{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:27:53Z","timestamp":1768566473049,"version":"3.49.0"},"posted":{"date-parts":[[2023,12,7]]},"group-title":"Health Informatics","reference-count":49,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T00:00:00Z","timestamp":1701907200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,11,2]]},"abstract":"<jats:title>Structured Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>Preeclampsia poses a significant threat to women\u2019s long-term health. However, what diseases are affected and at what level they are affected by PE needs a thorough investigation.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To conduct the first large-scale, non-hypothesis-driven study using EHR data from multiple medical centers to comprehensively explore adverse health outcomes after preeclampsia<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective multi-cohort case-control study<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>We analyzed 3,592 preeclampsia patients and 23,040 non-preeclampsia controls from the University of Michigan Healthcare System. We externally validated the findings using UK Biobank data (443 cases, 14,870 controls) and Cedar Sinai data(2755 cases, 60,305 controls).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Main outcomes<\/jats:title>\n                  <jats:p>We showed that six complications are significantly affected by PE. We demonstrate the effect of race as well as preeclampsia severity on these complications.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>PE significantly increases the risk of later hypertension, uncomplicated and complicated diabetes, renal failure and obesity, after careful confounder adjustment. We also identified that hypothyroidism risks are significantly reduced in PE patients, particularly among African Americans. Severe PE affects hypertension, renal failure, uncomplicated diabetes and obesity more than mild PE, as expected. Caucasians are affected more negatively than African Americans by PE on future hypertension, uncomplicated and complicated diabetes and obesity.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study fills a gap in the comprehensive assessment of preeclampsia\u2019s long-term effects using large-scale EHR data and rigorous statistical methods. Our findings emphasize the need for extended monitoring and tailored interventions for women with a history of preeclampsia, by considering pre-existing conditions, preeclampsia severity, and racial differences.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Key Points<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Question<\/jats:title>\n                    <jats:p>Which complications are more or less likely to occur in patients after preeclampsia (PE), compared to those with normal pregnancies? How do the severity of PE and patient race further affect these complications?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>In a retrospective case-control study on 3 datasets (n = 26,632, n = 15,313, n= 63,060), we identified 5 complications with significantly increased risk due to PE, including hypertension, uncomplicated and complicated diabetes, renal failure and obesity, after careful confounder adjustment. We also identified that hypothyroidism risks are reduced in PE patients, particularly significant among African Americans. Severe PE affects hypertension, renal failure, uncomplicated diabetes and obesity more than mild PE, as expected. Caucasians are affected more negatively than African Americans by PE on future hypertension, uncomplicated and complicated diabetes and obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Meaning<\/jats:title>\n                    <jats:p>Patients with a history of PE should be closely monitored and carefully assessed for the risks of developing these complications.<\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.1101\/2023.12.05.23299296","type":"posted-content","created":{"date-parts":[[2023,12,7]],"date-time":"2023-12-07T18:25:28Z","timestamp":1701973528000},"source":"Crossref","is-referenced-by-count":2,"title":["Discover overlooked complications after preeclampsia from three real-world medical record datasets of over 100,000 pregnancies"],"prefix":"10.64898","author":[{"given":"Haoming","family":"Zhu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leyang","family":"Tao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanling","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Hsuan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiping Paul","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Langen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruowang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lana X","family":"Gamire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2024110423401160000_2023.12.05.23299296v3.1","doi-asserted-by":"publisher","DOI":"10.1081\/PRG-100104165"},{"key":"2024110423401160000_2023.12.05.23299296v3.2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2009.02.010"},{"key":"2024110423401160000_2023.12.05.23299296v3.3","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003018"},{"key":"2024110423401160000_2023.12.05.23299296v3.4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.3439"},{"key":"2024110423401160000_2023.12.05.23299296v3.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.118.313276"},{"key":"2024110423401160000_2023.12.05.23299296v3.6","doi-asserted-by":"publisher","DOI":"10.1152\/ajprenal.00071.2020"},{"key":"2024110423401160000_2023.12.05.23299296v3.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2010.10.010"},{"key":"2024110423401160000_2023.12.05.23299296v3.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.385301.BE"},{"key":"2024110423401160000_2023.12.05.23299296v3.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2008.06.042"},{"key":"2024110423401160000_2023.12.05.23299296v3.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7393.791"},{"key":"2024110423401160000_2023.12.05.23299296v3.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706790"},{"key":"2024110423401160000_2023.12.05.23299296v3.