{
  "abstract": "Background There is a known association between pre-eclampsia (PE) and other hypertensive disorders of pregnancy (HDP), and increased risk of cardiovascular diseases (CVD). Reproductive history is associated with maternal mortality. We studied the causes of death in women of reproductive age and how a history of HDP affects mortality.Methods We collected and analysed the perinatal data of national registers in a study of 555 345 women born in Finland during 1966—1990. The follow-up started from the woman’s first birth and ended on the first CVD, death or at the end of the follow-up of 23 years.Results There were 295 373 women whose first birth was registered 1997—2019 and among them, 1287 deaths (cancer 493 deaths, preventable causes (suicide, accidents, alcohol, other external causes) 450 deaths, CVD 126 deaths). The diagnosis of PE or other HDP increased CVD mortality (risk ratio 2.69 (95% CI 1.40, 5.16) and 2.02 (95% CI 1.21, 3.38), respectively), compared with normotensive pregnancy. In the Poisson regression analyses, in women with other HDP than PE, a higher CVD mortality was found (mortality rate ratio 3.98, 95% CI 1.97, 8.04). Survival analysis showed reduced survival in women with PE for both CVD and all-cause mortality.Conclusions  Reproductive history, specifically preventable and CVD cause, has a significant role in mortality of women of reproductive age. Women have an increased risk of CVD death, and reduced survival of CVD mortality, if they have PE or other HDP, in the pregnancy associated with their first birth.",
  "authors": [
    {
      "affiliations": [
        "Tampere Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland",
        "Department of Clinical Genetics, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland"
      ],
      "name": "Tanja Saarela"
    },
    {
      "affiliations": [
        "Tampere Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland",
        "Department of Obstetrics and Gynaecology, Satasairaala Central Hospital, Wellbeing Services County of Satakunta, Pori, Finland",
        "Department of Obstetrics and Gynaecology, University of Turku, Turku, Finland"
      ],
      "name": "Laura Peltomäki"
    },
    {
      "affiliations": [
        "Tampere Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland",
        "Department of Obstetrics and Gynaecology, Kanta-Häme Central Hospital, Wellbeing Services County of Kanta-Häme, Hameenlinna, Finland"
      ],
      "name": "Anna Kivioja"
    },
    {
      "affiliations": [
        "Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland",
        "Department of Food and Nutrition, University of Helsinki, Helsinki, Finland"
      ],
      "name": "Tiina Jääskeläinen"
    },
    {
      "affiliations": [
        "Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland"
      ],
      "name": "Jari Haukka"
    },
    {
      "affiliations": [
        "Tampere Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland",
        "Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland",
        "Institute for Molecular Medicine, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland",
        "Department of Obstetrics and Gynaecology, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland"
      ],
      "name": "Hannele Laivuori"
    }
  ],
  "title": "External causes are leading causes of death in women of reproductive age: a registry study on maternal perinatal health, hypertensive pregnancy disorders and mortality in Finland",
  "uid": "6f187d1f-2b13-53f7-954d-190d2b21b087"
}