Women With History of Preeclampsia or Gestational Hypertension Have Increased Risk of Cardiovascular Disease

MedicalResearch.com Interview with:

Jennifer J. Stuart, ScD Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology  Department of Epidemiology Harvard T.H. Chan School of Public Health  Division of Women's Health Brigham and Women's Hospital and Harvard Medical School

Dr. Stuart

Jennifer J. Stuart, ScD
Postdoctoral Research Fellow in Reproductive & Cardiovascular Epidemiology
Department of Epidemiology
Harvard T.H. Chan School of Public Health
Division of Women’s Health
Brigham and Women’s Hospital and Harvard Medical School

 MedicalResearch.com: What is the background for this study?

Response: Preeclampsia and gestational hypertension are common pregnancy complications involving high blood pressure that develops for the first time during pregnancy and returns to normal after delivery. Approximately 10 to 15% of all women who have given birth have a history of either preeclampsia or gestational hypertension. Previous studies have shown that women with a history of high blood pressure in pregnancy are more likely to develop cardiovascular disease events like heart attack and stroke later in life when compared to women with normal blood pressure in pregnancy. However, what is less clear is to what extent these women are more likely to develop chronic hypertension, diabetes, and high cholesterol and when these risk factors begin to emerge after pregnancy.

We examined this question in a cohort of nearly 60,000 American women who we were able to follow for up to 50 years after their first pregnancy. Previous studies have been limited by small numbers, short follow-up, or a lack of information on shared risk factors, such as pre-pregnancy body mass index, smoking, and family history. This research was conducted within the Nurses’ Health Study II, which collected data on these pre-pregnancy factors in tens of thousands of women over several decades.

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Most Strokes In Women With Preeclampsia During Pregnancy Occur After Delivery

MedicalResearch.com Interview with:

Eliza Miller, M.D. Vascular neurology fellow New York-Presbyterian Hospital/Columbia University Medical Center New York City

Dr. Eliza Miller

Eliza Miller, M.D.
Vascular neurology fellow
New York-Presbyterian Hospital/Columbia University Medical Center
New York City 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Preeclampsia is a common disorder that causes high blood pressure during pregnancy. It affects about 1 in 20 pregnant women. Women with preeclampsia are at higher risk for stroke during pregnancy and post-partum, but it’s very difficult to predict who is going to have a stroke. Our study looked at a large dataset of billing data from New York State, and compared women who had preeclampsia and strokes to women who had preeclampsia but did not have a stroke.

We found that preeclamptic women with urinary tract infections, bleeding or clotting disorders, or preexisting high blood pressure were at higher risk of having strokes during pregnancy or postpartum.

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Pregnant Women Should Have Blood Pressure Screening for Preeclampsia Throughout Pregnancy

MedicalResearch.com Interview with:

Dr. Maureen Phipps, USPTS Task Force member Department chair and Chace-Joukowsky professor of obstetrics and gynecology Assistant dean for teaching and research on women's health Warren Alpert Medical School of Brown University

Dr. Phipps

Dr. Maureen Phipps, USPTS Task Force member
Department chair and Chace-Joukowsky professor of obstetrics and gynecology
Assistant dean for teaching and research on women’s health
Warren Alpert Medical School of Brown University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Preeclampsia, which includes high blood pressure after 20 weeks of pregnancy, is one of the most serious health problems affecting pregnant women. After reviewing the evidence, the Task Force found the benefits of screening for preeclampsia outweighed the harms and recommended screening pregnant women for preeclampsia with blood pressure measurements throughout pregnancy. The evidence showed mothers and their babies are likely to benefit from screening, as screening leads to treatment that reduces their risk of severe complications, including death.

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Preeclampsia Raises Risk of Autism Spectrum Disorder

Cheryl K. Walker, MD Associate Professor Department of Obstetrics & Gynecology Faculty, The MIND Institute School of Medicine, University of California, Davis MedicalResearch.com Interview with:
Cheryl K. Walker, MD

Associate Professor
Department of Obstetrics & Gynecology
Faculty, The MIND Institute
School of Medicine, University of California, Davis

Medical Research: What is the background for this study? What are the main findings?

Dr. Walker: Autism spectrum disorder (ASD) is a neurobehavioral condition identified in 1 in 68 U.S. children and is part of a broader group of developmental disabilities that affects 1 in 6 children.  Growing evidence suggests that Autism spectrum disorder and developmental delay originate during fetal life.  Preeclampsia is a complicated and frequently dangerous pregnancy condition that appears to arise from a shallow placental connection and may increase the risk of abnormal neurodevelopment through several pathways.

Medical Research: What are the main findings?

Dr. Walker: Children with Autism spectrum disorder were more than twice as likely to have been exposed to preeclampsia compared with children with typical development.  Risk for ASD was increased further in children born to mothers with more severe presentations of preeclampsia.  Mothers of children with developmental delay were more than 5 times more likely to have had severe forms preeclampsia – often with evidence of reduced placental function – compared with mothers of children with typical development.

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