Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health最新文献

The impact of maternal chronic hypertension in pregnancy on offspring long-term respiratory morbidity 妊娠期母体慢性高血压对子代长期呼吸道疾病的影响

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-11 DOI: 10.1016/j.preghy.2025.101405

Nir Roguin , Gil Gutvirtz , Tamar Wainstock , Eyal Sheiner

Objective

Maternal chronic hypertension has been associated with various adverse pregnancy and neonatal outcomes, including superimposed preeclampsia and preterm labor, both linked to adverse short- and long-term outcomes. However, most studies investigating offspring long-term outcomes did not isolate chronic hypertension from other hypertensive disorders. Hence, we decided to explore a possible association between maternal chronic hypertension and long-term respiratory morbidity in offspring.

Study design

This population-based cohort included all singleton deliveries from 1991 to 2021 at a tertiary medical center. Offspring of mothers with chronic hypertension were compared to those of normotensive pregnancies. Offspring long-term respiratory morbidity, up to the age of 18 years, was compared using diagnoses from community and hospital records. Kaplan–Meier survival analysis was used to compare the cumulative incidence and a GEE model adjusted for potential confounders.

Results

A total of 342,365 singleton deliveries occurred, of which 3,097 (0.9 %) were to mothers with chronic hypertension. Respiratory morbidity rate of children who were exposed in-utero to maternal chronic hypertension was significantly higher than children from pregnancies that were uncomplicated by hypertensive disorders (p < 0.001). However, cumulative respiratory morbidity was comparable between the groups (Kaplan-Meier Log-rank test p = 0.06). In the GEE model adjusted for maternal age, gestational age, low birthweight, cesarean delivery, fertility treatments, pre-gestational diabetes, smoking, obesity, ethnicity, and child birth year was not independently associated with offspring respiratory morbidity (adjusted HR (aHR) 1.09, 95 % CI 0.74–1.59, p = 0.662)

Conclusion

In our cohort, maternal chronic hypertension is not an independent risk factor for offspring long-term respiratory morbidity.

目的：母体慢性高血压与各种不良妊娠和新生儿结局有关，包括叠加子痫前期和早产，两者都与不良的短期和长期结局有关。然而，大多数调查后代长期预后的研究并没有将慢性高血压与其他高血压疾病分开。因此，我们决定探索母体慢性高血压与后代长期呼吸系统疾病之间的可能联系。研究设计：以人群为基础的队列包括1991年至2021年在三级医疗中心分娩的所有单胎分娩。将慢性高血压母亲的后代与正常妊娠的后代进行比较。根据社区和医院记录的诊断，比较了18岁以下后代的长期呼吸道发病率。Kaplan-Meier生存分析用于比较累积发病率和校正潜在混杂因素的GEE模型。结果共发生单胎分娩342365例，其中慢性高血压产妇3097例（0.9%）。妊娠期暴露于母体慢性高血压的患儿呼吸系统患病率显著高于未合并高血压疾病的妊娠期患儿（p < 0.001）。然而，两组间累积呼吸道发病率具有可比性（Kaplan-Meier Log-rank检验p = 0.06）。在经母亲年龄、胎龄、低出生体重、剖宫产、生育治疗、孕前糖尿病、吸烟、肥胖、种族和出生年份调整后的GEE模型中，与后代呼吸系统疾病无独立相关性（调整后HR (aHR) 1.09, 95% CI 0.74-1.59, p = 0.662）。结论在我们的队列中，母亲慢性高血压不是后代长期呼吸系统疾病的独立危险因素。

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引用次数: 0

Cardiovascular phenotype in women 1–3 years after hypertensive pregnancy disorders: Impact of sex-independent and pregnancy-specific risk factors 高血压妊娠障碍后1-3年妇女的心血管表型：性别无关和妊娠特异性危险因素的影响

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-10 DOI: 10.1016/j.preghy.2025.101404

Kristina Klepp , Kjartan Moe , Kristin Angel , Thomas G. von Lueder , Meryam Sugulle , Charlotte P.Ø. Ziesler , Ralf Dechend , Anne Cathrine Staff

Objectives

The underlying mechanisms for adversely altered cardiovascular phenotype after hypertensive disorders of pregnancy (HDP) remain poorly understood. We aimed to explore the impact of sex-independent cardiovascular disease (CVD) risk factors on associations between HDP and postpartum echocardiographic findings.

