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Preeclampsia and Long-term Risk of Maternal Retinal Disorders

Auger, Nathalie MD, MSc; Fraser, William D. MD, MSc; Paradis, Gilles MD, MSc; Healy-Profitós, Jessica MPH; Hsieh, Ada; Rhéaume, Marc-André MD

doi: 10.1097/AOG.0000000000001758
Contents: Original Research

OBJECTIVE: To evaluate whether preeclampsia is associated with risk of maternal retinal disease in the decades after pregnancy.

METHODS: We carried out a longitudinal cohort study of 1,108,541 women who delivered neonates in any hospital in Quebec, Canada, between 1989 and 2013. We tracked women for later hospitalizations until March 31, 2014. Preeclampsia was measured at delivery categorized by severity (mild or severe) and onset (before or at 34 weeks or more of gestation). Main outcomes were hospitalizations and inpatient procedures for retinal detachment, retinopathy, or other retinal disorders. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) comparing preeclampsia with no preeclampsia adjusting for diabetes and hypertension.

RESULTS: Compared with no preeclampsia, women with preeclampsia had a higher incidence of hospitalization for retinal detachment (52.9 compared with 23.9/10,000), retinopathy (60.5 compared with 8.0/10,000), and other retinal disorders (13.3 compared with 7.3/10,000). Preeclampsia was most strongly associated with traction detachments (HR 2.39, 95% CI 1.52–3.74), retinal breaks (HR 2.48, 95% CI 1.40–4.41), and diabetic retinopathy (HR 4.13, 95% CI 3.39–5.04). Severe and early-onset preeclampsia was associated with even higher risk compared with mild or late-onset preeclampsia.

CONCLUSION: Preeclampsia, particularly severe or early-onset preeclampsia, is associated with an increased risk of maternal retinal disease in the decades after pregnancy.

Preeclampsia is associated with an increased risk of maternal retinal disorders well past pregnancy.

University of Montreal Hospital Research Centre, the Institut national de santé publique du Québec, the Department of Epidemiology, Biostatistics, and Occupational Health and the Faculty of Medicine, McGill University, the Department of Ophthalmology, University of Montreal, Montreal, and the Department of Obstetrics & Gynecology, Sherbrooke University Hospital Research Centre, Sherbrooke, Québec, Canada.

Corresponding author: Nathalie Auger, MD, MSc, 190 Cremazie Boulevard E, Montreal, Quebec H2P 1E2, Canada; email: nathalie.auger@inspq.qc.ca.

Supported by the Canadian Institutes for Health Research (MOP-130452). N.A. acknowledges a career award from the Fonds de recherche du Québec-Santé.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2017 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.