Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis

被引:1802
|
作者
Bellamy, Leanne
Casas, Juan-Pablo
Hingorani, Aroon D.
Williams, David J. [1 ]
机构
[1] UCL, Elizabeth Garrett Anderson Obstet Hosp, Inst Womens Hlth, London WC1E 6DH, England
[2] Imperial Coll Sch Med, London, England
[3] London Sch Hyg & Trop Med, Dept Epidemiol & Populat Hlth, London, England
[4] UCL, British Heart Fdn Labs, Dept Med, London WC1E 6DH, England
来源
BMJ-BRITISH MEDICAL JOURNAL | 2007年 / 335卷 / 7627期
关键词
D O I
10.1136/bmj.39335.385301.BE
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To quantify the risk of future cardiovascular diseases, cancer, and mortality after pre-eclampsia. Design Systematic review and meta-analysis. Data sources Embase and Medline without language restrictions, including papers published between 1960 and December 2006, and hand searching of reference lists of relevant articles and reviews for additional reports. Review methods Prospective and retrospective cohort studies were included, providing a dataset of 3 488 160 women with 198 252 affected by pre-eclampsia (exposure group) and 29 495 episodes of cardiovascular disease and cancer (study outcomes). Results After pre-eclampsia women have an increased risk of vascular disease. The relative risks (95% confidence intervals) for hypertension were 3.70 (2.70 to 5.05) after 14.1 years weighted mean follow-up, for ischaernic heart disease 2.16 (1.86 to 2.52) after 11.7 years, for stroke 1.81 (1.45 to 2.27) after 10.4 years, and for venous thromboembolism 1.79 (1.37 to 2.33) after 4.7 years. No increase in risk of any cancer was found (0.96, 0.73 to 1.27), including breast cancer (1.04, 0.78 to 1.39) 17 years after pre-eclampsia. Overall mortality after pre-eclampsia was increased: 1.49 (1.05 to 2.14) after 14.5 years. Conclusions A history of pre-eclampsia should be considered when evaluating risk of cardiovascular disease in women. This association might reflect a common cause for pre-eclampsia and cardiovascular disease, or an effect of pre-ecampsia on disease development, or both. No association was found between pre-eclampsia and future cancer.
引用
收藏
页码:974 / 977
页数:6
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