Pub Date : 2024-11-23DOI: 10.1016/j.preghy.2024.101172
Jesus Serrano-Lomelin , Graeme N. Smith , Sandra T. Davidge , Meghan Riddell , Radha Chari , Susan Crawford , Jeffrey A. Bakal , Maria B. Ospina
Objective
To explore direct and indirect associations of diabetes, mental health, and asthma diagnosed before or during pregnancy with gestational hypertension (GH) or preeclampsia (PE).
Study design
This population-based case-control study conducted in Alberta, Canada, analyzed perinatal registry data from primiparous pregnant women aged 16 years and above, with no prior hypertension history, during the period 2010 to 2013. Cases of GH and PE were matched on gestational age with a random sample of controls at a 1:3 ratio.
Main outcome measures
We examined the presence of type 2 diabetes mellitus (T2DM) or gestational diabetes, depression, anxiety, and asthma diagnoses within five years before and during pregnancy. To estimate direct and indirect associations between these diagnoses and GH and PE, we used multivariable logistic and mediation models, adjusting for covariates.
Results
The analysis included 18,381 women (3,443 GH cases, 1,152 PE cases, and 13,786 controls). We found a direct association between anxiety during pregnancy and GH (adjusted Odds Ratio [aOR] 2.18, 95 % confidence interval (CI) 1.43–3.31). Depression before pregnancy increased the odds of anxiety during pregnancy (aOR 4.78, 95 % CI 2.89–7.92) resulting in an indirect effect on GH (aOR 3.63, 95 % CI 1.67––7.87). For PE, we observed direct associations with pre-pregnancy T2DM (aOR 1.58, 95 % CI 1.12–2.24), gestational diabetes (aOR 1.28, 95 % CI 1.04–1.56), and asthma during pregnancy (aOR 2.23, 95 % CI 1.41–3.51).
Conclusion
These findings highlight the interplay of mental health factors in influencing GH and underscore the clinical importance of diabetes and asthma in the pathogenesis of PE.
研究设计这项基于人群的病例对照研究在加拿大艾伯塔省进行，分析了 2010 年至 2013 年期间 16 岁及以上、无高血压病史的初产孕妇的围产期登记数据。GH 和 PE 病例与随机对照样本的孕龄按 1:3 的比例进行了匹配。主要结果测量我们研究了怀孕前五年内和怀孕期间是否患有 2 型糖尿病（T2DM）或妊娠糖尿病、抑郁症、焦虑症和哮喘诊断。为了估计这些诊断与 GH 和 PE 之间的直接和间接关联，我们使用了多变量逻辑模型和中介模型，并对协变量进行了调整。结果分析包括 18,381 名妇女（3,443 名 GH 病例、1,152 名 PE 病例和 13,786 名对照组）。我们发现孕期焦虑与 GH 之间存在直接联系（调整后比值比 [aOR] 2.18，95% 置信区间 (CI) 1.43-3.31）。孕前抑郁会增加孕期焦虑的几率（aOR 4.78，95 % CI 2.89-7.92），从而对 GH 产生间接影响（aOR 3.63，95 % CI 1.67-7.87）。对于 PE，我们观察到与孕前 T2DM（aOR 1.58，95 % CI 1.12-2.24）、妊娠糖尿病（aOR 1.28，95 % CI 1.04-1.56）和孕期哮喘（aOR 2.23，95 % CI 1.41-3.51）直接相关。
{"title":"Associations of Diabetes, Mental Health, and Asthma with Hypertensive Disorders of Pregnancy: A Population-based Case-Control Study in Alberta, Canada","authors":"Jesus Serrano-Lomelin , Graeme N. Smith , Sandra T. Davidge , Meghan Riddell , Radha Chari , Susan Crawford , Jeffrey A. Bakal , Maria B. Ospina","doi":"10.1016/j.preghy.2024.101172","DOIUrl":"10.1016/j.preghy.2024.101172","url":null,"abstract":"<div><h3>Objective</h3><div>To explore direct and indirect associations of diabetes, mental health, and asthma diagnosed before or during pregnancy with gestational hypertension (GH) or preeclampsia (PE).</div></div><div><h3>Study design</h3><div>This population-based case-control study conducted in Alberta, Canada, analyzed perinatal registry data from primiparous pregnant women aged 16 years and above, with no prior hypertension history, during the period 2010 to 2013. Cases of GH and PE were matched on gestational age with a random sample of controls at a 1:3 ratio.