Pre-eclampsia in a first pregnancy and subsequent pregnancy outcomes: a nationwide cohort study

• Published in: Journal of epidemiology and community health (1979) 2023-11, Vol.77 (11), p.694-703
• Main Authors: Havers-Borgersen, Eva, Fosbøl, Emil, Johansen, Marianne, Køber, Lars, Morris, Jonathan M, Seeho, Sean K M
• Format: Article
• Language: English
• Subjects: Age; Birth; Birth rate; Births; Cardiovascular disease; CARDIOVASCULAR DISEASES; Cohort analysis; Diabetes; Emigration; EPIDEMIOLOGY; Ethnicity; Gestational age; Hospitals; Hypertension; Infant mortality; Length of stay; Maternal mortality; Morbidity; Mortality; Neonates; Observational studies; OBSTETRICS; Original research; Pre-eclampsia; Preeclampsia; Pregnancy; Pregnancy complications; Registration; Regression analysis; Stillbirth; Womens health
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech-2023-220829

BackgroundFor women whose first pregnancy was complicated by pre-eclampsia (PE), particularly if severe and requiring early birth, the risk of recurrence and maternal and neonatal outcomes at subsequent birth are important considerations.MethodsIn this observational cohort study, all primiparous women who gave birth in Denmark between 1997 and 2016 were identified using nationwide registries. Women were stratified by whether they developed PE and followed from date of birth until subsequent birth, emigration, death or end of study (December 2016). The cumulative incidences of subsequent birth among women with versus without PE were assessed using the Aalen-Johansen estimator. Subsequent outcomes including PE recurrence and maternal and neonatal morbidity and mortality were also examined. Factors associated with subsequent birth and recurrent PE were examined using multivariable Cox regression models.ResultsAmong 510 615 primiparous women with singleton pregnancies, 21 683 (4.2%) developed PE, with 1819 (0.4%) being early-onset PE (birth