Incidence and recurrence rate of XXXX : a longitudinal linked national cohort study in the Netherlands.

@entity1 @entity101 @entity5869
OBJECTIVE: @entity1 who have experienced a @entity5869 have a risk of recurrence, but exact information to quantify this risk is currently not available. We studied the incidence and recurrence rate of @entity5869 in a subsequent pregnancy and the influence of @entity101 . STUDY DESIGN: We conducted a retrospective national cohort study of all singleton pregnancies that ended from 1999-2007 in the Netherlands. A longitudinal linked national cohort of these @entity1 with information on a subsequent singleton delivery was used. We calculated and compared incidence and recurrence rates of @entity5869 for @entity1 in total, stratified by gestational age of first @entity5869 and by the presence of a @entity101 in their first pregnancy. RESULTS: We studied 1,570,635 @entity1 of which 3496 (0.22%) experienced a @entity5869 . Information was available on a subsequent singleton delivery for 264,424 deliveries. Of these, 521 @entity1 (0.20%) had a @entity5869 in the first pregnancy vs 214 @entity1 (0.08%) in the second pregnancy. The risk of @entity5869 in a subsequent pregnancy was significantly higher in @entity1 with a previous @entity5869 compared with @entity1 without (5.8% vs 0.06%; adjusted odds ratio [aOR], 93; 95% confidence interval [CI], 62-139). @entity1 with a @entity5869 that occurred at term in their first pregnancy were more at risk for recurrence (aOR, 188; 95% CI, 116-306) than @entity1 with a preterm (aOR, 52; 95% CI, 25-111) or early preterm (<32 weeks of gestation) @entity5869 in their first pregnancy (aOR, 39; 95% CI, 13-116). @entity5869 was more frequent among @entity1 with a @entity101 compared with normotensive @entity1 (0.44% vs 0.16%; odds ratio, 2.7; 95% CI, 2.3-3.3). @entity1 with a @entity101 were less at risk for recurrence than were normotensive @entity1 (aOR, 0.68; 95% CI, 0.27-1.6). No interaction between a @entity101 in the first pregnancy and the recurrence risk was found. CONCLUSION: @entity1 with a @entity5869 in their first pregnancy have a greatly increased risk of @entity5869 in a subsequent pregnancy. @entity101 increase the risk of @entity5869 but do not increase the recurrence rate in a subsequent pregnancy. We suggest elective induction from 37 weeks of gestation for @entity1 with a history of @entity5869 at term in a previous pregnancy.