</div></div><div><h3>Main outcome measures</h3><div>We examined the presence of type 2 diabetes mellitus (T2DM) or gestational diabetes, depression, anxiety, and asthma diagnoses within five years before and during pregnancy. To estimate direct and indirect associations between these diagnoses and GH and PE, we used multivariable logistic and mediation models, adjusting for covariates.</div></div><div><h3>Results</h3><div>The analysis included 18,381 women (3,443 GH cases, 1,152 PE cases, and 13,786 controls). We found a direct association between anxiety during pregnancy and GH (adjusted Odds Ratio [aOR] 2.18, 95 % confidence interval (CI) 1.43–3.31). Depression before pregnancy increased the odds of anxiety during pregnancy (aOR 4.78, 95 % CI 2.89–7.92) resulting in an indirect effect on GH (aOR 3.63, 95 % CI 1.67––7.87). For PE, we observed direct associations with pre-pregnancy T2DM (aOR 1.58, 95 % CI 1.12–2.24), gestational diabetes (aOR 1.28, 95 % CI 1.04–1.56), and asthma during pregnancy (aOR 2.23, 95 % CI 1.41–3.51).</div></div><div><h3>Conclusion</h3><div>These findings highlight the interplay of mental health factors in influencing GH and underscore the clinical importance of diabetes and asthma in the pathogenesis of PE.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101172"},"PeriodicalIF":2.5,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-22DOI: 10.1016/j.preghy.2024.101171
Ana Filipa Ferreira , Joana Araújo , Maria João Azevedo , Francisca Saraiva , Sílvia O. Diaz , Carla Sousa , Ana Paula Machado , Benedita Sampaio-Maia , Carla Ramalho , Adelino F. Leite-Moreira , António Sousa Barros , Mário Santos , Inês Falcão-Pires
Background
Considering the limited information available on right cardiac remodelling during gestation, we aimed to characterise the right cardiovascular (CV) remodelling and reverse remodelling (RR) induced by pregnancy and postpartum, respectively, and the impact of perinatal CV risk (CVR) factors on these processes.
Methods
This prospective cohort was recruited at two tertiary centres during 2019–2022, including 51 healthy pregnant women and 79 with perinatal CVR factors. Participants were evaluated by transthoracic echocardiography during pregnancy (1st[1T] and 3rd[3T] trimesters) and postpartum (one-month[PP1], six-months[PP2], and one-year postpartum[PP3]). Generalised linear mixed-effects models were used for statistical analysis.
Results
Similar enlargement of the right atrium (RA) and right ventricle (RV) dimensions was observed throughout pregnancy, normalising at PP2 values similar to PT1. This anatomical postpartum recovery was accompanied by an increase of RV global longitudinal strain, being statistically significant in perinatal CVR group. Interestingly, at 3T, this group revealed lower RV and RA strain compared to healthy participants. Despite both groups maintained preserved RV systolic function from 1T to PP3, a significant reduction of TAPSE and tricuspid S’ velocity was observed at PP1. Concomitantly, all participants showed a significant increase of E/A at the same time-point, suggesting the recovery of diastolic deterioration seen from 1T to 3T that was persistingly higher in the perinatal CVR group througout the postpartum. Constant pulmonary artery systolic pressure (PASP) was documented throughout follow-up time, showing consistently higher values in the perinatal CVR group. All these echocardiographic index changes were within the normality range.
Conclusion
This study described subtle right cardiac changes within the normal/physiological range, recovering six-months after delivery. Coexisting perinatal CVR factors seem to affect the magnitude of RV diastolic function changes, PASP and myocardial deformation without any impact on other RV systolic function indexes.
