Long term mortality of mothers and fathers after pre-eclampsia: population based cohort studyPre-eclampsia and cardiovascular disease later in life: who is at risk?
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Objective: To assess whether mothers and fathers have a higher long term risk of death, particularly from cardiovascular disease and cancer, after the mother has had pre-eclampsia. Design: Population based cohort study of registry data. Subjects: Mothers and fathers of all 626 272 births that were the mothers' first deliveries, recorded in the Norwegian medical birth registry from 1967 to 1992. Parents were divided into two cohorts based on whether the mother had pre-eclampsia during the pregnancy. Subjects were also stratified by whether the birth was term or preterm, given that pre-eclampsia might be more severe in preterm pregnancies. Main outcome measures: Total mortality and mortality from cardiovascular causes, cancer, and stroke from 1967 to 1992, from data from the Norwegian registry of causes of death. Results: Women who had pre-eclampsia had a 1.2-fold higher long term risk of death (95% confidence interval 1.02 to 1.37) than women who did not have pre-eclampsia. The risk in women with pre-eclampsia and a preterm delivery was 2.71-fold higher (1.99 to 3.68) than in women who did not have pre-eclampsia and whose pregnancies went to term. In particular, the risk of death from cardiovascular causes among women with pre-eclampsia and a preterm delivery was 8.12-fold higher (4.31 to 15.33). However, these women had a 0.36-fold (not significant) decreased risk of cancer. The long term risk of death was no higher among the fathers of the pre-eclamptic pregnancies than the fathers of pregnancies in which pre-eclampsia did not occur. Conclusions: Genetic factors that increase the risk of cardiovascular disease may also be linked to pre-eclampsia. A possible genetic contribution from fathers to the risk of pre-eclampsia was not reflected in increased risks of death from cardiovascular causes or cancer among fathers. What is already known on this topic: Maternal and fetal genes (including those inherited from the father) may contribute to pre-eclampsia, which occurs in 3-5% of pregnancies One set of candidate genes for pre-eclampsia is the maternal genes for thrombophilia, which may increase the mother's risk of death from cardiovascular disease What this study adds: Women who have pre-eclampsia during a pregnancy that ends in a preterm delivery have an eightfold higher risk of death from cardiovascular disease compared with women who do not have pre-eclampsia and whose pregnancy goes to term Fathers of pregnancies in which pre-eclampsia occurred have no increased risk of death from cardiovascular disease These results are compatible with maternal genes for thrombophilia having an effect on the risk of pre-eclampsia and of death from cardiovascular disease
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Long-term follow-up is recommended for individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia, as they have increased lifetime cardiovascular risk.
“Long-term follow-up is recommended for these individuals, as they have increased lifetime cardiovascular risk (152).”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [152]
The Discussion reports increased later cardiovascular risk for women with pre-eclampsia who delivered preterm, but says those who delivered at term had no increased cardiovascular mortality. The copy does not recommend long-term clinical follow-up or establish the stated risk for gestational hypertension or superimposed pre-eclampsia. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe American College of Obstetricians and Gynecologists recommends that, postpartum, individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia have their blood pressures observed for 72 h in the hospital and 7-10 days postpartum.
“The American College of Obstetricians and Gynecologists also recommends that, postpartum, individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia have their blood pressures observed for 72 h in the hospital and 7-10 days postpartum.”
From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [152]
The Materials and methods section (page not provided) defines pre-eclampsia cases, and the Discussion addresses cardiovascular risk years later. Neither addresses an American College of Obstetricians and Gynecologists recommendation for postpartum blood-pressure observation. Searches for the organization and the 72-hour and 7–10-day intervals found no supporting passage. (LLM, conf=0.76)
Experimental — accuracy not yet measuredPostpartum individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia have increased lifetime cardiovascular risk.
“Long-term follow-up is recommended for these individuals as they have increased lifetime cardiovascular risk (51).”
From 10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [51]
The American College of Obstetricians and Gynecologists recommends that postpartum individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia have their blood pressures observed for 72 hours in the hospital and for 7-10 days postpartum.
“The American College of Obstetricians and Gynecologists also recommends that postpartum individuals with gestational hypertension, preeclampsia, and superimposed preeclampsia have their blood pressures observed for 72 h in the hospital and for 7 -10 days postpartum.”
From 10. Cardiovascular Disease and Risk Management: <i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [51]
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References 28 · Cited by 1,040
Research works printed but not linked: 24
- Roberts JM, Cooper DW. Pathogenesis and genetics of pre-eclampsia. Lancet 2001;357:53-6.
- Higgins JR, de Swiet M. Blood-pressure measurement and classification in pregnancy. Lancet 2001;357:131-5.
- Marcoux S, Brisson J, Fabia J. The effect of cigarette smoking on the risk of pre-eclampsia and gestational hypertension. Am J Epidemiol 1989;130:950-7.
- Cnattingius S, Mills JL, Yuen J, Eriksson O, Salonen H. The paradoxical effect of smoking in preeclamptic pregnancies: smoking reduces the inci- dence but increases the rates of perinatal mortality, abruption placentae, and intrauterine growth restriction. Am J Obstet Gynecol 1997;177:156-61.
