Pregnancy and perinatal complications and mortality: Collaborative Perinatal Project mortality linkage study

Eunice Kennedy Shriver National Institute Of Child Health & Human Development

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Abstract

The overarching goal of this study is to link pregnancy data to mortality data, from the CPP to the NDI. A successful linkage of such data offers the potential to investigate associations between a spectrum of pregnancy-related complications and neonatal outcomes with total mortality and cause specific mortality. Thus, the primary study objective is to link CPP records to the NDI. Secondarily, such a linkage will facilitate the investigation of numerous important hypothesis on the relationship between gravid health and overall and cause-specific mortality for both women and their children. Examples of specific hypotheses are listed below. 1) Pregnancy induced hypertension and preeclampsia are significantly associated with total mortality and cause specific mortality, in particular CVD mortality; 2) Gestational diabetes mellitus is significantly associated with total mortality and cause specific mortality, in particular diabetes and CVD mortality; 3) Pre-term delivery is significantly associated with total mortality and cause specific mortality. 4) Asthma in pregnancy is significantly associated with total mortality and cause specific mortality; 5) Longer time to pregnancy is significantly associated with total mortality and cause specific mortality; 6) Placental characteristics (e.g. infarcts, thrombi) in association with total mortality and particularly CVD mortality in a subgroup with data (n=36,259). The linkage data was received in September 2017. Before the main analyses could be completed, critical work on the validity of the linkage was necessary. In July 2019 a manuscript on the feasibility of linking the Collaborative Perinatal Project to death records was accepted in the journal Epidemiology. We found that linking this historic cohort with mortality records was feasible with reasonable agreement on vital status when compared to other data sources. Analyses addressing aims 1-3, and 6 above are underway. An abstract on preliminarily findings of the associations between pregnancy hypertension, gestational diabetes, and preterm delivery was presented in June 2019.