Pregnancy-Induced Hypertensive Disorders before and after a National Economic Collapse: A Population Based Cohort Study.

• Published in: PLOS ONE
• Main Authors: Eiríksdóttir, Védís Helga, Valdimarsdóttir, Unnur Anna, Ásgeirsdóttir, Tinna Laufey, Hauksdóttir, Arna, Lund, Sigrún Helga, Bjarnadóttir, Ragnheiður Ingibjörg, Cnattingius, Sven, Zoëga, Helga
• Other Authors: 1 Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland 2 Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA 3 Univ Iceland, Fac Econ, Reykjavik, Iceland 4 Landspitali Univ Hosp, Dept Obstet & Gynecol, Reykjavik, Iceland 5 Karolinska Inst, Dept Med, Clin Epidemiol Unit, Stockholm, Sweden
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library Science 2016
• Subjects: Háþrýstingur; Meðganga; Hypertension; Pregnancy-Induced; Adrenergic beta-Antagonists; Iceland
• Online Access: http://hdl.handle.net/2336/604626; https://doi.org/10.1371/journal.pone.0138534

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access. Data on the potential influence of macroeconomic recessions on maternal diseases during pregnancy are scarce. We aimed to assess potential change in prevalence of pregnancy-induced hypertensive disorders (preeclampsia and gestational hypertension) during the first years of the major national economic recession in Iceland, which started abruptly in October 2008. Women whose pregnancies resulted in live singleton births in Iceland in 2005-2012 constituted the study population (N = 35,211). Data on pregnancy-induced hypertensive disorders were obtained from the Icelandic Medical Birth Register and use of antihypertensive drugs during pregnancy, including β-blockers and calcium channel blockers, from the Icelandic Medicines Register. With the pre-collapse period as reference, we used logistic regression analysis to assess change in pregnancy-induced hypertensive disorders and use of antihypertensives during the first four years after the economic collapse, adjusting for demographic and pregnancy characteristics, taking aggregate economic indicators into account. Compared with the pre-collapse period, we observed an increased prevalence of gestational hypertension in the first year following the economic collapse (2.4% vs. 3.9%; adjusted odds ratio [aOR] 1.47; 95 percent confidence interval [95%CI] 1.13-1.91) but not in the subsequent years. The association disappeared completely when we adjusted for aggregate unemployment rate (aOR 1.04; 95% CI 0.74-1.47). Similarly, there was an increase in prescription fills of β-blockers in the first year following the collapse (1.9% vs.3.1%; aOR 1.43; 95% CI 1.07-1.90), which disappeared after adjusting for aggregate unemployment rate (aOR 1.05; 95% CI 0.72-1.54). No changes were observed for preeclampsia or use of calcium channel blockers between the pre- and post-collapse ...