Study design

Echocardiography was conducted in 100 women 1–3 years after HDP (n = 65) and normotensive pregnancies according to a standard protocol (n = 35).

Main outcome measures

Associations between previous HDP and echocardiographic measurements were explored by uni- and multivariate regression analyses. We adjusted for age, body mass index, mean arterial blood pressure and family history of CVD. P-value < 0.05 was considered statistically significant.

Results

Women after HDP displayed more adverse cardiometabolic profiles, including more frequent Stage 2 hypertension and less frequent normal blood pressure compared to controls (18 % vs 3 % and 46 % vs 83 %, both p < 0.05). The HDP group had more adverse echocardiographic profiles compared to controls. In univariate regression analyses, HDP was associated with Total Vascular Resistance and Septal Wall diameter. After adjustments for sex-independent cardiovascular risk factors, HDP was significantly associated with Septal Wall diameter in diastole and Relative Wall thickness.

Conclusions

Associations between previous HDP and postpartum echocardiographic findings remained significant after adjustment, but were mostly explained by sex-independent CVD risk factors. Women with previous HDP also displayed more adverse cardiometabolic profiles, including higher hypertension rates. Our findings highlight the need for intensified postpartum CVD prevention in women after HDP. In this cohort, echocardiography provided limited additional information beyond well-known risk factors in the evaluation of CVD risk in asymptomatic women with previous HDP.

目的妊娠期高血压疾病（HDP）后心血管表型不良改变的潜在机制尚不清楚。我们旨在探讨性别无关的心血管疾病（CVD）危险因素对HDP和产后超声心动图结果之间关系的影响。研究设计：根据标准方案，对100名HDP后1-3年的妇女（n = 65）和正常妊娠（n = 35）进行超声心动图检查。通过单因素和多因素回归分析探讨了既往HDP和超声心动图测量之间的关系。我们调整了年龄、体重指数、平均动脉血压和心血管疾病家族史。p值<； 0.05认为有统计学意义。结果：与对照组相比，HDP后的女性表现出更多的不良心脏代谢特征，包括更频繁的2期高血压和更少的正常血压（18% vs 3%, 46% vs 83%，均p <； 0.05）。与对照组相比，HDP组有更多的不良超声心动图。在单变量回归分析中，HDP与总血管阻力和室间隔壁直径相关。在调整了与性别无关的心血管危险因素后，HDP与舒张期室间隔壁直径和相对壁厚显著相关。结论调整后，既往HDP与产后超声心动图结果之间的相关性仍然显著，但主要由与性别无关的CVD危险因素解释。既往患有HDP的女性也表现出更多的不良心脏代谢特征，包括更高的高血压率。我们的研究结果强调了HDP后妇女加强产后心血管疾病预防的必要性。在这个队列中，超声心动图提供了有限的额外信息，除了已知的危险因素，在评估无症状的既往HDP妇女的CVD风险。

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引用次数: 0

Artificial intelligence for non-invasive hemodynamic profiling in pregnancy: Development of a novel scoring system 妊娠期无创血流动力学分析的人工智能：一种新型评分系统的发展。

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-06 DOI: 10.1016/j.preghy.2025.101396

Nevardo Calderón-Restrepo , Carolina Pemberthy-López , Nazareth Campo-Campo , Luisa Durango-Gutiérrez , Diego Álvarez-Montoya , Jaime Gallo-Villegas , Jorge Gutiérrez-Marín , Dagnovar Aristizábal-Ocampo

Objectives

Hemodynamic profiling during pregnancy is critical for risk stratification and management of hypertensive disorders such as preeclampsia. Traditional assessment via echocardiography, while accurate, is costly and not universally accessible. This study aimed to develop and validate a simple, non-invasive, artificial intelligence–driven scoring system (AI-SCORE) that classifies maternal hemodynamic profiles using readily available clinical variables.

