A woman's reproductive success: Long-term implications for chronic diseases and death
Pregnancy outcomes and long-term maternal mortality risk have never before been addressed based on the woman's complete reproductive history. The project will fundamentally change how physicians interpret the effects of adverse pregnancy outcomes on mother's future health and may also lead to new opportunities for diagnosis and prevention of latent maternal diseases that are expressed first as pregnancy failure.
Main content
Pregnancy problems like preeclampsia, gestational diabetes and preterm birth have long been studied in relation to the infant's health.
Studies have begun to consider how such problems might influence the mother's long-term mortality. Women die at younger ages if they: delivered preterm, developed preeclampsia or the child had low birth weight.
Observations are typically based on studies of the 1st pregnancy which leads to invalid conclusions: adverse pregnancy outcomes may impede a 2nd pregnancy, and women with one pregnancy have higher mortality than women with more pregnancies.
We will study long-term maternal health in relation to complete pregnancy histories utilizing the Medical Birth Registry of Norway - one of the few settings in the world where this is available. This unique source of population-based data covers 1967-2009, with 2.5 million births in 1.2 million sibships, linked to death- and education-registries.
Preliminary analyses suggest that long-term mortality is better predicted by the mother's total reproductive experience and that the association of preeclampsia in the first pregnancy with maternal cardiovascular disease disappears in mothers who continue with healthy pregnancies.
Focus will be on preeclampsia, preterm birth, perinatal death, birth defects, and fetal growth. We will study variation in total maternal mortality, deaths due to cardiovascular causes, site-specific cancers and stroke, contrast the results with paternal survival, and evaluate effect differences between social strata (maternal education).
Link to 'The Research Council of Norway':
http://www.forskningsradet.no/servlet/Satellite?c=Prosjekt&cid=1253972098562&pagename=folkehelse/Hovedsidemal&p=1222932153146
