Dr. David J. Williams, from University College London, and colleagues searched Medline and Embase for prospective and retrospective cohort studies examining the impact of preeclampsia on future cardiovascular disease and cancer as well as mortality. A total of 25 studies, which included more than 3 million women, were included in the analysis.
Preeclampsia was associated with increased risks of hypertension, ischemic heart disease, stroke, and venous thromboembolism during follow-up. The relative risks ranged from 1.79 for venous thromboembolism after 4.7 years of follow-up to 3.70 for hypertension after 14.1 years of follow-up.
A history of preeclampsia was also tied to a 49% increase in overall mortality after 14.5 years, the authors note.
By contrast, with up to 17 years of follow-up, there was no evidence that a history of preeclampsia increased the risk of any malignancy.
Meanwhile, Dr. Elisabeth Balstad Magnussen, from Trondheim University Hospital in Norway, and colleagues conducted a population-based cohort study, involving 3494 women, to examine whether cardiovascular risk factors increase the odds of preeclampsia. Of the women, 133 (3.8%) successfully delivered after a preeclamptic pregnancy.
The researchers found that various cardiovascular risk factors, including high blood pressure, elevated triglyceride levels, and obesity, did, in fact, increase the risk of preeclampsia. For instance, women with a systolic blood pressure of 130 mm Hg or higher were 7.1-times more likely to develop preeclampsia than were women with a pressure of 111 mm Hg or lower.
Oral contraceptive use at baseline appeared to reduce the risk of preeclampsia by 50%, the report indicates.
"Women with a history of preeclampsia (or gestational hypertension) should have their risk of cardiovascular disease actively assessed at three to six months postpartum," Dr. L. A. Magee and Dr. P. von Dadelszen, from the University of British Columbia in Vancouver, Canada, note in a related editorial.
These women "should pursue a heart-healthy diet and lifestyle. All of these women should probably be screened early for traditional risk markers of cardiovascular disease, and they should be treated, at a minimum, according to published guidelines."
Last Updated: 2007-11-01 19:01:10 -0400 (Reuters Health)
BMJ Online First 2007.
Placenta function profile in second trimester identifies high-risk pregnancies, April 9, 2007
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