Premium
Hyperemesis gravidarum and long‐term mortality: a population‐based cohort study
Author(s) -
Fossum S,
Vikanes ÅV,
Næss Ø,
Vos L,
Grotmol T,
Halvorsen S
Publication year - 2017
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14454
Subject(s) - medicine , hazard ratio , proportional hazards model , population , confidence interval , cohort , cohort study , confounding , obstetrics , standardized mortality ratio , environmental health
Objective To investigate whether exposure to hyperemesis gravidarum ( HG ) is associated with increased maternal long‐term mortality. Design Population‐based cohort study. Setting Medical Birth Registry of Norway (1967–2002) linked to the Cause of Death Registry. Population Women in Norway with singleton births in the period 1967–2002, with and without HG . Women were followed until 2009 or death. Methods Cox proportional hazard regression model was applied to estimate hazard ratios ( HR s) with 95% confidence interval ( CI ). Main outcome measures The primary outcome was all‐cause mortality during follow up. Secondary outcomes were cause‐specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders). Results Of 999 161 women with singleton births, 13 397 (1.3%) experienced HG . During a median follow up of 26 years (25 902 036 person‐years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long‐term all‐cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75–0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84–1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83–1.29), but a lower long‐term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75–0.98). Conclusion In this large population‐based cohort study, HG was not associated with an increased risk of long‐term all‐cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer. Tweetable abstract Population‐based cohort study: Hyperemesis was not associated with an increased risk of long‐term mortality.