{"title":"Cardiovascular remodelling and reverse remodelling during pregnancy and postpartum: Looking at the right side","authors":"Ana Filipa Ferreira , Joana Araújo , Maria João Azevedo , Francisca Saraiva , Sílvia O. Diaz , Carla Sousa , Ana Paula Machado , Benedita Sampaio-Maia , Carla Ramalho , Adelino F. Leite-Moreira , António Sousa Barros , Mário Santos , Inês Falcão-Pires","doi":"10.1016/j.preghy.2024.101171","DOIUrl":"10.1016/j.preghy.2024.101171","url":null,"abstract":"<div><h3>Background</h3><div>Considering the limited information available on right cardiac remodelling during gestation, we aimed to characterise the right cardiovascular (CV) remodelling and reverse remodelling (RR) induced by pregnancy and postpartum, respectively, and the impact of perinatal CV risk (CVR) factors on these processes.</div></div><div><h3>Methods</h3><div>This prospective cohort was recruited at two tertiary centres during 2019–2022, including 51 healthy pregnant women and 79 with perinatal CVR factors. Participants were evaluated by transthoracic echocardiography during pregnancy (1st[1T] and 3rd[3T] trimesters) and postpartum (one-month[PP1], six-months[PP2], and one-year postpartum[PP3]). Generalised linear mixed-effects models were used for statistical analysis.</div></div><div><h3>Results</h3><div>Similar enlargement of the right atrium (RA) and right ventricle (RV) dimensions was observed throughout pregnancy, normalising at PP2 values similar to PT1. This anatomical postpartum recovery was accompanied by an increase of RV global longitudinal strain, being statistically significant in perinatal CVR group. Interestingly, at 3T, this group revealed lower RV and RA strain compared to healthy participants. Despite both groups maintained preserved RV systolic function from 1T to PP3, a significant reduction of TAPSE and tricuspid S’ velocity was observed at PP1. Concomitantly, all participants showed a significant increase of E/A at the same time-point, suggesting the recovery of diastolic deterioration seen from 1T to 3T that was persistingly higher in the perinatal CVR group througout the postpartum. Constant pulmonary artery systolic pressure (PASP) was documented throughout follow-up time, showing consistently higher values in the perinatal CVR group. All these echocardiographic index changes were within the normality range.</div></div><div><h3>Conclusion</h3><div>This study described subtle right cardiac changes within the normal/physiological range, recovering six-months after delivery. Coexisting perinatal CVR factors seem to affect the magnitude of RV diastolic function changes, PASP and myocardial deformation without any impact on other RV systolic function indexes.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101171"},"PeriodicalIF":2.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-22DOI: 10.1016/j.preghy.2024.101166
Winter S. Bruner , Robert L. Davis , Nicole Bush , Kaja Lewinn , W. Alex Mason , Claire L. Simpson
Background
Preeclampsia is a hypertensive disorder in pregnancy known to increase the risk of mortality and other pregnancy-related issues, such as prematurity. Currently, there no known prophylactics or treatment options available for preeclampsia. More research is needed to better understand factors that increase preeclampsia risk. Vitamin D deficiency is consistently associated with developing preeclampsia. In addition to micronutrient deficiency, the presence of two fetal apolipoprotein L1 high-risk variants are also associated with preeclampsia risk. We hypothesized that a potential additive effect between high-risk apolipoprotein L1 genotype status and nutritional deficiencies would place individuals at a higher risk of developing preeclampsia.
Objective (s)
The objective of this study was to determine the risk of developing preeclampsia in African American women with vitamin D deficiency and maternal/fetal high-risk apolipoprotein L1 genotype.
Study Design
This was a case-control study using a subset of 999 African American mother and infant pairs collected from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood cohort in Memphis, TN. We performed multiple logistic regression to examine the association of preeclampsia with 2nd and 3rd trimester vitamin D concentrations. Concentrations were dichotomized into high or low categories. Vitamin D deficiency was defined as a concentration less than 20 ng/mL. Further analyses assessed whether maternal or fetal apolipoprotein genotype status modified the association between vitamin D association and preeclampsia. The reference group included individuals with both high vitamin D and low-risk apolipoprotein genotype.
Results
Pregnancies with low vitamin D in the 3rd trimester were at an increased risk for preeclampsia (odds ratio 2.10; 95 % confidence interval 1.09–4.12; P-value, 0.03). Risk for preeclampsia was greatest among pregnancies with fetal high-risk genotype and low vitamin D levels in the 2nd trimester (odds ratio, 2.79; 95 % confidence interval, 1.06–6.83; P-value, 0.03) and 3rd trimester (odds ratio 6.40; 95 % confidence interval 2.07–19.18; P-value, <0.01).
Conclusion(s)
Our significant findings suggest that the risk of preeclampsia associated with low vitamin D levels, especially during the 3rd trimester, is magnified by the presence of fetal high-risk apolipoprotein L1 genotype.
