期刊
STROKE
卷 40, 期 4, 页码 1176-1180出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.108.538025
关键词
coronary artery disease; pre-eclampsia; pregnancy; pregnancy complications; stroke
资金
- British Heart Foundation
- Academy of Finland
- Paivikki and Sakari Sohlberg Foundation
- Finnish Diabetes Research Foundation
- Finnish Foundation for Cardiovascular Research
- Finnish Foundation for Pediatric Research
- Finnish Medical Societies (Duodecim and Finska lakaresallskapet)
- Signe and Ane Gyllenberg Foundation
- Sigrid Juselius Foundation
- Yrjo Jahnsson Foundation
- Juho Vainio Foundation
- MRC [MC_U147585827] Funding Source: UKRI
- Medical Research Council [U1475000001, MC_U147585827, U1475000004] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10082] Funding Source: researchfish
Background and Purpose-Women who develop pre-eclampsia in pregnancy are at increased risk of cardiovascular disease. The offspring from pregnancies complicated by pre-eclampsia have higher blood pressures during childhood, but little is known about their long-term health. We hypothesized that pre-eclampsia would lead to an increased risk of cardiovascular disease in the offspring. Methods-We traced 6410 babies born in Helsinki, Finland, from 1934 to 1944. We used the mothers' blood pressure levels and the presence of proteinuria during pregnancy to define pre-eclampsia and gestational hypertension without proteinuria according to modem criteria. Results-Two hundred eighty-four of the pregnancies were complicated by pre-eclampsia (120 with nonsevere and 164 with severe disease) and 1592 by gestational hypertension. The crude hazard ratio for all forms of stroke among people whose mothers had pre-eclampsia was 1.9 (1.2 to 3.0; P=0.01); among people whose mothers had gestational hypertension, it was 1.4 (1.0 to 1.8; P=0.03). There was no evidence that these pregnancy disorders were associated with coronary heart disease in the offspring. Pre-eclampsia, in particular severe disease, was associated with a reduced mean head circumference at birth, whereas gestational hypertension was associated with an increased head circumference in relation to body length. Conclusions-People born after pregnancies complicated by pre-eclampsia or gestational hypertension are at increased risk of stroke. The underlying processes may include a local disorder of the blood vessels of the brain as a consequence of either reduced brain growth or impaired brain growth leading to brain-sparing responses in utero. (Stroke. 2009;40:1176-1180.)
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