Study design

In this cross-sectional study, 90 low-risk pregnant women at a single tertiary center underwent standard echocardiographic evaluation as the reference. Mean arterial pressure (MAP) and cardiac output data extracted from echocardiography were subjected to principal component analysis followed by K means clustering to identify hemodynamic profiles. A general regression neural network was then trained on clinical predictors—trimester, age, weight, heart rate, and the MAP/heart rate index—to generate the AI-SCORE. Model performance was assessed by area under the receiver operating characteristic curve (AUC-ROC) for discriminating among profiles.

Results

The median maternal age was 27 years (interquartile range [IQR] 24–31); 30 % of participants were classified as obese. Three hemodynamic profiles were identified: high-resistance (hypodynamic): 36.7 % of participants; normodynamic: 38.9 %; hyperdynamic: 24.4 %. Profiles were evenly distributed across trimesters. The AI-SCORE achieved AUC-ROC values of 0.706–0.811 for pairwise profile discrimination. Lower scores corresponded to the high-resistance/hypodynamic phenotype, while higher scores indicated a hyperdynamic state.

Conclusion

The AI-SCORE reliably identifies maternal hemodynamic phenotypes using non-invasive, low-cost clinical inputs. By enabling rapid bedside profiling, this tool has the potential to enhance screening, diagnosis, and tailored management of hypertensive disorders in pregnancy.

目的：妊娠期血液动力学分析对高血压疾病如先兆子痫的风险分层和管理至关重要。传统的超声心动图评估虽然准确，但费用昂贵，而且不能普遍使用。本研究旨在开发和验证一种简单、无创、人工智能驱动的评分系统（AI-SCORE），该系统使用现成的临床变量对产妇血液动力学特征进行分类。研究设计：在这项横断面研究中，90名低危孕妇在单一三级中心接受了标准超声心动图评估作为参考。从超声心动图中提取的平均动脉压（MAP）和心输出量数据进行主成分分析，然后进行K均值聚类以确定血流动力学特征。然后对临床预测指标（妊娠期、年龄、体重、心率和MAP/心率指数）进行一般回归神经网络训练，生成AI-SCORE。通过受试者工作特征曲线下面积（AUC-ROC）来评估模型的性能，以区分不同的剖面。结果：产妇年龄中位数为27岁（四分位数间距[IQR] 24-31）；30%的参与者被归类为肥胖。确定了三种血液动力学特征：高阻力（低动力）：36.7%的参与者；常动力：38.9%；超动力：24.4%。剖面图在三个月间均匀分布。AI-SCORE的AUC-ROC值为0.706-0.811。较低的分数对应于高抗性/低动力表型，而较高的分数表明高动力状态。结论：AI-SCORE通过无创、低成本的临床输入可靠地识别母体血液动力学表型。通过快速床边分析，该工具有可能加强妊娠期高血压疾病的筛查、诊断和量身定制的管理。

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引用次数: 0

Chronic hypertension in pregnancy is a risk factor for offspring long-term neurological morbidity 妊娠期慢性高血压是子代长期神经系统疾病的危险因素

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-05 DOI: 10.1016/j.preghy.2025.101399

Shahar Messing , Gil Gutvirtz , Tamar Wainstock , Eyal Sheiner

Purpose

The prevalence of maternal chronic hypertension is on the rise. Hypertensive disorders of pregnancy are associated with adverse pregnancy and neonatal outcomes; however, offspring long-term outcomes are less investigated. We evaluated the long-term neurological morbidity of offspring exposed in-utero to maternal chronic hypertension, unrelated to preeclampsia.