背景：子痫前期是一种妊娠期高血压疾病，已知会增加死亡率和其他与妊娠有关的问题（如早产）的风险。目前，子痫前期尚无已知的预防或治疗方案。要更好地了解增加子痫前期风险的因素，还需要进行更多的研究。维生素 D 缺乏一直与先兆子痫有关。除微量营养素缺乏外，胎儿存在两种载脂蛋白 L1 高危变异也与子痫前期风险有关。我们假设，高危载脂蛋白 L1 基因型状态与营养缺乏之间的潜在叠加效应将使个体罹患先兆子痫的风险更高。研究目的：本研究旨在确定维生素 D 缺乏和母体/胎儿高危载脂蛋白 L1 基因型的非裔美国妇女罹患先兆子痫的风险：这是一项病例对照研究，研究人员从田纳西州孟菲斯市的 "影响幼儿神经认知发育和学习的条件 "队列中收集了 999 对非裔美国人母婴。我们进行了多元逻辑回归，以研究先兆子痫与孕期第二和第三季度维生素 D 浓度的关系。维生素 D 浓度被分为高或低两类。维生素 D 缺乏定义为浓度低于 20 纳克/毫升。进一步的分析评估了母体或胎儿载脂蛋白基因型状态是否会改变维生素D与子痫前期之间的关系。参照组包括高维生素D和低风险脂蛋白基因型的个体：怀孕三个月时维生素 D 含量低的孕妇患先兆子痫的风险增加（几率比 2.10；95% 置信区间 1.09-4.12；P 值 0.03）。在胎儿高危基因型和维生素 D 水平较低的孕妇中，子痫前期的风险最大（几率比为 2.79；95% 置信区间为 1.06-6.83；P 值为 0.03），其次是第二孕期和第三孕期（几率比为 6.40；95% 置信区间为 2.07-19.18；P 值为 0.03）：我们的重要研究结果表明，胎儿存在高风险载脂蛋白 L1 基因型会放大与维生素 D 水平低相关的子痫前期风险，尤其是在妊娠第 3 个月。
{"title":"Effect of fetal apolipoprotein L1 genotype and vitamin D deficiencies on preeclampsia risk","authors":"Winter S. Bruner , Robert L. Davis , Nicole Bush , Kaja Lewinn , W. Alex Mason , Claire L. Simpson","doi":"10.1016/j.preghy.2024.101166","DOIUrl":"10.1016/j.preghy.2024.101166","url":null,"abstract":"<div><h3>Background</h3><div>Preeclampsia is a hypertensive disorder in pregnancy known to increase the risk of mortality and other pregnancy-related issues, such as prematurity. Currently, there no known prophylactics or treatment options available for preeclampsia. More research is needed to better understand factors that increase preeclampsia risk. Vitamin D deficiency is consistently associated with developing preeclampsia. In addition to micronutrient deficiency, the presence of two fetal apolipoprotein L1 high-risk variants are also associated with preeclampsia risk. We hypothesized that a potential additive effect between high-risk apolipoprotein L1 genotype status and nutritional deficiencies would place individuals at a higher risk of developing preeclampsia.</div></div><div><h3>Objective (s)</h3><div>The objective of this study was to determine the risk of developing preeclampsia in African American women with vitamin D deficiency and maternal/fetal high-risk apolipoprotein L1 genotype.</div></div><div><h3>Study Design</h3><div>This was a case-control study using a subset of 999 African American mother and infant pairs collected from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood cohort in Memphis, TN. We performed multiple logistic regression to examine the association of preeclampsia with 2nd and 3rd trimester vitamin D concentrations. Concentrations were dichotomized into high or low categories. Vitamin D deficiency was defined as a concentration less than 20 ng/mL. Further analyses assessed whether maternal or fetal apolipoprotein genotype status modified the association between vitamin D association and preeclampsia. The reference group included individuals with both high vitamin D and low-risk apolipoprotein genotype.</div></div><div><h3>Results</h3><div>Pregnancies with low vitamin D in the 3rd trimester were at an increased risk for preeclampsia (odds ratio 2.10; 95 % confidence interval 1.09–4.12; P-value, 0.03). Risk for preeclampsia was greatest among pregnancies with fetal high-risk genotype and low vitamin D levels in the 2nd trimester (odds ratio, 2.79; 95 % confidence interval, 1.06–6.83; P-value, 0.03) and 3rd trimester (odds ratio 6.40; 95 % confidence interval 2.07–19.18; P-value, <0.01).</div></div><div><h3>Conclusion(s)</h3><div>Our significant findings suggest that the risk of preeclampsia associated with low vitamin D levels, especially during the 3rd trimester, is magnified by the presence of fetal high-risk apolipoprotein L1 genotype.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101166"},"PeriodicalIF":2.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1016/j.preghy.2024.101168
Klara Palm , Catherine Cluver , Eduard Langenegger , Stephen Tong , Susan Walker , Henrik Imberg , Roxanne Hastie , Lina Bergman
Objectives
To assess whether plasma concentrations of the circulating inflammatory proteins Interleukin-6 (IL-6), Vascular Cell Adhesion Molecule-1 (VCAM-1) and C-Reactive Protein (CRP) are increased in women with preeclampsia with end-organ complications, compared with women with preeclampsia without end-organ complications.
