Preterm Deliveries and Hypertension: Examining two sides of a study

Dr Mgha Consul and Dr Prasanna Latha discuss two sides of the study on preterm delivery.
Representational image of pregnancy.
Representational image of pregnancy.

Name of study: Preterm delivery has been associated with a high risk of hypertension in the future
By who and where: Icahn School of Medicine at Mount Sinai in New York City, and JAMA Cardiology

What does it say?
✥ Women who delivered preterm babies are more prone to lifelong hypertension. 
✥ Preterm deliveries can increase your chances of a stroke, and cardiovascular problems or related death. 
✥ A national cohort study was conducted in which it was found that those delivered before 37 weeks had a 1.67-fold increased risk of hypertension in the next decade of life.

For

Has an effect  
Dr Megha Consul, Principal Consultant, Paediatrics, Max Hospital, Gurgaon

It appears that preterm delivery contributes to or modulates the mechanisms that lead to cardiovascular diseases in women, which is, maybe, because of the triggering of inflammation that is undetectable before pregnancy. This event changes the lining of the small vessels, leading to cardiovascular diseases. Preterm delivery should, therefore, be recognised as a lifelong risk factor for hypertension in women. A history of preterm deliveries may help identify women who are at a greater risk for hypertension, thereby pushing them in the direction of prevention. 

Against

It is inconclusive 
Dr Prasanna Latha, Senior Obstetrician and Gynaecologist, Kamineni Hospitals, Hyderabad

The association between hypertension in pregnancy leading to preterm delivery is proven but not the opposite. This is because most of the conditions that lead to preterm deliveries, per se, can lead to hypertension in these women, like diabetes. Also, the basic pathophysiologic mechanisms that lead to cardiovascular disease (CVD) may contribute to preterm delivery, which makes it difficult to conclude whether preterm delivery is the cause or effect of CVD and chronic hypertension in future. 

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