Methods

A population-based retrospective study of singleton births (1991–2021) at a tertiary center. Deliveries of women with chronic hypertension (without superimposed preeclampsia) compared with women without chronic hypertension or any other hypertensive disorder. Offspring long-term (until age 18) neurological morbidity was compared from clinics and hospitalizations records. A Kaplan–Meier survival curve was used to compare the cumulative incidence of neurological morbidity and a Generalized estimation equation (GEE) model was constructed to control for confounders.

Results

A total of 342,635 singleton births were included, 3,097 (0.9 %) were in mothers with chronic hypertension. The total neurological morbidity rate as well as the cumulative incidence of neurological morbidity over time (Kaplan-Meier, p < 0.001) was significantly higher in children exposed to maternal chronic hypertension as compared with unexposed children. The GEE model, controlling for repeated deliveries, maternal age, ethnicity, fertility treatments use, gestational age, child birth year and cesarean delivery, found that maternal chronic hypertension is an independent risk factor for offspring long-term neurological morbidity (aHR = 1.56, 95 %CI 1.34–1.81, p < 0.001).

Conclusion

Maternal chronic hypertension, unrelated to superimposed preeclampsia, is an independent risk factor for offspring long-term neurological morbidity. Nevertheless, the absolute risk remains relatively low. Further studies are warranted to elucidate underlying mechanisms and identify preventive strategies.

目的产妇慢性高血压患病率呈上升趋势。妊娠期高血压疾病与不良妊娠和新生儿结局相关；然而，对后代的长期结果调查较少。我们评估了胎儿在子宫内暴露于与子痫前期无关的母体慢性高血压的长期神经系统发病率。方法对某三级医疗中心1991-2021年单胎分娩人群进行回顾性研究。慢性高血压妇女（无叠加子痫前期）与无慢性高血压或任何其他高血压疾病妇女的分娩比较。后代长期（直到18岁）的神经系统发病率从诊所和住院记录进行比较。Kaplan-Meier生存曲线用于比较神经系统疾病的累积发病率，并构建广义估计方程（GEE）模型来控制混杂因素。结果共纳入342,635例单胎分娩，其中慢性高血压产妇3097例（0.9%）。与未暴露于母体慢性高血压的儿童相比，暴露于母体慢性高血压的儿童的总神经系统发病率以及随时间累积的神经系统发病率（Kaplan-Meier, p < 0.001）显著高于未暴露于母体慢性高血压的儿童。GEE模型控制了重复分娩、母亲年龄、种族、生育治疗使用、胎龄、孩子出生年份和剖宫产，发现母亲慢性高血压是子代长期神经系统疾病的独立危险因素（aHR = 1.56, 95% CI 1.34-1.81, p < 0.001）。结论母亲慢性高血压是子代长期神经系统疾病的独立危险因素，与子痫前期无关。然而，绝对风险仍然相对较低。需要进一步的研究来阐明潜在的机制和确定预防策略。

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引用次数: 0

Preconception health as a target for improved pregnancy outcomes: Where do we go from here? 孕前健康作为改善妊娠结局的目标：我们从这里走向何方？

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-03 DOI: 10.1016/j.preghy.2025.101395

McKenzie K. Jancsura , Ira Bernstein , Stefan R. Hansson , David E. Cantonwine , Keith M. Godfrey , Judith Stephenson , Régine Steegers-Theunissen , Shane Norris , Dominik Heider , James M. Roberts

Preconception health status, especially of women, but also of men, is known to influence pregnancy outcomes. Despite knowledge of the growing importance of preconception health, numerous challenges remain for conducting research in this population and delivering appropriate clinical care. The 2023 Global Pregnancy Collaboration annual workshop focused on exploring preconception health as it relates to adverse pregnancy outcomes. Here we summarize the proceedings and the current state of the science. We particularly focus on quantifying the exposome as a rich target for investigation of factors that increase the risk for and/ or contribute to preeclampsia and other adverse pregnancy outcomes. We conclude with recommendations for the scientific and clinical community to address knowledge gaps regarding the links between preconception health and adverse pregnancy outcomes.