- Lie RT, Rasmussen S, Brunborg H, Gjessing HK, Lie-Nielsen E, Irgens LM. Fetal and maternal contributions to risk of pre-eclampsia: population based study. BMJ 1998;316:1343-7.
- Mogren I, Høgberg U, Winkvist A, Stenlund H. Familial occurrence of pre-eclampsia. Epidemiology 1999;10:518-22.
- Li DK, Wi S. Changing paternity and the risk of pre-eclampsia/eclampsia in the subsequent pregnancy. Am J Epidemiol 2000;151:57-62.
- Chesley LC, Annitto JE, Cosgrove RA. The remote prognosis of eclamp- tic women. Am J Obstet Gynecol 1976;124:446-59.
- Fisher KA, Luger A, Spargo BH, Lindheimer MD. Hypertension in preg- nancy: clinical-pathological correlations and remote prognosis. Medicine (Baltimore) 1981;60:267-76.
- Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, et al. Increased frequency of genetic thrombophilia in women with complica- tions of pregnancy. N Engl J Med 1999;340:9-13.
- De Groot CJ, Bloemenkamp KW, Duvekot EJ, Helmerhorst FM, Bertina RM, Van Der Meer F, et al. Preeclampsia and genetic risk factors for thrombosis: a case-control study. Am J Obstet Gynecol 1999;181:975-80.
- Albrektsen G, Heuch I, Tretli S, Kvåle G. Breast cancer incidence before age 55 in relation to parity and age at first and last births: a prospective study of one million Norwegian women. Epidemiology 1994;5:604-11.
- Albrektsen G, Heuch I, Kvåle G. The short-term and long-term effect of a pregnancy on breast cancer risk: a prospective study of 802 457 parous Norwegian women. Br J Cancer 1995;72:480-4.
- Albrektsen G, Heuch I, Kvåle G. Multiple births, sex of children and sub- sequent breast-cancer risk for the mothers: a prospective study in Norway. Int J Cancer 1995;60:341-4.
- Innes KE, Byers TE. Preeclampsia and breast cancer risk. Epidemiology 1999;10:722-32.
- Irgens LM. The medical birth registry of Norway. Epidemiological research and surveillance throughout 30 years. Acta Obstet Gynecol Scand 2000;79:435-9.
- Lindheimer MD, Katz AI. Hypertension in pregnancy. N Engl J Med 1985;313:675-80.
- Smith GD, Harding S, Rosato M. Relation between infants' birth weight and mothers' mortality: prospective observational study. BMJ 2000;320: 839-40.
- Smith GD, Whitley E, Gissler M, Hemminki E. Birth dimensions of offspring, premature birth, and the mortality of mothers. Lancet 2000;356:2066-7.
- Kyrklund-Blomberg NB, Cnattingius S. Preterm birth and maternal smoking: risks related to gestational age and onset of delivery. Am J Obstet Gynecol 1998;179:1051-5.
- Lie RT, Rasmussen S, Brunborg H, Gjessing HK, Lie-Nielsen E, Irgens LM. Fetal and maternal contributions to risk of pre-eclampsia: population based study. BMJ 1998;316:1343-7.
- Xiong X, Demianczuk NN, Buekens P, Saunders LD. Association of preeclampsia with high birth weight for gestational age. Am J Obstet Gyne- col 2000;183:148-55.
- Arias F, Rodriquez L, Rayne SC, Kraus FT. Maternal placental vasculo- pathy and infection: two distinct subgroups among patients with preterm labor and preterm ruptured membranes. Am J Obstet Gynecol 1993;168: 585-91.
- Sibai B, El-Nazer A, Gonzalez-Ruiz A. Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis. Am J Obstet Gynecol 1986;155:1011-6.
- Authors
- Irgens, H. U., Roberts, J. M., Reisæter, L., Irgens, L. M., & Lie, R. T.
- Affiliations
- University of Pittsburgh (US)
- Corresponding author
- Irgens, Lorentz M
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2001-11-24
- Volume
- 323
- Issue
- 7323
- Pages
- 1213-1217
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC59993
- OpenAlex
- W1479945039
- Cited by
- 1,040
- References
- 28
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 22 · 2023: 28 · 2022: 30 · 2021: 43 · 2020: 39 · 2019: 42 · 2018: 41 · 2017: 44 · 2016: 45 · 2015: 65 · 2014: 57 · 2013: 71 · 2012: 63
- FWCI
- 20.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- preeclampsia, long-term mortality, cardiovascular disease, cancer mortality, stroke, preterm birth, fathers, maternal genetic risk, thrombophilia, genetic susceptibility, pregnancy outcomes, genetic polymorphism
- MeSH terms
- Cardiovascular Diseases, Fathers, Female, Humans, Obstetric Labor, Premature, Male, Maternal Mortality, Neoplasms, Norway, Pre-Eclampsia, Pregnancy, Registries, Cohort Studies, Survival Rate, Risk Assessment, Genetic Predisposition to Disease, Stroke
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