These studies were undertaken to investigate risks of maternal and perinatal complications in pregnant women with chronic hypertensive disease, and to investigate future risk of preeclampsia in women born small for gestational age (SGA). Population based cohort studies using the Swedish Medical Birth Register from different years were performed.The maternal complications mild and severe preeclampsia, gestational diabetes and abruptio placenta were studied in a population of 681 515 women, with a prevalence of 0,5% for chronic hypertension. Risk estimates were adjusted for differences in maternal characteristics as age, parity, BMI, ethnicity and smoking habits. Chronic hypertensive women wore found to have significantly increased risks of all complications.The perinatal complication SGA was studied in a population of 560 188, with a prevalence of 0,5% for chronic hypertension. Risk estimates were adjusted for differences in maternal characteristics and for the secondary complications mild and severe preeclampsia. Chronic hypertensive women were found to suffer a significantly increased risk of giving birth to an offspring that is SGA.The perinatal complication fetal/infant mortality was studied in a population of 1 222 952 with a prevalence of 0,6% for chronic hypertension. Risk estimates were adjusted for differences in maternal characteristics and for the complications mild and severe preeclampsia, gestational diabetes, abruptio placenta and offspring being SGA In the analysis an effect modification by gender was included. Chronic hypertensive women were found to have a significantly increased risk for stillbirth and neonatal death in male, but not in female, offspring…
Contents
Introduction
Background
Chronic hypertension
Characteristics of the hypertensive woman
Preeclampsia
Gestational diabetes
Abruptio placenta
Small for gestational age
Perinatal death
Intrauterine death
Neonatal death
Insulin resistance syndrome
The Barker hypothesis
The fetal origins hypothesis
The catch-up-growth hypothesis
Aims of the studies
Material and methods
Data sources
The Swedish Medical Birth Register
The Cause of Death Register
Definitions of diagnoses
Chronic hypertension
Preeclampsia
Gestational diabetes
Abruptio placenta
Small for gestational age
Perinatal death
Post neonatal death
Validation of the diagnosis chronic hypertension
Design and statistical analyses of the studies
Paper I and II
Paper III
Paper IV
Overview of the papers
Ethics
Results
Study I
Study II
Study III
Study IV
Discussion
Chronic hypertension
Maternal complications
Perinatal complication
SGA
Perinatal death
Complications across generations
Aims for the future
Conclusions
Acknowledgements
References
Author: Zetterström, Karin
Source: Uppsala University Library
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