Dr Emily Beard4, Dr Ketan Panat3, Professor Heath Ecroyd2, Dr Megan Kelly1,3
1School of Medical, Indigenous & Health Sciences, University Of Wollongong, Wollongong, Australia, 2Molecular Horizons and School of Chemistry and Molecular Biosciences, University of Wollongong, Wollongong, Australia, 3Graduate School of Medicine, University of Wollongong, Wollongong, Australia, 4Gold Coast Health, Australia
Biography:
Biographies to come
Abstract:
Preeclampsia and other disorders of pregnancy have been associated with a range of longer-term sequelae. This study examined rates of disease presentation following preeclampsia or other pregnancy complications within a 10-year period to identify any disease risk and time to onset of disease.
An analysis was conducted on patient data collected between 2008-2017 at the Illawarra Shoalhaven Local Health District (ISLHD), NSW Australia. Patients were included if they were over 18 years of age, had been pregnant, and were subsequently admitted for any cardiovascular events, kidney disease, or diabetes. Incidence rates of disease were compared between healthy pregnancies and those that included either preeclampsia (PE), gestational hypertension (GHTN), gestational diabetes (GD) or a combination of these.
Data from 9446 patients were analysed, comprising 66.4% uncomplicated pregnancies, 5.1% PE, 7.4% GHTN, 17.2% GD, 1.5% PE + GD and 2.0% GHTN + GD. Only five instances of chronic kidney disease occurred. Hypertension was more common following PE, GHTN or GD, compared to healthy pregnancies (X²=79.1, 5, p<0.001). The mean (±SD) time to onset was 4.3 (±2.1) years for healthy pregnancies and this was similar for all conditions (PE: 4.8±3.1 years, GHTN: 4.1±1.9 years, and GD: 4.4±2.1 years). Incidence of diabetes was only increased in the GD cohort (X²=63.7, 5, p<0.001). The time to onset of diabetes was similar between healthy and complicated pregnancies, with the median (IQR) for healthy pregnancies 3.4(3.0) years, 3.0 (±3.2) years for PE, 3.3(2.8) years for GD, and 5.5 (±3.7) years for GHTN.
Routine screening for hypertension and diabetes following pregnancy complications is currently advised, but often not prioritised. This study has demonstrated an increased risk of hypertension and diabetes following PE, GD or GHTN and that these conditions arise on average 4-years post-pregnancy.
Keywords
Preeclampsia, gestational diabetes, long-term disease-risk