Hypertensive disorders of pregnancy among women with a history of leukemia or lymphoma

Sonia T Anand; Kelli K Ryckman; Rebecca J Baer; Mary E Charlton; Patrick J Breheny; William W Terry; Monica R McLemore; Deborah A Karasek; Laura L Jelliffe-Pawlowski; Elizabeth A Chrischilles

doi:10.1016/j.preghy.2022.07.002

Journal article

Hypertensive disorders of pregnancy among women with a history of leukemia or lymphoma

Sonia T Anand, Kelli K Ryckman, Rebecca J Baer, Mary E Charlton, Patrick J Breheny, William W Terry, Monica R McLemore, Deborah A Karasek, Laura L Jelliffe-Pawlowski and Elizabeth A Chrischilles

Pregnancy hypertension, Vol.29, p.101

08/01/2022

DOI: 10.1016/j.preghy.2022.07.002

PMCID: PMC9629696

PMID: 35853379

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Abstract

Keywords Gestational hypertension; Leukemia; Lymphoma; Pregnancy; Preeclampsia; Eclampsia Highlights * Risk of hypertensive disorders of pregnancy among women with history of leukemia/lymphoma. * No conclusive results for of hypertensive disorders of pregnancy by cancer treatments. * Higher risk of severe preeclampsia in women with a history of leukemia/lymphoma. Objective Hypertension during pregnancy can adversely affect maternal and fetal health. This study assessed whether diagnosis of leukemia or lymphoma prior to pregnancy is associated with hypertensive disorders of pregnancy including gestational hypertension, preeclampsia and eclampsia. Study design A cross-sectional study used two statewide population-based datasets that linked birth certificates with sources of maternal medical history: hospital discharges in California and Surveillance, Epidemiology, and End Results (SEER) cancer registry data in Iowa. Birth years included 2007--2012 in California and 1989--2018 in Iowa. Main outcome measures Primary outcome measure was hypertension in pregnancy measured from combined birth certificate and hospital diagnoses in California (for gestational hypertension, preeclampsia, or eclampsia) and birth certificate information (gestational hypertension or eclampsia) in Iowa. Results After adjusting for maternal age, race, education, smoking, and plurality, those with a history of leukemia/lymphoma were at increased risk of hypertensive disorders of pregnancy in Iowa (odds ratio (OR) = 1.86; 95% CI 1.07--3.23), but not in California (OR = 1.12; 95% CI 0.87--1.43). In sensitivity analysis restricting to more severe forms of hypertension in pregnancy (preeclampsia and eclampsia) in the California cohort, the effect estimate increased (OR = 1.29; 95% CI 0.96--1.74). Conclusion In a population-based linked cancer registry-birth certificate study, an increased risk of hypertensive disorders of pregnancy was observed among leukemia or lymphoma survivors. Findings were consistent but non-significant in a second, more ethnically diverse study population with less precise cancer history data. Improved monitoring and surveillance may be warranted for leukemia or lymphoma survivors throughout their pregnancies. Author Affiliation: (a) Department of Epidemiology, University of Iowa, Iowa City, IA, United States (b) Department of Pediatrics, University of Iowa, Iowa City, IA, United States (c) Department of Pediatrics, University of California San Diego, La Jolla, CA, United States (d) California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, United States (e) Department of Biostatistics, University of Iowa, Iowa City, IA, United States (f) Department of Family Health Care Nursing, University of California San Francisco, San Francisco, CA, United States (g) Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States * Corresponding author at: 145 N. Riverside Drive, S441A CPHB, Iowa City, IA 52242, United States. Article History: Received 24 May 2021; Revised 30 May 2022; Accepted 3 July 2022 Byline: Sonia T. Anand (a), Kelli K. Ryckman (a,b), Rebecca J. Baer (c,d), Mary E. Charlton (a), Patrick J. Breheny (e), William W. Terry (b), Monica R. McLemore (f), Deborah A. Karasek (g), Laura L. Jelliffe-Pawlowski (d,g), Elizabeth A. Chrischilles [e-chrischilles@uiowa.edu] (a,*)

Analysis

Cancer

Epidemiology

Hypertension

Leukemia

Lymphomas

Oncology, Experimental

Pregnancy

Pregnant women

Details

Title: Subtitle: Hypertensive disorders of pregnancy among women with a history of leukemia or lymphoma
Creators: Sonia T Anand - University of Iowa
Kelli K Ryckman - University of Iowa
Rebecca J Baer - University of California System
Mary E Charlton - University of Iowa
Patrick J Breheny - University of Iowa
William W Terry - University of Iowa
Monica R McLemore - University of California System
Deborah A Karasek - University of California, San Francisco
Laura L Jelliffe-Pawlowski - University of California, San Francisco
Elizabeth A Chrischilles - University of Iowa
Resource Type: Journal article
Publication Details: Pregnancy hypertension, Vol.29, p.101
DOI: 10.1016/j.preghy.2022.07.002
PMID: 35853379
PMCID: PMC9629696
NLM abbreviation: Pregnancy Hypertens
ISSN: 2210-7789
eISSN: 2210-7797
Publisher: Elsevier B.V
Grant note: DOI: 10.13039/100000054, name: National Cancer Institute, award: P30 CA086862-18S6
Language: English
Date published: 08/01/2022
Description audience: Academic
Academic Unit: Pharmacy; Stead Family Department of Pediatrics; Epidemiology; Biostatistics; Internal Medicine
Record Identifier: 9984280660202771

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