Evidence map›Paper›PMID 33952535›Full record

ArticleBMJ open2021

Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases.

William Parry-Smith, Dana Šumilo, Anuradhaa Subramanian, Krishna Gokhale, Kelvin Okoth, Ioannis Gallos, Arri Coomarasamy, Krishnarajah Nirantharakumar

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

William Parry-SmithDepartment of Obstetrics and Gynaecology, Shrewsbury and Telford Hospital NHS Trust, Telford, UK william.parry-smith1@nhs.net.ORCID 0000-0002-0017-7266
Dana ŠumiloInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.ORCID 0000-0001-6732-2459
Anuradhaa SubramanianInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Krishna GokhaleInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Kelvin OkothInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
Ioannis GallosInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Arri CoomarasamyInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Krishnarajah NirantharakumarInstitute of Applied Health Research, University of Birmingham, Birmingham, UK.
University of Birmingham · GBMax Planck Institute for Metabolism Research · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the long-term risk of developing hypertension and cardiovascular disease (CVD) among those women who suffered a postpartum haemorrhage (PPH) compared with those women who did not.

designPopulation-based longitudinal open cohort study.

settingEnglish primary care (The Health Improvement Network (THIN)) and secondary care (Hospital Episode Statistics (HES)) databases. POPULATION: Women exposed to PPH during the study period matched for age and date of delivery, and unexposed.

methodsWe conducted an open cohort study using linked primary care THIN and HES Databases, from 1 January 1997 to 31 January 2018. A total of 42 327 women were included: 14 109 of them exposed to PPH during the study period and 28 218 matched for age and date of delivery, and unexposed to PPH. HRs for cardiovascular outcomes among women who had and did not have PPH were estimated after controlling for covariates using multivariate Cox regression models. OUTCOME MEASURES: Risk of hypertensive disease, ischaemic heart disease, heart failure, stroke or transient ischaemic attack.

resultsDuring a median follow-up of over 4 years, there was no significant difference in the risk of hypertensive disease after adjustment for covariates (adjusted HR (aHR): 1.03 (95% CI: 0.87 to 1.22); p=0.71). We also did not observe a statistically significant difference in the risk of composite CVD (ischaemic heart disease, heart failure, stroke or transient ischaemic attack) between the exposed and the unexposed cohort (aHR: 0.86 (95% CI: 0.52 to 1.43; p=0.57).

conclusionOver a median follow-up of 4 years, we did not observe an association between PPH and hypertension or CVD.

Indexed as

Cardiovascular DiseasesHypertensionPostpartum HemorrhageCohort StudiesFemaleHumansLongitudinal StudiesPregnancyRisk FactorsSecondary Health Carecardiologyepidemiologyobstetrics

Identifiers

PMID33952535
PMCPMC8103369
OpenAlexW3158502114

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.