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Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases

OBJECTIVE: To investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not. DESIGN: Population-based longitudinal open cohort study. SETTING: English primary care (The He...

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Autores principales: Parry-Smith, William, Šumilo, Dana, Subramanian, Anuradhaa, Gokhale, Krishna, Okoth, Kelvin, Gallos, Ioannis, Coomarasamy, Arri, Nirantharakumar, Krishnarajah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103369/
https://www.ncbi.nlm.nih.gov/pubmed/33952535
http://dx.doi.org/10.1136/bmjopen-2020-041566
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author Parry-Smith, William
Šumilo, Dana
Subramanian, Anuradhaa
Gokhale, Krishna
Okoth, Kelvin
Gallos, Ioannis
Coomarasamy, Arri
Nirantharakumar, Krishnarajah
author_facet Parry-Smith, William
Šumilo, Dana
Subramanian, Anuradhaa
Gokhale, Krishna
Okoth, Kelvin
Gallos, Ioannis
Coomarasamy, Arri
Nirantharakumar, Krishnarajah
author_sort Parry-Smith, William
collection PubMed
description OBJECTIVE: To investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not. DESIGN: Population-based longitudinal open cohort study. SETTING: English primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases. POPULATION: Women exposed to PPH during the study period matched for age and date of delivery, and unexposed. METHODS: We conducted an open cohort study using linked primary care THIN and HES Databases, from 1 January 1997 to 31 January 2018. A total of 42 327 women were included: 14 109 of them exposed to PPH during the study period and 28 218 matched for age and date of delivery, and unexposed to PPH. HRs for cardiovascular outcomes among women who had and did not have PPH were estimated after controlling for covariates using multivariate Cox regression models. OUTCOME MEASURES: Risk of hypertensive disease, ischaemic heart disease, heart failure, stroke or transient ischaemic attack. RESULTS: During a median follow-up of over 4 years, there was no significant difference in the risk of hypertensive disease after adjustment for covariates (adjusted HR (aHR): 1.03 (95% CI: 0.87 to 1.22); p=0.71). We also did not observe a statistically significant difference in the risk of composite CVD (ischaemic heart disease, heart failure, stroke or transient ischaemic attack) between the exposed and the unexposed cohort (aHR: 0.86 (95% CI: 0.52 to 1.43; p=0.57). CONCLUSION: Over a median follow-up of 4 years, we did not observe an association between PPH and hypertension or CVD.
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spelling pubmed-81033692021-05-24 Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases Parry-Smith, William Šumilo, Dana Subramanian, Anuradhaa Gokhale, Krishna Okoth, Kelvin Gallos, Ioannis Coomarasamy, Arri Nirantharakumar, Krishnarajah BMJ Open Obstetrics and Gynaecology OBJECTIVE: To investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not. DESIGN: Population-based longitudinal open cohort study. SETTING: English primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases. POPULATION: Women exposed to PPH during the study period matched for age and date of delivery, and unexposed. METHODS: We conducted an open cohort study using linked primary care THIN and HES Databases, from 1 January 1997 to 31 January 2018. A total of 42 327 women were included: 14 109 of them exposed to PPH during the study period and 28 218 matched for age and date of delivery, and unexposed to PPH. HRs for cardiovascular outcomes among women who had and did not have PPH were estimated after controlling for covariates using multivariate Cox regression models. OUTCOME MEASURES: Risk of hypertensive disease, ischaemic heart disease, heart failure, stroke or transient ischaemic attack. RESULTS: During a median follow-up of over 4 years, there was no significant difference in the risk of hypertensive disease after adjustment for covariates (adjusted HR (aHR): 1.03 (95% CI: 0.87 to 1.22); p=0.71). We also did not observe a statistically significant difference in the risk of composite CVD (ischaemic heart disease, heart failure, stroke or transient ischaemic attack) between the exposed and the unexposed cohort (aHR: 0.86 (95% CI: 0.52 to 1.43; p=0.57). CONCLUSION: Over a median follow-up of 4 years, we did not observe an association between PPH and hypertension or CVD. BMJ Publishing Group 2021-05-05 /pmc/articles/PMC8103369/ /pubmed/33952535 http://dx.doi.org/10.1136/bmjopen-2020-041566 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Obstetrics and Gynaecology
Parry-Smith, William
Šumilo, Dana
Subramanian, Anuradhaa
Gokhale, Krishna
Okoth, Kelvin
Gallos, Ioannis
Coomarasamy, Arri
Nirantharakumar, Krishnarajah
Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases
title Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases
title_full Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases
title_fullStr Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases
title_full_unstemmed Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases
title_short Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases
title_sort postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an english population-based longitudinal study using linked primary and secondary care databases
topic Obstetrics and Gynaecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103369/
https://www.ncbi.nlm.nih.gov/pubmed/33952535
http://dx.doi.org/10.1136/bmjopen-2020-041566
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