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Hyperemesis gravidarum and long-term mortality: a population-based cohort study
S Fossum1,2, Å V Vikanes3, Ø Naess4,2
1Department of Cardiology, Oslo University Hospital Ulleval, Oslo, Norway.
Objective:
To investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long-term mortality.
Design:
Population-based cohort study.
Setting:
Medical Birth Registry of Norway (1967-2002) linked to the Cause of Death Registry.
Population:
Women in Norway with singleton births in the period 1967-2002, with and without HG. Women were followed until 2009 or death.
Methods:
Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI).
Main Outcome Measures:
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).
Results:
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).
Conclusion:
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.
Tweetable Abstract:
Population-based cohort study: Hyperemesis was not associated with an increased risk of long-term mortality.