众所周知，孕前健康状况，特别是妇女，但也包括男子，会影响怀孕结果。尽管人们认识到孕前健康的重要性日益增加，但在这一人群中开展研究和提供适当的临床护理方面仍存在许多挑战。2023年全球妊娠协作年度研讨会的重点是探讨与不良妊娠结果相关的孕前健康问题。在这里，我们总结了这方面的进展和科学现状。我们特别关注将暴露体量化，作为研究增加子痫前期和其他不良妊娠结局的风险和/或促成因素的丰富目标。最后，我们为科学和临床界提出建议，以解决有关孕前健康与不良妊娠结局之间联系的知识差距。

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引用次数: 0

Burden and determinants of preeclampsia and eclampsia in Ugandan tertiary healthcare facilities: a systematic review 负担和决定因素先兆子痫和子痫在乌干达三级医疗设施：一个系统的审查

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-01 DOI: 10.1016/j.preghy.2025.101398

Prosper Akankwasa , Jackson Kakooza , John Katongole , Esther Namutosi , Ephraim Onaba , Catherine Lewis , Emmanuel Okurut

Preeclampsia and eclampsia, hypertensive disorders of pregnancy, significantly contribute to maternal and perinatal morbidity and mortality in low- and middle-income countries like Uganda. Comprehensive data on their prevalence and determinants in Uganda’s tertiary healthcare facilities are limited. A systematic review was conducted searching PubMed, Lens.org, and Google Scholar for observational studies from Ugandan tertiary hospitals published between January 2015 and March 2025. Due to heterogeneity, a narrative synthesis was performed using the Synthesis without Meta-analysis (SWiM) framework, with study quality assessed via the Newcastle-Ottawa Scale. Ten studies, primarily from Mulago and Mbarara hospitals, met the final inclusion criteria. Limited population-based prevalence data were available, with one study reporting preeclampsia prevalence of 4.3 %. Key determinants included young maternal age, nulliparity, and delayed care-seeking. Complications such as HELLP syndrome (18.6 %) and non-proteinuric preeclampsia (24.6 %) were frequent, with systemic challenges like limited laboratory capacity noted. Preeclampsia and eclampsia impose a substantial burden in Uganda’s tertiary facilities, necessitating enhanced antenatal screening and timely referral. The scarcity of standardized prevalence data underscores the need for broader epidemiological surveillance.

在乌干达等低收入和中等收入国家，先兆子痫和妊娠高血压疾病子痫是造成孕产妇和围产期发病率和死亡率的重要原因。关于其在乌干达三级保健设施中的流行程度和决定因素的综合数据有限。检索PubMed、Lens.org和谷歌Scholar，对2015年1月至2025年3月间发表的乌干达三级医院的观察性研究进行了系统评价。由于异质性，我们使用无meta分析的综合（SWiM）框架进行叙事综合，并通过纽卡斯尔-渥太华量表评估研究质量。主要来自Mulago和Mbarara医院的10项研究符合最终纳入标准。基于人群的患病率数据有限，一项研究报告子痫前期患病率为4.3%。主要决定因素包括产妇年龄小、未生育和延迟求医。HELLP综合征（18.6%）和非蛋白尿性先兆子痫（24.6%）等并发症是常见的，并伴有系统挑战，如实验室能力有限。子痫前期和子痫给乌干达的三级医疗设施造成了沉重负担，因此需要加强产前筛查和及时转诊。标准化流行病学数据的缺乏突出表明需要进行更广泛的流行病学监测。

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引用次数: 0

Corrigendum to "First trimester preeclampsia screening and risk of placental lesions." [Pregnancy Hypertens. 41 (2025) 101236]. “妊娠早期子痫前期筛查和胎盘病变风险”的勘误表。妊娠高血压，41(2025)101236。

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-01 Epub Date: 2025-11-01 DOI: 10.1016/j.preghy.2025.101275

Camilla Bellingeri, Fausta Beneventi, Irene De Maggio, Carolina Spada, Alessina Bini Smaghi, Maura Cortese, Elisa Ligari, Claudia Alpini, Arsenio Spinillo