Study design
We used samples from a large prospective biobank collection (Preeclampsia Obstetric Adverse Event biobank), and two large, randomized preeclampsia therapeutic treatment trials. All samples were collected in Cape Town, South Africa. The last plasma sample collected prior to birth was analyzed for IL-6, VCAM-1 and CRP concentrations. We categorized cases according to disease severity and compared circulating levels of these analytes. Covariate adjustment was performed.
Results
183 women were included. Compared with women without end-organ complications (n = 119), those with preeclampsia with two or more end-organ complications (n = 15) had a 4.9-fold (95 % CI, 1.81–13.09, p = 0.001) increase in IL-6 and a 1.7-fold (95 % CI, 1.11–2.72, p = 0.012) increase in VCAM-1 plasma concentrations. Comparing women with two or more end-organ complications to those with one end-organ complication (n = 49), plasma concentrations of IL-6 were 3.2-fold (95 % CI, 1.18–8.39, p = 0.018) increased, while there was no statistically significant difference for VCAM-1 (1.2-fold higher, 95 % CI, 0.79–1.91, p = 0.50). Plasma concentrations of CRP did not differ between the groups.
Conclusions
Plasma concentrations of IL-6 and VCAM-1, but not CRP, were increased among women with preeclampsia and end-organ complications, compared with women without end-organ complications. IL-6 and VCAM-1 could be drivers of disease in preeclampsia and potentially useful to identify women at high risk of severe disease.
{"title":"Circulating concentrations of pro-inflammatory cytokines in preeclampsia with varying disease severity","authors":"Klara Palm , Catherine Cluver , Eduard Langenegger , Stephen Tong , Susan Walker , Henrik Imberg , Roxanne Hastie , Lina Bergman","doi":"10.1016/j.preghy.2024.101168","DOIUrl":"10.1016/j.preghy.2024.101168","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess whether plasma concentrations of the circulating inflammatory proteins Interleukin-6 (IL-6), Vascular Cell Adhesion Molecule-1 (VCAM-1) and C-Reactive Protein (CRP) are increased in women with preeclampsia with end-organ complications, compared with women with preeclampsia without end-organ complications.</div></div><div><h3>Study design</h3><div>We used samples from a large prospective biobank collection (Preeclampsia Obstetric Adverse Event biobank), and two large, randomized preeclampsia therapeutic treatment trials. All samples were collected in Cape Town, South Africa. The last plasma sample collected prior to birth was analyzed for IL-6, VCAM-1 and CRP concentrations. We categorized cases according to disease severity and compared circulating levels of these analytes. Covariate adjustment was performed.</div></div><div><h3>Results</h3><div>183 women were included. Compared with women without end-organ complications (n = 119), those with preeclampsia with two or more end-organ complications (n = 15) had a 4.9-fold (95 % CI, 1.81–13.09, p = 0.001) increase in IL-6 and a 1.7-fold (95 % CI, 1.11–2.72, p = 0.012) increase in VCAM-1 plasma concentrations. Comparing women with two or more end-organ complications to those with one end-organ complication (n = 49), plasma concentrations of IL-6 were 3.2-fold (95 % CI, 1.18–8.39, p = 0.018) increased, while there was no statistically significant difference for VCAM-1 (1.2-fold higher, 95 % CI, 0.79–1.91, p = 0.50). Plasma concentrations of CRP did not differ between the groups.</div></div><div><h3>Conclusions</h3><div>Plasma concentrations of IL-6 and VCAM-1, but not CRP, were increased among women with preeclampsia and end-organ complications, compared with women without end-organ complications. IL-6 and VCAM-1 could be drivers of disease in preeclampsia and potentially useful to identify women at high risk of severe disease.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101168"},"PeriodicalIF":2.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1016/j.preghy.2024.101169
Saije K. Endacott , Cassandra Brennan , Richard G.S. Kahl , Oyepeju M. Onifade , Kym M. Rae , Eugenie R. Lumbers , Kirsty G. Pringle , The Gomeroi Gaaynggal Advisory Committee
Objective
To determine the levels of soluble (pro)renin receptor (s(P)RR) in women carrying Aboriginal and/or Torres Strait Islander (First Nations) babies and investigate whether s(P)RR levels change in women who have complicated pregnancies.
