Table 2 General characteristics of systematic reviews included in the umbrella review
Author/year | Countries included in the reviews | Systematic review objective | Pregnancy complication | Comparator | Population source (number of participants in each meta-analysis/systematic review) | Outcome | Study designs (number of studies) | Quality appraisal tool | Funding source | AMSTAR 2 overall rating |
|---|---|---|---|---|---|---|---|---|---|---|
Alonso-Ventura 2020 [16] | Australia, Brazil, Canada, Denmark, Finland, Iceland, Israel, Japan, Norway, Portugal, Sweden, the Netherlands, Turkey, UK, USA | To evaluate the association between preeclampsia and eclampsia on subsequent metabolic and biochemical outcomes. | Pre-eclampsia, eclampsia and HELLP syndrome | Women without Preeclampsia, eclampsia and HELLP syndrome. Women with uncomplicated pregnancies | Women with history of pregnancy (17,267) | Systolic blood pressure, diastolic blood pressure, hypertension | Cohort (41) | Newcastle–Ottawa Scale | None | Moderate |
Bellamy 2007 [17] | Finland, Iceland, Jordan, New Zealand, Scotland, Spain, Sweden, UK, USA | To quantify the risk of future cardiovascular diseases, cancer, and mortality after preeclampsia. | Preeclampsia | Women who completed pregnancies without developing preeclampsia | Women with history of pregnancy (21,030) | Hypertension | Cohort (13) | The authors extracted relevant study characteristics for definition of exposure, outcome, sample size and degree of confounding, and used these in a sensitivity analysis | Department of Health’s National Institute for Health Research Biomedical Research Centre and British Heart Foundation | Moderate |
Brown 2013 [116] | Brazil, Denmark, Finland, Iceland, Iran, Jordan, New Zealand, Norway, Portugal, Spain, Sweden, Thailand, UK, USA | To assess the current evidence and quantify the risks of cardiovascular disease (CVD), cerebrovascular events and hypertension associated with prior diagnosis of preeclampsia | Preeclampsia | Women who had uncomplicated/normotensive pregnancies | Women with history of pregnancy (82,255) | Hypertension | Cohort (30) | Authors used criteria based on how studies defined exposures and outcomes | Newcastle upon Tyne Hospitals NHS Foundation Trust. | Moderate |
Dall'Asta 2021 [117] | Not provided | To elucidate whether preeclampsia and the gestational age at onset of the disease (early- vs. late-onset preeclampsia) have an impact on the risk of long-term maternal cardiovascular complications. | Preeclampsia | Women with previous normal pregnancy | Women with history of pregnancy (2,695,024) | Hypertension | Cohort (13) Case–control (2) | Newcastle–Ottawa Scale | Not provided | Moderate |
Giorgione 2021 [14] | Canada, Israel, Kenya, Norway, Switzerland, The Netherlands, UK, USA | To estimate the incidence of hypertension in the first 2 years after Hypertensive disorders of pregnancy | Hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, eclampsia, HELLP syndrome) | Women without hypertensive disorders of pregnancy during pregnancy | Women with history of pregnancy (8041) | Hypertension | Cohort (14) Case–control (1) | Newcastle–Ottawa Scale | European Union's 2020 research and innovation programme under the Marie Sklodowska-Curie grant | High |
Pathirana 2021 [15] | Australia, Austria, Brazil, Canada, Chile, Denmark, Finland, Germany, Greece, Hong Kong, Hungary, India, Iran, Ireland, Italy, Korea, New Zealand, Norway, Poland, Senegal. South Korea, Spain, Sweden, Switzerland, Thailand, The Netherlands, UK, USA, Vienna | To synthesise evidence on conventional cardiovascular disease (CVD) risk factors among women with previous Gestational Diabetes Mellitus (GDM) | Gestational diabetes mellitus | Women with no history of gestational diabetes mellitus | Women with history of pregnancy (changes in systolic blood pressure as outcome = 50,118, changes in diastolic blood pressure as outcome = 49,495) | Systolic blood pressure, diastolic blood pressure | Cohort (27) Case–control (10) Cross-sectional (11) | Newcastle–Ottawa Scale | NHMRC Australia Public Health Early Career Fellowship and University of Adelaide | High |
Sukmanee 2022 [113] | Australia, Canada, China, Denmark, Indonesia, Iran, Israel, Japan, Kenya, Korea, Netherlands, Norway, Singapore, South Africa, Spain, Sweden, Taiwan, Tanzania, UK, USA | To evaluate the risk of cardiovascular outcomes later in life in women with prior Hypertensive Disorders of Pregnancy in different years postpartum and in preeclamptic women with severe features, or early onset of preeclampsia. | Hypertensive disorders of pregnancy (gestational hypertension and preeclampsia, not chronic hypertension.) | Women with prior normotensive pregnancies, preeclampsia without severe features, or late-onset preeclampsia (developed after 34 completed weeks of gestation) depending on individual included studies | Women with history of pregnancy (215,528) | Hypertension | Cohort (37) | Newcastle–Ottawa Scale | Thailand Science Research and Innovation (TSRI) Research Career Development Grant and Prince of Songka University | High |
Xu 2022 [112] | Brazil, Britain, China, France, Japan, Jordan, The Netherlands, Pakistan, Spain, Sweden, USA | To comprehensively evaluate the association between hypertensive disorders in pregnancy and the risk of developing chronic hypertension. | Hypertensive disorders of pregnancy or with the specific types of gestational hypertension and preeclampsia | Women without hypertensive disorders of pregnancy or specific types of preeclampsia and gestational hypertension | Women with history of pregnancy (hypertensive disorders of pregnancy as exposure = 228,317, preeclampsia as exposure = 341,060, gestational hypertension as exposure = 933) | Hypertension | Hypertensive disorders of pregnancy Cohort (5) Case–control (5) Cross-sectional (1) Gestational hypertension; cohort (1) Case–control (2) Preeclampsia; cohort (10) Case–control (3) | Newcastle–Ottawa Scale | National Natural Science Foundation of China | High |
Vounzoulaki 2020 [114] | Australia, Canada, Finland, France, Hungary, India, Iran, Israel, Italy, Korea, Pakistan, Spain, Sri Lanka, Sweden, UK, USA | To estimate and compare progression rates to type 2 diabetes mellitus (T2DM) in women with gestational diabetes mellitus (GDM) and healthy controls | Gestational diabetes mellitus | Women with normoglycemic pregnancy | Women with history of pregnancy (1,332,373) | T2DM | Cohort (20) | Newcastle–Ottawa Scale | National Institute for Health Research | High |
Zhao 2021 [115] | Australia, Canada, Denmark, Finland, Netherlands, Norway, Sweden, Taiwan, UK, USA | To quantify the association of previous Hypertensive Disorders of Pregnancy with incident diabetes mellitus | Hypertensive disorders of pregnancy (gestational hypertension, preeclampsia) | Women without hypertensive disorders of pregnancy | Women with history of pregnancy (number of participants not provided) | T2DM | Cohort; (hypertensive disorders of pregnancy (16), gestational hypertension (7), preeclampsia (11) | Newcastle–Ottawa Scale | None | High |