Dataset Information

Maternal risk of hypertension 7-15 years after pregnancy: clues from the placenta.

ABSTRACT:

Objective

To assess whether pre-eclampsia (PE)-related placental/extraplacental membrane findings are linked to moderately elevated blood pressure (BP) in pregnancy and later-life hypertension.

Design

Prospective cohort.

Setting

52 prenatal clinics, 5 Michigan communities.

Sample

The POUCH Study recruited women at 16-27 weeks' gestation (1998-2004) and studied a sub-cohort in depth. This sample (n = 490) includes sub-cohort women with detailed placental assessments and cardiovascular health evaluations 7-15 years later in the POUCHmoms follow-up study.

Methods

PE-related placental/extraplacental membrane findings (i.e. mural hyperplasia, unaltered/abnormal vessels or atherosis in decidua; infarcts) were evaluated in relation to pregnancy BP and odds of Stage 2 hypertension at follow up using weighted polytomous regression. Follow-up hypertension odds also were compared in three pregnancy BP groups: normotensives (referent) and moderately elevated BP with or without PE-related placental/extraplacental membrane findings.

Main outcome measures

Stage 2 hypertension (SBP ≥140 mmHg and/or DBP ≥90 mmHg, or using antihypertensive medications) at follow up.

Results

After excluding women with pregnancy hypertension (i.e. chronic, PE, gestational), mural hyperplasia and unaltered/abnormal decidual vessels were each associated with Stage 2 hypertension at follow up: adjusted odds ratio (aOR) = 2.7, 95% CI 1.1-6.6, and aOR = 1.7 (95% CI 0.8-3.4), respectively. Women with moderately elevated BP in pregnancy and evidence of mural hyperplasia or unaltered/abnormal decidual vessels had greater odds of Stage 2 hypertension at follow up: aOR = 4.5 (95% CI 1.6-12.5 and aOR = 2.6, 95% CI 1.1-5.9, respectively.

Conclusions

PE-related placental/extraplacental membrane findings help risk-stratify women with moderately elevated BP in pregnancy for later development of hypertension.

Tweetable abstract

Placental findings associated with mother's risk of later-life hypertension.

SUBMITTER: Holzman CB

PROVIDER: S-EPMC10243612 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Publications

Maternal risk of hypertension 7-15 years after pregnancy: clues from the placenta.

Holzman C B CB Senagore P P Xu J J Dunietz G L GL Strutz K L KL Tian Y Y Bullen B L BL Eagle M M Catov J M JM

BJOG : an international journal of obstetrics and gynaecology 20201009 5

<h4>Objective</h4>To assess whether pre-eclampsia (PE)-related placental/extraplacental membrane findings are linked to moderately elevated blood pressure (BP) in pregnancy and later-life hypertension.<h4>Design</h4>Prospective cohort.<h4>Setting</h4>52 prenatal clinics, 5 Michigan communities.<h4>Sample</h4>The POUCH Study recruited women at 16-27 weeks' gestation (1998-2004) and studied a sub-cohort in depth. This sample (n = 490) includes sub-cohort women with detailed placental assessments a ...[more]

PMID: 32931608

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Dataset Information

Maternal risk of hypertension 7-15 years after pregnancy: clues from the placenta.

Objective

Design

Setting

Sample

Methods

Main outcome measures

Results

Conclusions

Tweetable abstract

Publications

Maternal risk of hypertension 7-15 years after pregnancy: clues from the placenta.

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