Hypertensive disorders of pregnancy among women with a history of leukemia or lymphoma

Sonia T Anand; Kelli K Ryckman; Rebecca J Baer; Mary E Charlton; Patrick J Breheny; William W Terry; Monica R McLemore; Deborah A Karasek; Laura L Jelliffe-Pawlowski; Elizabeth A Chrischilles

doi:10.1016/j.preghy.2022.07.002

Hypertensive disorders of pregnancy among women with a history of leukemia or lymphoma

Pregnancy Hypertens. 2022 Aug:29:101-107. doi: 10.1016/j.preghy.2022.07.002. Epub 2022 Jul 6.

Affiliations

¹ Department of Epidemiology, University of Iowa, Iowa City, IA, United States.
² Department of Epidemiology, University of Iowa, Iowa City, IA, United States; Department of Pediatrics, University of Iowa, Iowa City, IA, United States.
³ Department of Pediatrics, University of California San Diego, La Jolla, CA, United States; California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States.
⁴ Department of Biostatistics, University of Iowa, Iowa City, IA, United States.
⁵ Department of Pediatrics, University of Iowa, Iowa City, IA, United States.
⁶ Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA, United States.
⁷ Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States.
⁸ California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States.
⁹ Department of Epidemiology, University of Iowa, Iowa City, IA, United States. Electronic address: e-chrischilles@uiowa.edu.

Abstract

Objective: Hypertension during pregnancy can adversely affect maternal and fetal health. This study assessed whether diagnosis of leukemia or lymphoma prior to pregnancy is associated with hypertensive disorders of pregnancy including gestational hypertension, preeclampsia and eclampsia.

Study design: A cross-sectional study used two statewide population-based datasets that linked birth certificates with sources of maternal medical history: hospital discharges in California and Surveillance, Epidemiology, and End Results (SEER) cancer registry data in Iowa. Birth years included 2007-2012 in California and 1989-2018 in Iowa.

Main outcome measures: Primary outcome measure was hypertension in pregnancy measured from combined birth certificate and hospital diagnoses in California (for gestational hypertension, preeclampsia, or eclampsia) and birth certificate information (gestational hypertension or eclampsia) in Iowa.

Results: After adjusting for maternal age, race, education, smoking, and plurality, those with a history of leukemia/lymphoma were at increased risk of hypertensive disorders of pregnancy in Iowa (odds ratio (OR) = 1.86; 95% CI 1.07-3.23), but not in California (OR = 1.12; 95% CI 0.87-1.43). In sensitivity analysis restricting to more severe forms of hypertension in pregnancy (preeclampsia and eclampsia) in the California cohort, the effect estimate increased (OR = 1.29; 95% CI 0.96-1.74).

Conclusion: In a population-based linked cancer registry-birth certificate study, an increased risk of hypertensive disorders of pregnancy was observed among leukemia or lymphoma survivors. Findings were consistent but non-significant in a second, more ethnically diverse study population with less precise cancer history data. Improved monitoring and surveillance may be warranted for leukemia or lymphoma survivors throughout their pregnancies.

Keywords: Eclampsia; Gestational hypertension; Leukemia; Lymphoma; Preeclampsia; Pregnancy.

MeSH terms

Cross-Sectional Studies
Eclampsia*
Female
Humans
Hypertension, Pregnancy-Induced*
Leukemia*
Lymphoma*
Pre-Eclampsia* / diagnosis
Pregnancy

Hypertensive disorders of pregnancy among women with a history of leukemia or lymphoma

Authors

Affiliations

Abstract

MeSH terms

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