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)05112-6"},{"key":"2024110423401160000_2023.12.05.23299296v3.13","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-013-0329-4"},{"key":"2024110423401160000_2023.12.05.23299296v3.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.02.016"},{"key":"2024110423401160000_2023.12.05.23299296v3.15","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2016.07.034"},{"key":"2024110423401160000_2023.12.05.23299296v3.16","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.0000120122.39231.88"},{"key":"2024110423401160000_2023.12.05.23299296v3.17","doi-asserted-by":"publisher","DOI":"10.1007\/s12350-014-9908-2"},{"key":"2024110423401160000_2023.12.05.23299296v3.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.xgen.2023.100257"},{"key":"2024110423401160000_2023.12.05.23299296v3.19","unstructured":"UK Biobank - UK Biobank. Accessed November 28, 2023. https:\/\/www.ukbiobank.ac.uk\/"},{"key":"2024110423401160000_2023.12.05.23299296v3.20","unstructured":"ICD - ICD-9-CM - International Classification of Diseases, Ninth Revision, Clinical Modification. June 29, 2023. Accessed November 28, 2023. https:\/\/www.cdc.gov\/nchs\/icd\/icd9cm.htm"},{"key":"2024110423401160000_2023.12.05.23299296v3.21","unstructured":"ICD-10 - CM International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). October 18, 2023. Accessed November 28, 2023. https:\/\/www.cdc.gov\/nchs\/icd\/icd-10-cm.htm"},{"key":"2024110423401160000_2023.12.05.23299296v3.22","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"2024110423401160000_2023.12.05.23299296v3.23","unstructured":"Elixhauser Comorbidity Software Refined for ICD-10-CM. Accessed November 28, 2023. https:\/\/hcup-us.ahrq.gov\/toolssoftware\/comorbidityicd10\/comorbidity_icd10.jsp"},{"key":"2024110423401160000_2023.12.05.23299296v3.24","doi-asserted-by":"publisher","DOI":"10.4103\/picr.PICR_87_17"},{"key":"2024110423401160000_2023.12.05.23299296v3.25","doi-asserted-by":"publisher","DOI":"10.21315\/mjms2018.25.4.12"},{"key":"2024110423401160000_2023.12.05.23299296v3.26","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-010-0087-7"},{"key":"2024110423401160000_2023.12.05.23299296v3.27","unstructured":"R Core Team. R: A language and environment for statistical computing. Published online 2021. https:\/\/www.R-project.org\/"},{"key":"2024110423401160000_2023.12.05.23299296v3.28","unstructured":"Wang W , Li Y , Yan J. touch: Tools of Utilization and Cost in Healthcare. Published online July 8, 2022. Accessed November 28, 2023. https:\/\/cran.r-project.org\/web\/packages\/touch\/index.html"},{"key":"2024110423401160000_2023.12.05.23299296v3.29","unstructured":"Wickham H , RStudio. tidyverse: Easily Install and Load the \u201cTidyverse.\u201d Published online February 22, 2023. Accessed November 29, 2023. https:\/\/cran.r-project.org\/web\/packages\/tidyverse\/index.html"},{"key":"2024110423401160000_2023.12.05.23299296v3.30","unstructured":"Spinu V , Grolemund G , Wickham H , et al. lubridate: Make Dealing with Dates a Little Easier. Published online September 27, 2023. Accessed November 29, 2023. https:\/\/cran.r-project.org\/web\/packages\/lubridate\/index.html"},{"key":"2024110423401160000_2023.12.05.23299296v3.31","unstructured":"Friedman J , Hastie T , Tibshirani R , et al. glmnet: Lasso and Elastic-Net Regularized Generalized Linear Models. Published online August 22, 2023. Accessed November 28, 2023. https:\/\/cran.r-project.org\/web\/packages\/glmnet\/index.html"},{"key":"2024110423401160000_2023.12.05.23299296v3.32","unstructured":"Kassambara A , Kosinski M , Biecek P , Fabian S. survminer: Drawing Survival Curves using \u201cggplot2.\u201d Published online March 9, 2021. Accessed November 29, 2023. https:\/\/cran.r-project.org\/web\/packages\/survminer\/index.html"},{"key":"2024110423401160000_2023.12.05.23299296v3.33","unstructured":"Kabacoff R. qacReg. Published online June 8, 2022. Accessed November 30, 2023. https:\/\/github.com\/Rkabacoff\/qacReg"},{"key":"2024110423401160000_2023.12.05.23299296v3.34","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.14781"},{"key":"2024110423401160000_2023.12.05.23299296v3.35","doi-asserted-by":"publisher","DOI":"10.3109\/10641950802629675"},{"key":"2024110423401160000_2023.12.05.23299296v3.36","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0000000000000308"},{"key":"2024110423401160000_2023.12.05.23299296v3.37","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-020-01369-x"},{"key":"2024110423401160000_2023.12.05.23299296v3.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2023.05.003"},{"key":"2024110423401160000_2023.12.05.23299296v3.39","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4336"},{"key":"2024110423401160000_2023.12.05.23299296v3.40","doi-asserted-by":"publisher","DOI":"10.3109\/00016349.2010.500367"},{"key":"2024110423401160000_2023.12.05.23299296v3.41","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad519"},{"key":"2024110423401160000_2023.12.05.23299296v3.42","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b4336"},{"key":"2024110423401160000_2023.12.05.23299296v3.43","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.107565"},{"key":"2024110423401160000_2023.12.05.23299296v3.44","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000349"},{"key":"2024110423401160000_2023.12.05.23299296v3.45","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-022-01261-5"},{"key":"2024110423401160000_2023.12.05.23299296v3.46","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.120.14781"},{"key":"2024110423401160000_2023.12.05.23299296v3.47","doi-asserted-by":"publisher","DOI":"10.1101\/2022.04.03.22273366"},{"key":"2024110423401160000_2023.12.05.23299296v3.48","doi-asserted-by":"publisher","DOI":"10.1101\/2023.03.23.23287655"},{"key":"2024110423401160000_2023.12.05.23299296v3.49","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2020.01.008"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2023.12.05.23299296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T19:46:04Z","timestamp":1768506364000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2023.12.05.23299296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,7]]},"references-count":49,"URL":"https:\/\/doi.org\/10.1101\/2023.12.05.23299296","relation":{},"subject":[],"published":{"date-parts":[[2023,12,7]]},"subtype":"preprint"}}