Objective To examine the association of maternal hypertensive disorder of pregnancy (HDP) with overall and cause specific mortality in offspring from birth to young adulthood. Design Nationwide population based cohort study. Setting Danish national health registers. Participants All 2 437 718 individuals live born in Denmark, 1978-2018, with follow-up from date of birth until date of death, emigration, or 31 December 2018, whichever came first. Main outcome measures The primary outcome was all cause mortality. Secondary outcomes were 13 specific causes of death in offspring from birth to young adulthood (age 41 years). Cox regression was used to assess the association, taking into consideration several potential confounders. The role of timing of onset and severity of pre-eclampsia, maternal history of diabetes, and maternal education were also studied. Results 102 095 mothers had HDP: 67 683 with pre-eclampsia, 679 with eclampsia, and 33 733 with hypertension. During follow-up to 41 years (median 19.4 (interquartile range 9.7-28.7) years), deaths occurred in 781 (58.94 per 100 000 person years) offspring born to mothers with pre-eclampsia, 17 (133.73 per 100 000 person years) born to mothers with eclampsia, 223 (44.38 per 100 000 person years) born to mothers with hypertension, and 19 119 (41.99 per 100 000 person years) born to mothers with no HDP. The difference in cumulative incidence in overall mortality between cohorts exposed and unexposed to maternal HDP was 0.37% (95% confidence interval 0.11% to 0.64%), and the population attributable fraction for maternal HDP was estimated as 1.09% (95% confidence interval 0.77% to 1.41%). Maternal HDP was associated with a 26% (hazard ratio 1.26, 95% confidence interval 1.18 to 1.34) higher risk of all cause mortality in offspring. The corresponding estimates for maternal pre-eclampsia, eclampsia, and hypertension were 1.29 (1.20 to 1.38), 2.88 (1.79 to 4.63), and 1.12 (0.98 to 1.28). Increased risks were also observed for several cause specific mortalities, such as deaths from conditions originating in the perinatal period (2.04, 1.81 to 2.30), cardiovascular diseases (1.52, 1.08 to 2.13), digestive system diseases (2.09, 1.27 to 3.43), and endocrine, nutritional, and metabolic diseases (1.56, 1.08 to 2.27). The increased risks were more pronounced among offspring of mothers with early onset and severe pre-eclampsia (6.06, 5.35 to 6.86) or with both HDP and diabetes history (1.57, 1.16 to 2.14) or HDP and low education level (1.49, 1.34 to 1.66). Conclusion Maternal HDP, particularly eclampsia and severe pre-eclampsia, is associated with increased risks of overall mortality and various cause specific mortalities in offspring from birth to young adulthood. No additional data available.

中文翻译：

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母亲妊娠期高血压疾病和后代从出生到成年早期的死亡率：基于全国人群的队列研究

目的 研究母体妊娠期高血压疾病 (HDP) 与后代从出生到成年早期的总体死亡率和特定原因死亡率之间的关系。设计基于全国人群的队列研究。设置丹麦国家健康登记册。参与者 1978 年至 2018 年在丹麦出生的所有 2 437 718 人，从出生之日到死亡、移民或 2018 年 12 月 31 日的随访，以先到者为准。主要结果指标 主要结果是全因死亡率。次要结果是后代从出生到成年早期（41 岁）的 13 种特定死因。Cox 回归用于评估关联，同时考虑了几个潜在的混杂因素。先兆子痫发作时间和严重程度、母亲糖尿病史、还研究了母性教育。结果 102 095 名母亲患有 HDP：先兆子痫 67 683 人，子痫 679 人，高血压 33 733 人。在长达 41 年的随访期间（中位数 19.4（四分位数间距 9.7-28.7）年），先兆子痫母亲所生的 781 名（每 10 万人年 58.94 人）后代死亡，17 人（每 10 万人年 133.73 人）患有子痫的母亲生育 223 人（每 10 万人年 44.38 人），患有高血压的母亲生育 223 人（每 10 万人年 44.38 人），没有 HDP 的母亲生育 19 119 人（每 10 万人年 41.99 人）。暴露于和未暴露于母体 HDP 的队列之间总死亡率的累积发生率差异为 0.37%（95% 置信区间 0.11% 至 0.64%），母体 HDP 的人口归因分数估计为 1.09%（95% 置信区间 0.77 % 至 1.41%)。母亲 HDP 与后代全因死亡率高 26%（风险比 1.26，95% 置信区间 1.18 至 1.34）的风险相关。产妇先兆子痫、子痫和高血压的相应估计值为 1.29（1.20 至 1.38）、2.88（1.79 至 4.63）和 1.12（0.98 至 1.28）。还观察到几种特定原因死亡率的风险增加，例如围产期疾病（2.04、1.81 至 2.30）、心血管疾病（1.52、1.08 至 2.13）、消化系统疾病（2.09、1.27 至 3.43）、内分泌、营养和代谢疾病（1.56、1.08 至 2.27）。早发和重度先兆子痫（6.06，5.35 至 6.86）或同时具有 HDP 和糖尿病史（1.57，1.16 至 2.14）或 HDP 和低教育水平（1. 49，1.34 至 1.66）。结论 母亲 HDP，尤其是子痫和重度先兆子痫，与后代从出生到成年早期的总体死亡率和各种原因特异性死亡率风险增加有关。没有可用的额外数据。