Abstract
Aim: To study the effects of hypertensive disorders of pregnancy on future health and mortality of mothers.
Methodology: The Aberdeen Maternity and Neonatal Databank (AMND) records and stores all pregnancy related events occurring in women living in the Grampian region of Scotland. From the AMND, we identified the first singleton pregnancy of all women with date of birth on or before 30th June 1969. These women were linked by means of their identifying information to the local renal biochemistry database (GRBD). GRBD captures all kidney function tests from primary and secondary care in the health region. A cohort study design was used where exposure was gestational hypertension or preeclampsia defined according to Davey and MacGillivray’s classification of hypertensive disorders of pregnancy. Outcome assessed was Chronic Kidney Disease (CKD) stages 1-5 based on KDOQI definition, occurring at least 1 year following delivery. These women were also linked to Scottish Morbidity Records to identify any hospital admissions for renal or cardiovascular disease; the Scottish Renal Registry to identify cases of renal replacement therapy, and the National Register for Births and Deaths to assess mortality. Those with gestational hypertension and preeclampsia were compared to normotensive women using multivariate logistic regression to obtain odds ratios (95% confidence intervals).
Results and Conclusion: We found an increased subsequent risk of chronic kidney disease associated with gestational hypertension {1.36 (1.14, 1.63)} and preeclampsia {1.92 (1.45, 2.56)}. Additionally, the study demonstrated that those with preeclampsia had a higher risk of both cardiovascular {2.33 (1.17, 4.64)} and all cause mortality {1.39 (1.06, 1.81)} compared to normotensive women. Multiple register linkages made validation and life course approach possible. These findings have important implications for the long term prognosis for women with hypertensive disorders of pregnancy, and for their follow up and management to mitigate these risks.
References:
Davey DA, MacGillivray I. (1988) The classification and definition of hypertensive disorders of pregnancy. American Journal of Obstetrics and Gynecology, 158(4): 892 – 898.
National Institute for Health and Clinical Excellence. Chronic kidney disease: early identification and management of chronic kidney disease in adults in primary and secondary care. NICE clinical guideline 73 http://guidance.nice.org.uk/CG73/NICEGuidance/pdf/English (accessed 24th July 2012)
Methodology: The Aberdeen Maternity and Neonatal Databank (AMND) records and stores all pregnancy related events occurring in women living in the Grampian region of Scotland. From the AMND, we identified the first singleton pregnancy of all women with date of birth on or before 30th June 1969. These women were linked by means of their identifying information to the local renal biochemistry database (GRBD). GRBD captures all kidney function tests from primary and secondary care in the health region. A cohort study design was used where exposure was gestational hypertension or preeclampsia defined according to Davey and MacGillivray’s classification of hypertensive disorders of pregnancy. Outcome assessed was Chronic Kidney Disease (CKD) stages 1-5 based on KDOQI definition, occurring at least 1 year following delivery. These women were also linked to Scottish Morbidity Records to identify any hospital admissions for renal or cardiovascular disease; the Scottish Renal Registry to identify cases of renal replacement therapy, and the National Register for Births and Deaths to assess mortality. Those with gestational hypertension and preeclampsia were compared to normotensive women using multivariate logistic regression to obtain odds ratios (95% confidence intervals).
Results and Conclusion: We found an increased subsequent risk of chronic kidney disease associated with gestational hypertension {1.36 (1.14, 1.63)} and preeclampsia {1.92 (1.45, 2.56)}. Additionally, the study demonstrated that those with preeclampsia had a higher risk of both cardiovascular {2.33 (1.17, 4.64)} and all cause mortality {1.39 (1.06, 1.81)} compared to normotensive women. Multiple register linkages made validation and life course approach possible. These findings have important implications for the long term prognosis for women with hypertensive disorders of pregnancy, and for their follow up and management to mitigate these risks.
References:
Davey DA, MacGillivray I. (1988) The classification and definition of hypertensive disorders of pregnancy. American Journal of Obstetrics and Gynecology, 158(4): 892 – 898.
National Institute for Health and Clinical Excellence. Chronic kidney disease: early identification and management of chronic kidney disease in adults in primary and secondary care. NICE clinical guideline 73 http://guidance.nice.org.uk/CG73/NICEGuidance/pdf/English (accessed 24th July 2012)
| Original language | English |
|---|---|
| Publication status | Published - 1 Oct 2012 |
| Event | NHS Scotland Research Conference - John McIntyre Conference Centre, Pollock Halls, Edinburgh, Edinburgh, United Kingdom Duration: 1 Oct 2012 → 1 Oct 2012 |
Conference
| Conference | NHS Scotland Research Conference |
|---|---|
| Country/Territory | United Kingdom |
| City | Edinburgh |
| Period | 1/10/12 → 1/10/12 |
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Aberdeen Maternity and Neonatal Databank
Bhattacharya, S. (Data Manager) & Wilde, K. (Supervisor), University of Aberdeen, 1986
http://www.abdn.ac.uk/iahs/research/obsgynae/amnd/overview.php and one more link, http://www.abdn.ac.uk/iahs/research/obsgynae/amnd/access.php (show fewer)
Dataset