ABSTRACT
Preeclampsia is a severe pregnancy complication with high potential for adverse effects
on maternal and fetal health during the perinatal period. It is also associated with
an increased risk of maternal cardiovascular disease later in life. Development of
preeclampsia can be decreased by prescribing low-dose aspirin to high-risk women.
At present, maternal and pregnancy factors are used to assess the risk of preeclampsia.
One additional factor that could add to the assessment of risk is a family history
of hypertension, cardiovascular disease, or diabetes, especially for nulliparous women
who do not have a pregnancy history to inform treatment decisions. Therefore, we conducted
a systematic review to assess the association between family history of the aforementioned
conditions and preeclampsia.
Four databases including MEDLINE, EMBASE, the Cochrane Library, and CINAHL/pre-CINAHL
were searched for observational studies that examined a family history of hypertension,
cardiovascular disease, or diabetes in women with preeclampsia and in a control population.
Studies were evaluated for quality using the Newcastle-Ottawa Scale. A total of 84
relevant studies were identified. A meta-analysis was not conducted due to suspected
heterogeneity in the included studies.
Most studies reported a positive association between a family history of hypertension
or cardiovascular disease and the development of preeclampsia. The majority of studies
examining family history of diabetes reported non-significant associations. Overall,
family history of hypertension or cardiovascular disease is associated with a higher
risk for developing preeclampsia and should be considered when assessing women in
the first trimester for low-dose aspirin.
RÉSUMÉ
La pré-éclampsie est une grave complication de grossesse qui comporte un risque élevé
d'effets défavorables sur la santé maternelle et fœtale en période périnatale. La
pré-éclampsie est également associée à une augmentation du risque de maladies cardiovasculaires
plus tard dans la vie chez la mère. Il est possible de réduire le risque de pré-éclampsie
en prescrivant de l'aspirine à faible dose aux femmes à risque élevé. À l'heure actuelle,
on a recours aux facteurs maternels et obstétricaux afin d’évaluer le risque de pré-éclampsie.
Les antécédents familiaux d'hypertension, de maladies cardiovasculaires et de diabète,
en particulier chez les femmes nullipares qui n'ont pas d'antécédents de grossesse
pouvant orienter les décisions relatives au traitement, constituent un facteur supplémentaire
dont on peut tenir compte lors de l’évaluation du risque. Nous avons donc mené une
revue systématique afin de déterminer la corrélation entre la pré-éclampsie et les
antécédents familiaux de ces maladies.
Des recherches ont été effectuées dans quatre bases de données, notamment Medline,
Embase et Cochrane Library, ainsi que CINAHL/pré-CINAHL, pour trouver des études observationnelles
ayant examiné les antécédents familiaux d'hypertension, de maladies cardiovasculaires
et de diabète chez les femmes atteintes de pré-éclampsie et au sein d'une population
témoin. On a évalué la qualité des études au moyen de l’échelle de Newcastle-Ottawa.
Au total, 84 études pertinentes ont été répertoriées. Aucune méta-analyse n'a été
menée en raison d'une hétérogénéité soupçonnée des études retenues.
La plupart des études indiquent une association positive entre les antécédents familiaux
d'hypertension ou de maladies cardiovasculaires et la manifestation d'une pré-éclampsie.
La majorité des études ayant examiné les antécédents familiaux de diabète ont indiqué
une association non significative. Dans l'ensemble, les antécédents familiaux d'hypertension
et de maladies cardiovasculaires sont associés à une augmentation du risque de pré-éclampsie.
Il y a donc lieu d'en tenir compte au premier trimestre au moment d’évaluer si on
doit envisager un traitement préventif par aspirine à faible dose.
Keywords
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Article info
Publication history
Published online: August 24, 2020
Footnotes
Disclosures: V.R.K. was supported by a Frederick Banting and Charles Best Canada Graduate Scholarship Doctoral Award from the Canadian Institutes of Health Research.
All authors have indicated they meet the journal's requirements for authorship.
Identification
Copyright
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc.
