Obstetric complications unevenly distributed in Finland - Blood pressure-related problems more prevalent in Eastern and Northern Finland
Keywords:Complications during pregnancy related to elevated blood pressure, such as pre-eclampsia and gestational hypertension, are more common in Eastern and Northern Finland than elsewhere in Finland. An increase in gestational hypertension may be linked to a limited amount of fiber in food purchases.
A recent study in Finland examined the pregnancy and health data of 109,306 Finnish women from 2013 to 2017. All the women who gave birth to their first child during this period were included. The material used was from the Medical Birth Register and the Care Register for Health Care. This information was combined by postcode to the grocery purchase data of 3,937 women of fertile age. The food purchase data was obtained from the S Group’s loyal customer program that covered purchases between September 2016 and December 2017.
Regional differences were examined for four general obstetric complications: gestational hypertension, pre-eclampsia (previously referred to as toxemia), gestational diabetes and premature delivery.
“The results showed that when compared to women giving birth in Southern Finland, gestational hypertension was more common in Northern Finland and pre-eclampsia was more in Eastern Finland. On the other hand, no significant regional differences were observed in the prevalence of gestational diabetes and premature delivery,” says Outi Pellonperä, Specialist in Obstetrics and Gynecology at the Turku University Hospital
Body mass index did not explain the regional differences in the incidence of blood pressure disorders, even though excess weight and obesity were the most significant risk factors in all obstetric complications examined.
The study found that in areas where the fiber content of purchased food was higher, the risk of gestational hypertension was lower.
“This suggests that dietary fiber can help protect against hypertension,” says Pellonperä.
The study also revealed that the abundant purchase of red and processed meat was linked to a slightly higher risk of premature labor.
Pregnancy acts as an early identifier of risks
Common complications related to pregnancy, such as gestational hypertension, pre-eclampsia and gestational diabetes, predict the susceptibility of a woman and the born child to later morbidity, such as their susceptibility to cardiovascular diseases and type 2 diabetes. For this reason, pregnancy provides an early opportunity to identify at-risk women and their children.
Finland has long had regional disparities in cardiovascular disease numbers. The North Karelia Project launched in the 1970s was able to eliminate risk factors and reduce these differences. Even so, recent statistics indicate that regional disparities remain clear: The prevalence of coronary artery disease and related mortality are still highest in Eastern and Northern Finland.
“We wanted to determine whether regional health disparities were visible in the obstetric complications experienced by the generation following the North Karelia Project and their food purchases. This study is the first to combine national health data and food purchase data with the aim of understanding regional differences,” says Saila Koivusalo, Senior Medical Officer in Charge of Research at HUS.
Targeted monitoring of pregnancy could prevent regional health inequalities
A study published in the Nordic scientific journal Acta Obstetricia et Gynecologica Scandinavica shows that there are regional differences in the prevalence of obstetric complications related to elevated blood pressure in Finland. This may predict higher levels of cardiovascular disease in these areas in the future. Gestational diabetes is a remarkably common complication, and consequently the prevention of both this and possible subsequent type 2 diabetes would be particularly important throughout the country. Although the trend in public health is a positive one in many respects, there are signs that, without targeted measures, these disparities may continue - or even increase in the future.
“This raises the question of whether a new kind of ‘North Karelia project’, which utilizes observations from sensitive stages of development such as pregnancy, and combines lifestyle guidance, regional targeting and long-term monitoring is needed as part to work to improve public health,” says Koivusalo.
Link to research article: Regional differences in the prevalence of obstetric complications in relation to maternal obesity and food purchases