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Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis

European Journal of Epidemiology volume 28, pages 1–19 (2013)Cite this article

Abstract

There is increasing evidence that pre-eclampsia, a principal cause of maternal morbidity, may also be a risk factor for future cardiovascular and cerebrovascular events. This review aimed to assess the current evidence and quantify the risks of cardiovascular disease (CVD), cerebrovascular events and hypertension associated with prior diagnosis of pre-eclampsia. Medline and Embase were searched with no language restrictions, as were core journals and reference lists from reviews up until January 2012. Case–control and cohort studies which reported cardiovascular and cerebrovascular diseases or hypertension diagnosed more than 6 weeks postpartum, in women who had a history of pre-eclampsia relative to women who had unaffected pregnancies, were included. Fifty articles were included in the systematic review and 43 in the meta-analysis. Women with a history of pre-eclampsia or eclampsia were at significantly increased odds of fatal or diagnosed CVD [odds ratio (OR) = 2.28, 95 % confidence interval (CI): 1.87, 2.78], cerebrovascular disease (OR = 1.76, 95 % CI 1.43, 2.21) and hypertension [relative risk (RR) = 3.13, 95 % CI 2.51, 3.89]. Among pre-eclamptic women, pre-term delivery was not associated with an increased risk of a future cardiovascular event (RR = 1.32, 95 % CI 0.79, 2.22). Women diagnosed with pre-eclampsia are at increased risk of future cardiovascular or cerebrovascular events, with an estimated doubling of odds compared to unaffected women. This has implications for the follow-up of all women who experience pre-eclampsia, not just those who deliver pre-term. This association may reflect shared common risk factors for both pre-eclampsia and cardiovascular and cerebrovascular disease.

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Acknowledgments

This research is funded by Newcastle upon Tyne Hospitals NHS Foundation Trust.

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  1. Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne, England, NE2 4AX, UK

    Kate Elizabeth Best & Ruth Bell

  2. Directorate of Women’s Services, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK

    Jason Waugh

  3. Institute of Cellular Medicine, Newcastle University, William Leech Building, The Medical School, Newcastle upon Tyne, NE2 4HH, UK

    Stephen Courtenay Robson

  4. Institute of Health & Society, Newcastle University, Sir James Spence Institute of Child Health, Royal Victoria Infirmary, Newcastle upon Tyne, England, NE1 4LP, UK

    Morven Caroline Brown & Mark Stephen Pearce

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Brown, M.C., Best, K.E., Pearce, M.S. et al. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol 28, 1–19 (2013). https://doi.org/10.1007/s10654-013-9762-6

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Keywords

  • Pre-eclampsia
  • Cardiovascular disease
  • Cerebrovascular disease
  • Hypertension