Arrhythmias & electrophysiologyCohort study
Risk of Incident Atrial Fibrillation in Women With a History of Hypertensive Disorders of Pregnancy: A Population-Based Retrospective Cohort Study
- Retrospective cohort study
- population-based
Competing risks Cox proportional hazards regression; ICES linked administrative databases
Authors' conclusion
Women exposed to HDP in their first delivery have a significantly increased cause-specific hazard ratios of incident AFib compared to their unexposed counterparts, with higher rates observed in subjects exposed to more severe de novo HDP diagnoses as well as chronic hypertension in pregnancy.
Study context
- Population
- Nulliparous women discharged for delivery of first live or stillborn singleton infant, Ontario, Canada, 2002–2017≈8% with hypertensive disorders of pregnancy (HDP)
- Participants
- 771,521 women
- Exposure
- History of any HDP vs no hypertension in pregnancy
- Outcome
- Incident AF before death
Main finding
Incident AF
Adjusted cause-specific hazard ratio
1.45
95% CI 1.28–1.64
As reported in the abstract
- Incident AF diagnoses, whole cohort (7 380 304 person-years)
- 2483 (0.3%)
- Median time to event (years postpartum)
- 7
Observational data: associations, not effects.
Further findings
| Outcome | adjusted cause-specific HR (95% CI) | |
|---|---|---|
| Death without previous AF diagnosis | 1.31 (1.16–1.47) | |
| 0.512Adjusted cause-specific hazard ratio (log scale) |
- Death without previous AF diagnosis — Deaths, whole cohort
- 2951 (0.4%)
Incident AF and death, by HDP subtype (more severe subtypes and prepregnancy chronic hypertension)
- Higher cause-specific rate of AF vs no hypertension in pregnancy (times)
- 1.5 to 2.2
- Higher cause-specific rate of death vs no hypertension in pregnancy (times)
- 1.4 to 2.1
- suggestive of a dose-response relationship
Original publication
Summarised from the published abstract; every number is checked against it