ABSTRACT
OBJECTIVE: To investigate whether exposure to hyperemesis gravidarum (hyperemesis) is associated with subsequent maternal cardiovascular morbidity. DESIGN: Nationwide cohort study. SETTING: Medical Birth Registry of Norway (1967-2002) linked to the nationwide Cardiovascular Disease in Norway project 1994-2009 (CVDNOR) and the Cause of Death Registry. POPULATION: Women in Norway with singleton births from 1967 to 2002, with and without hyperemesis, were followed up with respect to cardiovascular outcomes from 1994 to 2009. METHODS: Cox proportional hazards regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI). MAIN OUTCOME MEASURES: The first hospitalisation due to nonfatal stroke, myocardial infarction or angina pectoris, or cardiovascular death. RESULTS: Among 989 473 women with singleton births, 13 212 (1.3%) suffered from hyperemesis. During follow-up, a total of 43 482 (4.4%) women experienced a cardiovascular event. No association was found between hyperemesis and the risk of a fatal or nonfatal cardiovascular event (adjusted HR 1.08; 95% CI 0.99-1.18). Women with hyperemesis had higher risk of hospitalisation due to angina pectoris (adjusted HR 1.28; 95% CI 1.15-1.44). The risk of cardiovascular death was lower among hyperemetic women in age-adjusted analysis (HR 0.73; 95% CI 0.59-0.91), but the association was no longer significant when adjusting for possible confounders. CONCLUSION: Women with a history of hyperemesis did not have increased risk of a cardiovascular event (nonfatal myocardial infarction or stroke, angina pectoris or cardiovascular death) compared to women without.
Subject(s)
Angina Pectoris/diagnosis , Hospitalization/statistics & numerical data , Hyperemesis Gravidarum/diagnosis , Myocardial Infarction/diagnosis , Registries , Stroke/diagnosis , Adult , Angina Pectoris/complications , Angina Pectoris/mortality , Angina Pectoris/physiopathology , Case-Control Studies , Female , Humans , Hyperemesis Gravidarum/complications , Hyperemesis Gravidarum/mortality , Hyperemesis Gravidarum/physiopathology , Longitudinal Studies , Myocardial Infarction/complications , Myocardial Infarction/mortality , Myocardial Infarction/physiopathology , Norway , Pregnancy , Proportional Hazards Models , Risk Factors , Stroke/complications , Stroke/mortality , Stroke/physiopathology , Survival AnalysisSubject(s)
Cause of Death , Hyperemesis Gravidarum/mortality , Maternal Mortality , Female , Humans , PregnancyABSTRACT
OBJECTIVE: To investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long-term mortality. DESIGN: Population-based cohort study. SETTING: Medical Birth Registry of Norway (1967-2002) linked to the Cause of Death Registry. POPULATION: Women in Norway with singleton births in the period 1967-2002, with and without HG. Women were followed until 2009 or death. METHODS: Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI). MAIN OUTCOME MEASURES: The primary outcome was all-cause mortality during follow up. Secondary outcomes were cause-specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders). RESULTS: Of 999 161 women with singleton births, 13 397 (1.3%) experienced HG. During a median follow up of 26 years (25 902 036 person-years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long-term all-cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75-0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84-1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83-1.29), but a lower long-term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75-0.98). CONCLUSION: In this large population-based cohort study, HG was not associated with an increased risk of long-term all-cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer. TWEETABLE ABSTRACT: Population-based cohort study: Hyperemesis was not associated with an increased risk of long-term mortality.
Subject(s)
Cause of Death , Hyperemesis Gravidarum/mortality , Maternal Mortality , Adult , Cohort Studies , Female , Follow-Up Studies , Humans , Norway , Pregnancy , Proportional Hazards Models , Registries , Risk Factors , Survival Analysis , Young AdultABSTRACT
Presentamos el caso de una paciente que murió por hiperemesis gravídica y revisamos las muertes por esta causa en la Maternidad Concepción Palacios entre 1939 y 1994. Se registraron 2404 muertes maternas, de ellas 2143 por causas obstetricas. Siete pacientes murieron por hiperemesis gravídica, lo que representa el 0,291 por ciento de todas las muertes y el 0,326 por ciento de aquéllas por causas obstetricas. En relación con los nacidos vivos, hubo 5,05 muertes por cada millón
Subject(s)
Humans , Female , Pregnancy , Adult , Maternal Mortality/trends , Hyperemesis Gravidarum/mortalityABSTRACT
Durante el período estudiado se registraron 1.145 muertes maternas y el 0,34% de las muertes obstétricas. Las causas de muerte fueron bronconeumonia en 2 y en una no se encontró causa anatómica de la misma
