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The co-occurrence and cumulative prevalence of hypertension, rheumatoid arthritis, and hypothyroidism in preterm-born women in the Women’s Health Initiative

Published online by Cambridge University Press:  18 May 2023

Pamela L. Brewer Open the ORCID record for Pamela L. Brewer [Opens in a new window] ,
Amy L. D’Agata ,
Mary B. Roberts ,
Nazmus Saquib Open the ORCID record for Nazmus Saquib [Opens in a new window] ,
Peter F. Schnatz ,
JoAnn Manson ,
Charles B. Eaton  and
Mary C. Sullivan
Pamela L. Brewer*
Affiliation:
College of Nursing, University of Rhode Island, Providence, Rhode Island, USA
Amy L. D’Agata
Affiliation:
College of Nursing, University of Rhode Island, Providence, Rhode Island, USA
Mary B. Roberts
Affiliation:
Center for Primary Care and Prevention, Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, Rhode Island, USA
Nazmus Saquib
Affiliation:
College of Medicine, Sulaiman AlRajhi University, Saudi Arabia
Peter F. Schnatz
Affiliation:
Department of Obstetrics and Gynecology and Internal Medicine, Reading Hospital/Tower Health/Drexel University, Reading, Pennsylvania, USA
JoAnn Manson
Affiliation:
Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
Charles B. Eaton
Affiliation:
Department of Epidemiology, Brown University, Providence, Rhode Island, USA Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Mary C. Sullivan
Affiliation:
College of Nursing, University of Rhode Island, Providence, Rhode Island, USA
*
Corresponding author: Pamela L. Brewer, PhD, RN, University of Rhode Island Nursing Education Center, 350 Eddy Street, Providence, Rhode Island, 02903, USA. Email: pamela_brewer@uri.edu
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Abstract

Emerging evidence suggests that preterm-born individuals (<37 weeks gestation) are at increased risk of developing chronic health conditions in adulthood. This study compared the prevalence, co-occurrence, and cumulative prevalence of three female predominant chronic health conditions – hypertension, rheumatoid arthritis [RA], and hypothyroidism – alone and concurrently. Of 82,514 U.S. women aged 50–79 years enrolled in the Women’s Health Initiative, 2,303 self-reported being born preterm. Logistic regression was used to analyze the prevalence of each condition at enrollment with birth status (preterm, full term). Multinomial logistic regression models analyzed the association between birth status and each condition alone and concurrently. Outcome variables using the 3 conditions were created to give 8 categories ranging from no disease, each condition alone, two-way combinations, to having all three conditions. The models adjusted for age, race/ethnicity, and sociodemographic, lifestyle, and other health-related risk factors. Women born preterm were significantly more likely to have any one or a combination of the selected conditions. In fully adjusted models for individual conditions, the adjusted odds ratios (aORs) were 1.14 (95% CI, 1.04, 1.26) for hypertension, 1.28 (1.12, 1.47) for RA, and 1.12 (1.01, 1.24) for hypothyroidism. Hypothyroidism and RA were the strongest coexisting conditions [aOR 1.69, 95% CI (1.14, 2.51)], followed by hypertension and RA [aOR 1.48, 95% CI (1.20, 1.82)]. The aOR for all three conditions was 1.69 (1.22, 2.35). Perinatal history is pertinent across the life course. Preventive measures and early identification of risk factors and disease in preterm-born individuals are essential to mitigating adverse health outcomes in adulthood.

Keywords

Preterm birthhypertensionhypothyroidismrheumatoid arthritiswomen’s health
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 14 , Issue 4 , August 2023 , pp. 459 - 468
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Copyright
© The Author(s), 2023. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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