OBJECTIVES: To assess the risk of gestational hypertension (GH) and preeclampsia (PE) during a second pregnancy after occurrence during a first pregnancy. DESIGN: CONCEPTION is a French nationwide cohort study that used data from the National Health Data System (SNDS) database. We included all women who gave birth for the first time in France in 2010-2018, and who subsequently gave birth. We identified GH and PE through hospital diagnoses and the dispensing of anti-hypertensive drugs. The incidence rate ratios (IRR) of all HDP during the second pregnancy were estimated using Poisson models adjusted for confounding. RESULTS: Of the 2,829,274 women included, 238,506 (8.4%) were diagnosed with an HDP during their first pregnancy. In women with GH during their first pregnancy, 11.3% (IRR 95%CI=?4.5 [4.4-4.7]) and 3.4% (IRR=?5.0 [4.8-5.3]) developed GH and PE during their second pregnancy, respectively. In women with PE during their first pregnancy, 7.4% (IRR=?2.6 [2.5-2.7]) and 14.7% (IRR=?14.3 [13.6-15.0]) developed GH and PE during their second pregnancy, respectively. The more severe and early was the PE during the first pregnancy, the stronger was the likelihood of having PE during the second pregnancy. Maternal age, social deprivation, obesity, diabetes, and chronic hypertension were all associated with PE recurrence. CONCLUSION: These results can guide policymaking that focuses on improving counselling for women who wish to become pregnant more than once, by identifying those who would benefit more from tailored management of modifiable risk factors, and heightened surveillance during post-first pregnancies.
Auteur : Lailler Grégory, Grave Clémence, Gabet Amélie, Regnault Nolwenn, Deneux-Tharaux Catherine, Kretz Sandrine, Tsatsaris Vassilis, Plu-Bureau Geneviève, Blacher Jacques, Olié Valérie
BJOG : an international journal of obstetrics and gynaecology, 2023
