Background
Hypertensive disorders of pregnancy (HDP) affect 18 million women annually. It is increasingly recognised that HDP are associated with increased risk of maternal cardiovascular and renal disease. Less is known about the risk of other chronic diseases, particularly those which emerge in older age, such as dementia, retinal vascular disease, and stroke. It is unclear whether patients and healthcare professionals have adequate awareness of links between HDP and chronic disease. It is also unknown whether existing follow-up pathways after HDP are providing adequate opportunities for chronic disease prevention in Ireland.
Aim
To investigate the long-term impacts of HDP on the risk of chronic disease in women, and to explore optimal models of follow-up care in Ireland.
Objectives
To examine associations between HDP and long-term risk of dementia in a national cohort of parous women
To synthesise existing evidence on the associations between HDP and long-term risk of retinal vascular disease
To measure associations between HDP and long-term risk of retinal disease in parous women
To examine the mediating roles of postpartum hypertension and diabetes in the association of preeclampsia and maternal stroke
To explore women’s experiences and perceptions of follow-up care in the years after a diagnosis of preeclampsia in Ireland
To explore doctors’ perceptions and attitudes towards delivery of follow-up care to women after a diagnosis of preeclampsia in Ireland
Methods
Objectives 1, 3 and 4 will be addressed using large-scale epidemiological data on over 2 million parous women in the Swedish national registries. Women will be followed up from 1973-2021 inclusive using survival analysis methods. A systematic review will be undertaken to investigate associations between HDP and maternal retinal disorders (Objective 2). Semi-structured qualitative interviews will also be conducted to explore women and doctors’ experiences and perceptions of follow-up care after preeclamptic pregnancy in Ireland (Objectives 5-6).
