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Gestational hypertension causally elevates stroke risk in women, a finding that demands targeted cerebrovascular surveillance long after pregnancy ends.
A history of gestational hypertension (GH) may have consequences that extend far beyond childbirth, with new genetic evidence indicating that the pregnancy complication causally increases a woman's risk of stroke. The findings add weight to growing concerns that hypertensive disorders of pregnancy are not merely temporary complications but may mark the beginning of long-term cardiovascular vulnerability.
While previous observational studies have linked GH to numerous health conditions later in life, it has been cumbersome to determine whether these associations were truly causal or driven by other risk factors. To address this question, researchers used Mendelian randomization (MR), a genetic approach that minimizes confounding by using inherited genetic variants as proxies for disease risk. Using data from large genome-wide association studies (GWAS), they analyzed 149 genetic variants (single-nucleotide polymorphisms) associated with GH as instrumental variables.
The inverse-variance weighted (IVW) method served as the primary analysis to estimate causal effects on the outcomes of interest. Sensitivity analyses, including MR-Egger regression, weighted median, weighted mode, and simple mode methods, were conducted to assess the robustness of the findings and detect potential horizontal pleiotropy. An MR analysis identified a limited but significant causal impact of GH on women's long-term health outcomes.
Sensitivity analyses, including tests for horizontal pleiotropy, confirmed the stability of the findings and revealed no evidence of pleiotropic bias.
International Journal of Gynecology & Obstetrics
Causal effects of gestational hypertension on women's health: A Mendelian randomization analysis
Haizhao Luo et al.
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