Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia: population based cohort study

Abstract

OBJECTIVE: To examine the effect of cardiovascular risk factors before pregnancy on risk of pre-eclampsia. DESIGN: Population based prospective study. SETTING: Linkage between a Norwegian population based study (Nord-Trøndelag health study, HUNT-2) and Norway's medical birth registry. PARTICIPANTS: 3494 women who gave birth after participating in the Nord-Trøndelag health study at baseline; of whom 133 (3.8%) delivered after a pre-eclamptic pregnancy. MAIN OUTCOME MEASURE: Odds ratio of developing pre-eclampsia. RESULTS: After adjustment for smoking; previous pre-eclampsia; parity; maternal age, education, and socioeconomic position; and duration between baseline measurements and delivery, positive associations were found between prepregnancy serum levels of triglycerides, cholesterol, low density lipoprotein cholesterol, non-high density lipoprotein cholesterol, and blood pressure and risk of pre-eclampsia. The odds ratio of developing pre-eclampsia for women with baseline systolic blood pressures greater than 130 mm Hg (highest fifth) was 7.3 (95% confidence interval 3.1 to 17.2) compared with women with systolic blood pressures less than 111 mm Hg (lowest fifth). Similar results were found for nulliparous and parous women. Women who used oral contraceptives at baseline had half the risk of pre-eclampsia compared with never or former users (0.5, 0.3 to 0.9). CONCLUSION: Women with cardiovascular risk factors may be predisposed to pre-eclampsia.