Dataset Information

Hyperemesis gravidarum and long-term mortality: a population-based cohort study.

ABSTRACT: To investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long-term mortality.Population-based cohort study.Medical Birth Registry of Norway (1967-2002) linked to the Cause of Death Registry.Women in Norway with singleton births in the period 1967-2002, with and without HG. Women were followed until 2009 or death.Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI).The primary outcome was all-cause mortality during follow up. Secondary outcomes were cause-specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders).Of 999 161 women with singleton births, 13 397 (1.3%) experienced HG. During a median follow up of 26 years (25 902 036 person-years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long-term all-cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75-0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84-1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83-1.29), but a lower long-term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75-0.98).In this large population-based cohort study, HG was not associated with an increased risk of long-term all-cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer.Population-based cohort study: Hyperemesis was not associated with an increased risk of long-term mortality.

SUBMITTER: Fossum S

PROVIDER: S-EPMC5484313 | biostudies-other | 2017 Jun

REPOSITORIES: biostudies-other

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Hyperemesis gravidarum and long-term mortality: a population-based cohort study.

Fossum S S Vikanes Å V ÅV Naess Ø Ø Vos L L Grotmol T T Halvorsen S S

BJOG : an international journal of obstetrics and gynaecology 20161215 7

<h4>Objective</h4>To investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long-term mortality.<h4>Design</h4>Population-based cohort study.<h4>Setting</h4>Medical Birth Registry of Norway (1967-2002) linked to the Cause of Death Registry.<h4>Population</h4>Women in Norway with singleton births in the period 1967-2002, with and without HG. Women were followed until 2009 or death.<h4>Methods</h4>Cox proportional hazard regression model was applied to es ...[more]

PMID: 27981734

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Project description:BackgroundIt is unclear whether an upper gastrointestinal bleed is an isolated gastrointestinal event or an indicator of a deterioration in a patient's overall health status. Therefore, we investigated the excess causes of death in individuals after a non-variceal bleed compared with deaths in a matched sample of the general population.Methods and findingsLinked longitudinal data from the English Hospital Episodes Statistics (HES) data, General Practice Research Database (GPRD), and Office of National Statistics death register were used to define a cohort of non-variceal bleeds between 1997 and 2010. Controls were matched at the start of the study by age, sex, practice, and year. The excess risk of each cause of death in the 5 years subsequent to a bleed was then calculated whilst adjusting for competing risks using cumulative incidence functions. 16,355 patients with a non-variceal upper gastrointestinal bleed were matched to 81,523 controls. The total 5-year risk of death due to gastrointestinal causes (malignant or non-malignant) ranged from 3.6% (≤ 50 years, 95% CI 3.0%-4.3%) to 15.2% (≥ 80 years, 14.2%-16.3%), representing an excess over controls of between 3.6% (3.0%-4.2%) and 13.4% (12.4%-14.5%), respectively. In contrast the total 5-year risk of death due to non-gastrointestinal causes ranged from 4.1% (≤ 50 years, 3.4%-4.8%) to 46.6% (≥ 80 years, 45.2%-48.1%), representing an excess over controls of between 3.8% (3.1%-4.5%) and 19.0% (17.5%-20.6%), respectively. The main limitation of this study was potential misclassification of the exposure and outcome; however, we sought to minimise this by using information derived across multiple linked datasets.ConclusionsDeaths from all causes were increased following an upper gastrointestinal bleed compared to matched controls, and over half the excess risk of death was due to seemingly unrelated co-morbidity. A non-variceal bleed may therefore warrant a careful assessment of co-morbid illness seemingly unrelated to the bleed.

Dataset Information

Hyperemesis gravidarum and long-term mortality: a population-based cohort study.

Publications

Hyperemesis gravidarum and long-term mortality: a population-based cohort study.

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