Study Design
Cross-sectional analysis of data (2010–2018). Data/samples were from the Gomeroi Gaaynggal Study, a longitudinal cohort study based on Gomeroi/Kamilaroi lands (Tamworth), NSW, Australia. Third trimester samples (blood/urine) were collected from pregnant women carrying a First Nations baby (N = 188).
Methods/Main outcome measures
Plasma s(P)RR and markers of kidney function (plasma: creatinine, urea and cystatin C; urinary: creatinine, protein, albumin, angiotensinogen, nephrin and Na/K) were measured by enzyme-linked immunosorbent assay or standardised pathology procedures as needed.
Results
Soluble (P)RR was detected in plasma of women in the cohort (median: 19.86 ng/mL; IQR: 12.52–26.8). Soluble (P)RR levels correlated positively with maternal plasma creatinine (P = 0.0001) and gestational age in the third trimester (P = 0.002). Levels of s(P)RR tended to positively correlate with urinary protein/creatinine (P = 0.04) and nephrin/creatinine (P = 0.03). Soluble (P)RR levels tended to be higher in women who birthed prematurely (P = 0.06). Soluble (P)RR levels did not change with other pregnancy complications or outcomes (preeclampsia, GDM or small or large for gestational age birth).
Conclusions
Soluble (P)RR is present in the plasma of pregnant women carrying First Nations babies and is correlated with known urinary biomarkers of renal function. Increased maternal s(P)RR levels may be associated with increased risk of preterm birth.
{"title":"Soluble (pro)renin receptor (s(P)RR) levels in women carrying Aboriginal and/or Torres Strait Islander babies; the Gomeroi Gaaynggal study","authors":"Saije K. Endacott , Cassandra Brennan , Richard G.S. Kahl , Oyepeju M. Onifade , Kym M. Rae , Eugenie R. Lumbers , Kirsty G. Pringle , The Gomeroi Gaaynggal Advisory Committee","doi":"10.1016/j.preghy.2024.101169","DOIUrl":"10.1016/j.preghy.2024.101169","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the levels of soluble (pro)renin receptor (s(P)RR) in women carrying Aboriginal and/or Torres Strait Islander (First Nations) babies and investigate whether s(P)RR levels change in women who have complicated pregnancies.</div></div><div><h3>Study Design</h3><div>Cross-sectional analysis of data (2010–2018). Data/samples were from the Gomeroi Gaaynggal Study, a longitudinal cohort study based on Gomeroi/Kamilaroi lands (Tamworth), NSW, Australia. Third trimester samples (blood/urine) were collected from pregnant women carrying a First Nations baby (N = 188).</div></div><div><h3>Methods/Main outcome measures</h3><div>Plasma s(P)RR and markers of kidney function (plasma: creatinine, urea and cystatin C; urinary: creatinine, protein, albumin, angiotensinogen, nephrin and Na/K) were measured by enzyme-linked immunosorbent assay or standardised pathology procedures as needed.</div></div><div><h3>Results</h3><div>Soluble (P)RR was detected in plasma of women in the cohort (median: 19.86 ng/mL; IQR: 12.52–26.8). Soluble (P)RR levels correlated positively with maternal plasma creatinine (P = 0.0001) and gestational age in the third trimester (P = 0.002). Levels of s(P)RR tended to positively correlate with urinary protein/creatinine (P = 0.04) and nephrin/creatinine (P = 0.03). Soluble (P)RR levels tended to be higher in women who birthed prematurely (P = 0.06). Soluble (P)RR levels did not change with other pregnancy complications or outcomes (preeclampsia, GDM or small or large for gestational age birth).</div></div><div><h3>Conclusions</h3><div>Soluble (P)RR is present in the plasma of pregnant women carrying First Nations babies and is correlated with known urinary biomarkers of renal function. Increased maternal s(P)RR levels may be associated with increased risk of preterm birth.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101169"},"PeriodicalIF":2.5,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-18DOI: 10.1016/j.preghy.2024.101170
Paul P. Potnuru , Hayden Jefferies , Roy Lei , Paula Igwe , Yafen Liang
