics Female Follow-Up Studies Humans Hypertension Maternal Physiology Medical Disorders In Pregnancy Odds Ratio Placenta Placental Pathology Pre-Eclampsia Pregnancy Prospective Studies Regression Analysis Risk Assessment Risk Factors Risk Management Translational Research

  More +
• Source:
  BJOG. 128(5):827-836
• Pubmed ID:
  32931608
• Pubmed Central ID:
  PMC10243612
• Document Type:
  Journal Article
• Funding:
  T32 HD046377/HD/NICHD NIH HHSUnited States/ ; R01 HL103825/HL/NHLBI NIH HHSUnited States/ ; R01 HD034543/HD/NICHD NIH HHSUnited States/ ; R01-HL103825/HL/NHLBI NIH HHSUnited States/ ; R01-HD34543/NR/NINR NIH HHSUnited States/ ; U01 DP000143/DP/NCCDPHP CDC HHSUnited States/ ; U01-DP000143-01/CC/CDC HHSUnited States/
• Volume:
  128
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:c5ad1c7f4ffb80cbf1227e29366638948ae05e427af8bde3dea66b572e965af1
• Download URL:
  https://stacks.cdc.gov/view/cdc/129447/cdc_129447_DS1.pdf
• File Type:
  [PDF - 135.63 KB ]