Cardiovascular risk trajectories in women with history of pregnancy complications

In this project, we aimed to utilize uniquely longitudinal HUNT cohort data to gain new knowledge about the associations of common pregnancy complications with future cardiovascular disease (CVD) risk. The project was funded by the Research Council of Norway and conducted in collaboration with Brigham and Women’s Hospital and Harvard School of Public Health, and with the University of Bristol.

We estimated the life-course trajectories of blood pressure from pre-pregnancy to >50 ys of age and identified a long-lasting drop in mean blood pressures following pregnancy. From before first pregnancy to beyond 50 ys of age, women with preeclampsia in their first pregnancy consistently had higher mean measures of adiposity, blood pressure, heart rate, and serum lipids and glucose compared with women with a normotensive first pregnancy. This excess adiposity and blood pressure could explain much of the excess risk of CVD events in women with a history of preeclampsia. However, adding information on pregnancy complications did not substantially improve CVD prediction. We also examined associations of parity with life-course serum lipid levels and CVD risk related to offspring birthweight and preterm delivery.

Using a sibling design, we examined CVD risk factors in young adults born after pregnancy with preeclampsia or gestational hypertension. These offspring had a more adverse cardiovascular risk profile in young adulthood than offspring of normotensive pregnancies. However, their siblings, born after a normotensive pregnancy, had a similar risk profile, suggesting that shared genes or lifestyle may account for the association, rather than an intrauterine effect. We have subsequently followed up the study of potential long-term consequences of intrauterine exposures using intergenerational Mendelian randomization, see HUNT MCE Family Consortium.

We have further contributed to international consortia on genetic determinants of pregnancy-related traits such as placental weight.