<div><h3>Background</h3><div>Maternal pulmonary hypertension can pose substantial morbidity and mortality risks, particularly during labor and delivery. Although maternal pulmonary hypertension is conventionally considered a contraindication to pregnancy, advances in the management of pH may contribute to improving outcomes.</div></div><div><h3>Objectives</h3><div>In this nationwide study, we aim to characterize the prevalence of maternal pulmonary hypertension in the United States and its association with adverse cardiopulmonary outcomes during delivery hospitalizations.</div></div><div><h3>Study Design</h3><div>In this cross-sectional cohort study, we analyzed delivery hospitalizations in the National Inpatient Sample from 2016 to 2020. The primary exposure was maternal pulmonary hypertension. The primary outcome was a composite of maternal cardiopulmonary morbidity events during the delivery hospitalization including: death, heart failure, intraoperative heart failure, pulmonary edema, cardiac arrest, myocardial infarction, ventricular fibrillation, respiratory failure, pneumonia, acute kidney injury, and cardiac conversion. Propensity score matching was used to estimate the association between maternal pulmonary hypertension and adverse cardiopulmonary outcomes, adjusting for sociodemographic variables and validated clinical comorbidities as covariates. Secondary outcomes included mechanical circulatory support utilization, length of stay, and total hospitalization costs.</div></div><div><h3>Results</h3><div>Among 18,161,315 delivery hospitalizations, 4,630 patients had pulmonary hypertension, yielding a maternal pulmonary hypertension prevalence of 25 per 100,000 delivery hospitalizations with a yearly trend of increasing prevalence (odds ratio = 1.06, 95 % CI 1.01 to 1.11, P = 0.028). After propensity score matching to create well-balanced groups, 4,560 patients with pulmonary hypertension were compared to 4,560 patients without pulmonary hypertension. In this confounder-adjusted analysis, the primary composite outcome of cardiopulmonary morbidity and mortality occurred in 41.1 % of the PH group compared to 14.4 % in the no PH group (adjusted odds ratio = 4.16, 95 % CI 3.32 to 5.23, P < 0.001). Additionally, patients with PH had a higher incidence of mechanical circulatory support use (adjusted odds ratio = 9.08, 95 % CI 1.14 to 71.81, P = 0.037), longer length of stay (length of stay ratio = 2.82, 95 % CI 2.74 to 2.9, P < 0.001) and higher total hospitalization costs (total cost ratio = 1.67, 95 % CI 1.52 to 1.85, P < 0.001).</div></div><div><h3>Conclusions</h3><div>Maternal pulmonary hypertension is increasing in prevalence and is strongly associated with adverse cardiopulmonary outcomes in the United States, with 41.1% of pH patients experiencing a composite outcome of cardiopulmonary morbidity and mortality during delivery hospitalization. Our findings emphasize the importance of caring for patients with maternal pulmonary hype
{"title":"Maternal pulmonary hypertension and cardiopulmonary outcomes during delivery hospitalization in the United States: A nationwide study from 2016–2020","authors":"Paul P. Potnuru , Hayden Jefferies , Roy Lei , Paula Igwe , Yafen Liang","doi":"10.1016/j.preghy.2024.101170","DOIUrl":"10.1016/j.preghy.2024.101170","url":null,"abstract":"<div><h3>Background</h3><div>Maternal pulmonary hypertension can pose substantial morbidity and mortality risks, particularly during labor and delivery. Although maternal pulmonary hypertension is conventionally considered a contraindication to pregnancy, advances in the management of pH may contribute to improving outcomes.</div></div><div><h3>Objectives</h3><div>In this nationwide study, we aim to characterize the prevalence of maternal pulmonary hypertension in the United States and its association with adverse cardiopulmonary outcomes during delivery hospitalizations.