Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia: population based cohort study

doi:10.1136/bmj.39366.416817.BE

BMJ 2007;335:978 (10 November), doi:10.1136/bmj.39366.416817.BE (published 1 November 2007)

Research

Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia: population based cohort study

Elisabeth Balstad Magnussen, research fellow¹, Lars Johan Vatten, professor², Tom Ivar Lund-Nilsen, associate professor², Kjell Åsmund Salvesen, professor³, George Davey Smith, professor⁴, Pål Richard Romundstad, associate professor²

¹ Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, N-7489 Trondheim, Norway, and Trondheim University Hospital St Olav, Department of Obstetrics, Trondheim, ² Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, ³ Trondheim University Hospital St Olav, Department of Obstetrics, Trondheim, and Women and Child Health, Norwegian University of Science and Technology, Trondheim, ⁴ Department of Social Medicine, University of Bristol

Correspondence to: E B Magnussen elisabeth.b.magnussen{at}ntnu.no

Objective To examine the effect of cardiovascular risk factorsbefore pregnancy on risk of pre-eclampsia.

Design Population based prospective study.

Setting Linkage between a Norwegian population based study (Nord-Trøndelaghealth study, HUNT-2) and Norway's medical birth registry.

Participants 3494 women who gave birth after participating inthe Nord-Trøndelag health study at baseline; of whom133 (3.8%) delivered after a pre-eclamptic pregnancy.

Main outcome measure Odds ratio of developing pre-eclampsia.

Results After adjustment for smoking; previous pre-eclampsia;parity; maternal age, education, and socioeconomic position;and duration between baseline measurements and delivery, positiveassociations were found between prepregnancy serum levels oftriglycerides, cholesterol, low density lipoprotein cholesterol,non-high density lipoprotein cholesterol, and blood pressureand risk of pre-eclampsia. The odds ratio of developing pre-eclampsiafor women with baseline systolic blood pressures greater than130 mm Hg (highest fifth) was 7.3 (95% confidence interval 3.1to 17.2) compared with women with systolic blood pressures lessthan 111 mm Hg (lowest fifth). Similar results were found fornulliparous and parous women. Women who used oral contraceptivesat baseline had half the risk of pre-eclampsia compared withnever or former users (0.5, 0.3 to 0.9).

Conclusion Women with cardiovascular risk factors may be predisposedto pre-eclampsia.

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Magee, L A, Dadelszen, P v. (2007). Pre-eclampsia and increased cardiovascular risk. BMJ 335: 945-946 [Full text]

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