Preeclampsia and Long-Term Risk of Arrhythmias

First time mothers with a history of preeclampsia are at a future higher risk of developing arrhythmia than women without preeclampsia, according to results of a study published May 17, 2024 in the European Journal of Preventive Cardiology.1

Researchers from the Copenhagen University Hospital, Denmark sought to investigate if preeclampsia was linked to heart rhythm problems in primiparous mothers. For this they examined data from Danish nationwide registries to identify all primiparous women who gave birth in Denmark between 1997 and 2016. None of them had a history of arrhythmias. The study participants were then categorized based on whether they developed preeclampsia (PE) during their primiparous pregnancy. They were followed from the time of their primiparous pregnancy until the occurrence of one of the following events: Incident arrhythmia, death, emigration or until December  2018, which was when the study period ended.

A total of 523,271 primiparous women were included in the study. The median age of the cohort was 28 years. Of these, 23,367 women (4.5%) had preeclampsia; 21,271 (4.1%) were late-onset and 2096 (0.4%) were early-onset preeclampsia.

During the follow-up period, 5,440 women (1.04%) developed arrhythmias. This included 1.4% of women with PE and 1.0% of women without PE. The median time from primiparous pregnancy to incident arrhythmia was 7.1 years. Women with PE were associated with a significantly higher 20-year cumulative incidence of arrhythmias compared to those without PE (2.8% vs. 2.2%). Women with earlier onset of preeclampsia were at an even higher risk 

Women with preeclampsia were found to have a higher likelihood of developing arrhythmias (1.42%) compared to those without preeclampsia (1.42%) over the median follow-up period of 10.1 years. The adjusted hazard ratio (aHR) for the composite of cardiac arrest, ventricular tachycardia or fibrillation, or ICD implantation was 1.60. The aHR for the composite of advanced 2nd degree or 3rd degree atrioventricular block, sinoatrial dysfunction, or pacemaker implantation was 1.48. For the composite of supraventricular tachyarrhythmias or extrasystoles, the aHR was 1.34. For the composite of all the above-mentioned arrhythmias, the aHR was 1.37.

The association of preeclampsia with hypertension and heart disease is well established. This observational cohort study shows that primiparous women with preeclampsia have a significantly increased long-term rate of arrhythmias. Hence, women with a history of preeclampsia need extra attention and may benefit from cardiovascular risk assessment, regular screening and preventive education to prevent future such events. These measures could potentially mitigate the heightened risk of arrhythmias and improve long-term cardiovascular health outcomes in this population.

Reference

1.    Havers-Borgersen E, et al. Association between preeclampsia and long-term risk of arrhythmias. Eur J Prev Cardiol. 2024 May 17:zwae176. doi: 10.1093/eurjpc/zwae176.