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Mortality of mothers from cardiovascular and non‐cardiovascular causes following pregnancy complications in first delivery
Author(s) -
Lykke Jacob A.,
LanghoffRoos Jens,
Lockwood Charles J.,
Triche Elizabeth W.,
Paidas Michael J.
Publication year - 2010
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/j.1365-3016.2010.01120.x
Subject(s) - medicine , pregnancy , obstetrics , maternal morbidity , preterm delivery , intensive care medicine , gestation , genetics , biology
Summary 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.