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Research

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

BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39366.416817.BE (Published 08 November 2007) Cite this as: BMJ 2007;335:978
  1. Elisabeth Balstad Magnussen, research fellow1,
  2. Lars Johan Vatten, professor2,
  3. Tom Ivar Lund-Nilsen, associate professor2,
  4. Kjell Åsmund Salvesen, professor3,
  5. George Davey Smith, professor4,
  6. Pål Richard Romundstad, associate professor2
  1. 1Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology, N-7489 Trondheim, Norway, and Trondheim University Hospital St Olav, Department of Obstetrics, Trondheim
  2. 2Department of Public Health, Faculty of Medicine, Norwegian University of Science and Technology
  3. 3Trondheim University Hospital St Olav, Department of Obstetrics, Trondheim, and Women and Child Health, Norwegian University of Science and Technology, Trondheim
  4. 4Department of Social Medicine, University of Bristol
  1. Correspondence to: E B Magnussen elisabeth.b.magnussen{at}ntnu.no
  • Accepted 9 October 2007

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.

Footnotes

  • We thank the Nord-Trøndelag health study and the Norway's medical birth registry for providing the data and the women who participated in this study.

  • Contributors: PRR had the original idea for the study. EBM analysed the data and wrote the paper together with PRR. LV, GDS, and KÅS participated in the interpretation of results and the writing of the paper. TIL participated in the statistical analyses and interpretation of the results. PRR has access to the original data and is guarantor.

  • Funding: This study was supported by a grant from the Norwegian Medical Research Council. The Nord-Trøndelag health study is a collaboration between the Norwegian University of Science and Technology, the Norwegian Institute of Public Health, and Nord-Trøndelag County Council.

  • Competing interests: None declared.

  • Ethical approval: This study was approved by regional science ethics committees in Norway and the medical birth registry of Norway.

  • Accepted 9 October 2007
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