引用次数: 0

Slow early β-hCG elevation is associated with increased risk for hypertensive pregnancy complications 早期缓慢的β-hCG升高与高血压妊娠并发症的风险增加有关。

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-01 DOI: 10.1016/j.preghy.2025.101394

Inbal Navon , Avital Wertheimer , Anat Pardo , Alyssa Hochberg , Rita Zlatkin , Onit Sapir , Eyal Krispin , Liat Salzer-Sheelo , Eran Altman , Tzippy Shochat , Avi Ben-Haroush , Yoel Shufaro

Objective

To examine the association between rate of initial β-hCG rise following fresh in-vitro fertilization (IVF) cycles and long-term pregnancy complications.

Methods

A cohort study including all patients undergoing fresh IVF cycles who had a single gestational sac on the first ultrasound and resulted in a singleton live birth. The elevation rate between the first β-hCG value taken at day 15 ± 1.4 after oocyte pick-up and second β-hCG value taken 2 ± 0.5 days later was assessed. A slow elevation was defined as doubling time above the 90th percentile of the study population.

Results

Overall, 808 fresh IVF cycles qualified for inclusion in the study of whom 80 had a slow β-hCG elevation. There was no difference in baseline characteristics between the groups. The incidence of pregnancy induced hypertension was more than twice as high in the slow β-hCG elevation group compared to the normal β-hCG elevation group (14 % vs. 6 %, p 0.011). The adjusted risk ratio for this complication was 2.60 (95 % CI 1.26–5.33, p = 0.014) and remained significant after adjustment to maternal age, nulliparity and the first β-hCG value.

Conclusion

Patients with slow β-hCG elevation in the fifth gestational week were approximately at a 2.6-fold higher risk for pregnancy induced hypertension complications when compared to patients with a normal β-hCG elevation. The early detection of this previously unrecognized risk group could allow tighter follow-up during pregnancy, which could potentially reduce these complications.

目的：探讨体外受精（IVF）周期后β-hCG初始升高率与长期妊娠并发症的关系。方法：一项队列研究，包括所有接受新鲜试管婴儿周期的患者，他们在第一次超声检查时有一个单一的妊娠囊，导致一个单胎活产。测定取卵后第15±1.4天第一次β-hCG值与第2±0.5天第二次β-hCG值的升高率。缓慢升高被定义为在研究人群的第90百分位以上增加一倍的时间。结果：总的来说，808个新鲜试管婴儿周期符合纳入研究的条件，其中80个有缓慢的β-hCG升高。两组之间的基线特征没有差异。妊娠高血压的发生率在β-hCG缓慢升高组是正常β-hCG升高组的两倍多（14% vs. 6%, p 0.011）。该并发症的调整风险比为2.60 (95% CI 1.26 ~ 5.33, p = 0.014)，在调整产妇年龄、未生育和首次β-hCG值后，该风险比仍具有显著性。结论：妊娠第5周β-hCG缓慢升高的患者发生妊娠高血压并发症的风险约为β-hCG正常升高患者的2.6倍。早期发现这个以前未被认识到的风险群体可以在怀孕期间进行更严格的随访，这可能会减少这些并发症。

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引用次数: 0

Maternal death associated with preeclampsia in Indonesia 印度尼西亚与子痫前期相关的产妇死亡

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-01 DOI: 10.1016/j.preghy.2025.101400

Muhammad Ilham Aldika Akbar , Khanisyah Erza Gumilar , Muhammad Alamsyah Aziz , Adhi Pribadi , Muhammad Adrianes Bachnas , Rozi Aditya Aryanda , Gustaaf Dekker , HKFM Preeclampsia Research Group

Objective

To assess the clinical factors linked to maternal mortality due to preeclampsia (PE) in Indonesia, spanning from risk factors to maternal and perinatal outcomes. Our objective is to offer valuable insights that can be used to enhance healthcare policies and interventions for pregnant women in Indonesia.

