The association between spontaneous preterm birth and maternal hypertension in the fifth decade of life: a retrospective case-control study

BJOG. 2023 Apr;130(5):507-513. doi: 10.1111/1471-0528.17368. Epub 2022 Dec 21.

Abstract

Objective: To investigate whether a history of spontaneous preterm birth (SPTB) predisposes to maternal hypertension.

Design: Retrospective case-control study.

Setting: Two affiliated university medical hospitals in Amsterdam, the Netherlands.

Population: We included 350 women with a history of SPTB between 22 and 36+6 weeks and 166 women with a history of a term birth. Women with pregnancy complications that are known to be associated with cardiovascular disease were excluded.

Methods: Both groups underwent cardiovascular risk assessment 9-16 years after pregnancy. We performed a subgroup analysis based upon the severity of SPTB.

Main outcome measures: Hypertension. Secondary outcomes - metabolic syndrome, mean blood pressure, anthropometrics, blood and urine sampling, Framingham Risk Score and Systematic Coronary Risk Evaluation.

Results: A history of SPTB was significantly associated with hypertension; adjusted odds ratio 1.60 (95% confidence interval 1.04-2.46, p = 0.033). Abdominal obesity was more often diagnosed after SPTB (n = 163, 46.6% versus n = 54, 32.5%, p = 0.003) and was more pronounced with more severe preterm birth (p = 0.002).

Conclusions: The presence of hypertension 9-16 years after pregnancy was statistically significantly higher among women with a history of SPTB than among women with a history of uncomplicated term birth. Women with a history of SPTB were more often diagnosed with abdominal obesity, especially those with a history of extreme preterm birth.

Keywords: cardiovascular disease; cardiovascular risk; hypertension; preterm birth; spontaneous preterm birth.

MeSH terms

  • Case-Control Studies
  • Female
  • Humans
  • Hypertension* / complications
  • Hypertension* / epidemiology
  • Infant, Newborn
  • Obesity / complications
  • Obesity, Abdominal / complications
  • Pre-Eclampsia* / epidemiology
  • Pregnancy
  • Premature Birth* / epidemiology
  • Premature Birth* / etiology
  • Retrospective Studies