Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery
Corresponding Author
Jacob A. Lykke
Department of Obstetrics and Gynaecology, Roskilde Hospital, Roskilde, and
Department. of Obstetrics, Rigshospitalet, Copenhagen, Denmark,
Jacob Alexander Lykke, MD, Department of Obstetrics and Gynecology, Roskilde Hospital, Køgevej 7-9, SN.P. 4000 Roskilde, Denmark.E-mail: [email protected]Search for more papers by this authorJens Langhoff-Roos
Department. of Obstetrics, Rigshospitalet, Copenhagen, Denmark,
Search for more papers by this authorCharles J. Lockwood
Yale Women and Children's Center for Blood Disorders, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, and
Search for more papers by this authorElizabeth W. Triche
Department of Community Health, Section of Epidemiology, Brown University School of Medicine, Providence, RI, USA
Search for more papers by this authorMichael J. Paidas
Yale Women and Children's Center for Blood Disorders, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, and
Search for more papers by this authorCorresponding Author
Jacob A. Lykke
Department of Obstetrics and Gynaecology, Roskilde Hospital, Roskilde, and
Department. of Obstetrics, Rigshospitalet, Copenhagen, Denmark,
Jacob Alexander Lykke, MD, Department of Obstetrics and Gynecology, Roskilde Hospital, Køgevej 7-9, SN.P. 4000 Roskilde, Denmark.E-mail: [email protected]Search for more papers by this authorJens Langhoff-Roos
Department. of Obstetrics, Rigshospitalet, Copenhagen, Denmark,
Search for more papers by this authorCharles J. Lockwood
Yale Women and Children's Center for Blood Disorders, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, and
Search for more papers by this authorElizabeth W. Triche
Department of Community Health, Section of Epidemiology, Brown University School of Medicine, Providence, RI, USA
Search for more papers by this authorMichael J. Paidas
Yale Women and Children's Center for Blood Disorders, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, and
Search for more papers by this authorSummary
Lykke JA, Langhoff-Roos J, Lockwood CJ, Triche EW, Paidas MJ. Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery. Paediatric and Perinatal Epidemiology 2010.
The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy complications on early maternal death in a registry-based retrospective cohort study of 782 287 women with a first singleton delivery in Denmark 1978–2007, followed for a median of 14.8 years (range 0.25–30.2) accruing 11.6 million person-years. We employed Cox proportional hazard models of early death from cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy.
We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non-cardiovascular causes. Severe pre-eclampsia was associated with death from cardiovascular causes only. There was a less than additive effect on cardiovascular mortality hazard ratios with increasing number of pregnancy complications: preterm delivery 1.90 [95% confidence intervals 1.49, 2.43]; preterm delivery and small-for-gestational-age offspring 3.30 [2.25, 4.84]; preterm delivery, small-for-gestational-age offspring and pre-eclampsia 3.85 [2.07, 7.19]. Thus, we conclude that, separately and combined, preterm delivery and small-for-gestational-age are strong markers of early maternal death from both cardiovascular and non-cardiovascular causes, while hypertensive disorders of pregnancy are markers of early death of mothers from cardiovascular causes.
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