Methods

A multicenter retrospective cohort study was conducted across 30 hospitals in Indonesia from January 2022 to December 2023. Data were collected from medical records of pregnancies complicated by PE. Maternal risk factors, complications, and perinatal outcomes were analyzed in maternal survivors and maternal deaths.

Results

Among 6,763 cases, 1,808 with complete medical records were included (1,784 survivors, 24 deaths; 1.33 % mortality). No significant differences were found in maternal age, BMI, parity, chronic hypertension, diabetes, or previous PE. Pulmonary edema (aOR = 3.97; 95 % CI: 1.51–10.49; p = 0.005) and the need for ICU admission (aOR = 5.25; 95 % CI: 2.19–12.62; p < 0.001) were substantially correlated with an elevated risk of maternal mortality. HELLP syndrome (aOR = 1.94; 95 % CI: 0.76–4.95; p = 0.167) and acute kidney injury [AKI] (aOR = 3.10; 95 % CI: 0.95–10.09; p = 0.060) exhibited a tendency for increased risk (p > 0.05). Maternal death was also correlated with worse perinatal outcomes such as higher intrauterine fetal death rate (OR: 6.2; 95 % CI: 2.4–15.99; p < 0.001) and neonatal mortality (OR: 2.80; 95 % CI: 0.94–8.32; p = 0.06).

Conclusion

This investigation underlines the still significant risk of PE as a cause of maternal death in Indonesia, with pulmonary edema, AKI, and HELLP syndrome, as critical risk factors. Initiatives aimed at decreasing maternal mortality should prioritize the screening and early identification of PE, as well as the implementation of effective preventative interventions during antenatal care.

目的评估与印度尼西亚先兆子痫（PE）导致的孕产妇死亡相关的临床因素，从危险因素到孕产妇和围产期结局。我们的目标是提供宝贵的见解，可用于加强印度尼西亚孕妇的医疗保健政策和干预措施。方法于2022年1月至2023年12月在印度尼西亚30家医院进行多中心回顾性队列研究。数据来自妊娠合并PE的医疗记录。对产妇幸存者和产妇死亡的产妇危险因素、并发症和围产期结局进行分析。结果6763例患者中，有完整病历记录的1808例，其中幸存者1784例，死亡24例，死亡率1.33%。在产妇年龄、体重指数、胎次、慢性高血压、糖尿病或既往PE方面没有发现显著差异。肺水肿（aOR = 3.97; 95% CI: 1.51-10.49; p = 0.005）和需要进ICU （aOR = 5.25; 95% CI: 2.19-12.62; p < 0.001）与产妇死亡率升高的风险显著相关。HELLP综合征（aOR = 1.94; 95% CI: 0.76 ~ 4.95; p = 0.167）和急性肾损伤[AKI] （aOR = 3.10; 95% CI: 0.95 ~ 10.09; p = 0.060）表现出风险增加的趋势（p > 0.05）。孕产妇死亡还与较差的围产期结局相关，如较高的宫内胎儿死亡率（OR: 6.2; 95% CI: 2.4-15.99; p < 0.001）和新生儿死亡率（OR: 2.80; 95% CI: 0.94-8.32; p = 0.06）。结论：本研究强调，在印度尼西亚，肺水肿、AKI和HELLP综合征是孕产妇死亡的关键危险因素，肺水肿仍是导致孕产妇死亡的重要因素。旨在降低孕产妇死亡率的举措应优先考虑筛查和早期识别PE，以及在产前护理期间实施有效的预防性干预措施。

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引用次数: 0

Response to the letter: The impact of maternal age and BMI on hypertensive disorders of pregnancy: Moving beyond the cut-off effect 回复来信：产妇年龄和BMI对妊娠期高血压疾病的影响：超越截止效应

IF 2.9 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health

Pub Date : 2025-12-01 DOI: 10.1016/j.preghy.2025.101397

Cecilia Lazzari , Mariachiara Bosco , Simone Garzon , Chiara Simonetto , Jvan Casarin , Sonia Paolucci , Antonella Cromi , Fabio Ghezzi , Stefano Uccella

引用次数: 0