Pregnancy-induced hypertension and diabetes and the risk of cardiovascular disease, stroke, and diabetes hospitalization in the year following delivery

Am J Epidemiol. 2014 Jul 1;180(1):41-4. doi: 10.1093/aje/kwu118. Epub 2014 May 30.

Abstract

Although pregnancy events predict the long-term risk of chronic disease, little is known about their short-term impact because of the rarity of clinical events. We examined hospital discharge diagnoses linked to birth certificate data in the year following delivery for 849,639 births during 1995-2004 in New York City, New York. Adjusted odds ratios characterized the relationship between pregnancy complications and subsequent hospitalization for cardiovascular disease, stroke, and diabetes. Gestational hypertension was related to heart failure (adjusted odds ratio = 2.6, 95% confidence interval: 1.5, 4.5). Preeclampsia was related to all of the outcomes considered except type 1 diabetes, with adjusted odds ratios ranging from 2.0 to 4.1. Gestational diabetes was strongly related to the risk of subsequent diabetes (for type 1 diabetes, adjusted odds ratio = 40.4, 95% confidence interval: 23.8, 68.5; for type 2 diabetes, adjusted odds ratio = 22.6, 95% confidence interval: 16.9, 30.4) but to no other outcomes. The relationship of pregnancy complications to future chronic disease is apparent as early as the year following delivery. Moreover, elucidating short-term clinical outcomes offers the potential for etiological insights into the relationship between pregnancy events and chronic disease over the life course.

Keywords: cardiovascular disease; diabetes; gestational diabetes; preeclampsia; pregnancy; stroke.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Coronary Disease / epidemiology
  • Coronary Disease / etiology
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Heart Failure / epidemiology
  • Heart Failure / etiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypertension / complications*
  • Hypertension / etiology
  • Intracranial Hemorrhages / epidemiology
  • Intracranial Hemorrhages / etiology
  • New York City / epidemiology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / epidemiology*
  • Pregnancy in Diabetics / epidemiology*
  • Risk Factors
  • Stroke / epidemiology*
  • Stroke / etiology
  • Venous Thrombosis / epidemiology
  • Venous Thrombosis / etiology