</div></div><div><h3>Study Design</h3><div>In this cross-sectional cohort study, we analyzed delivery hospitalizations in the National Inpatient Sample from 2016 to 2020. The primary exposure was maternal pulmonary hypertension. The primary outcome was a composite of maternal cardiopulmonary morbidity events during the delivery hospitalization including: death, heart failure, intraoperative heart failure, pulmonary edema, cardiac arrest, myocardial infarction, ventricular fibrillation, respiratory failure, pneumonia, acute kidney injury, and cardiac conversion. Propensity score matching was used to estimate the association between maternal pulmonary hypertension and adverse cardiopulmonary outcomes, adjusting for sociodemographic variables and validated clinical comorbidities as covariates. Secondary outcomes included mechanical circulatory support utilization, length of stay, and total hospitalization costs.</div></div><div><h3>Results</h3><div>Among 18,161,315 delivery hospitalizations, 4,630 patients had pulmonary hypertension, yielding a maternal pulmonary hypertension prevalence of 25 per 100,000 delivery hospitalizations with a yearly trend of increasing prevalence (odds ratio = 1.06, 95 % CI 1.01 to 1.11, P = 0.028). After propensity score matching to create well-balanced groups, 4,560 patients with pulmonary hypertension were compared to 4,560 patients without pulmonary hypertension. In this confounder-adjusted analysis, the primary composite outcome of cardiopulmonary morbidity and mortality occurred in 41.1 % of the PH group compared to 14.4 % in the no PH group (adjusted odds ratio = 4.16, 95 % CI 3.32 to 5.23, P < 0.001). Additionally, patients with PH had a higher incidence of mechanical circulatory support use (adjusted odds ratio = 9.08, 95 % CI 1.14 to 71.81, P = 0.037), longer length of stay (length of stay ratio = 2.82, 95 % CI 2.74 to 2.9, P < 0.001) and higher total hospitalization costs (total cost ratio = 1.67, 95 % CI 1.52 to 1.85, P < 0.001).</div></div><div><h3>Conclusions</h3><div>Maternal pulmonary hypertension is increasing in prevalence and is strongly associated with adverse cardiopulmonary outcomes in the United States, with 41.1% of pH patients experiencing a composite outcome of cardiopulmonary morbidity and mortality during delivery hospitalization. Our findings emphasize the importance of caring for patients with maternal pulmonary hype","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101170"},"PeriodicalIF":2.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate a commercial a Congo Red urine devise for assessing preeclampsia risk.
Study design: Prospective non-intervention study among women presenting with clinical suspicion of preeclampsia. The devise was used at the time of enrolment and, depending on gestation, on 1–3 later occasions.
Outcome measures: Abnormal diffusion patterns classified as positive or negative, in relation to subsequent confirmation of preeclampsia (detection and false-positive rates, and predictive value) and the probability of diagnosis within a fixed time period (rule-in and rule-out).
Results
600 women were enrolled in the study and follow-up information was available on 538, of whom 95 had preeclampsia at delivery and 443 did not. At enrolment the detection rate was 18 % and the false-positive rate 3.2 %; positive predictive value – probability of positive result being associated with preeclampsia – was 55 % and negative predictive value – probability of negative result not being preeclampsia – was 85 %. A positive test ruled-in delivery with preeclampsia within 28 days among 35 % and ruled-out preeclampsia with 7 days among 98 %. Repeat testing after enrolment yielded similar results to the initial sample.
Conclusion
The test has screening potential although published studies differ in the observed detection rate. Using the test to rule-out preeclampsia within 7 days can provide a significant management advantage especially for triaging patients and selecting those who can be managed at the peripheral centres.
{"title":"Validation of urinary Congo Red preeclampsia detection point-of-care devise","authors":"K Aparna Sharma , Manisha Kumar , Sangeeta Gupta , Vatsla Dadhwal , Kiran Guleria , Anubhuti Rana , Howard Cuckle , Ashok Khurana","doi":"10.1016/j.preghy.2024.101167","DOIUrl":"10.1016/j.preghy.2024.101167","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate a commercial a Congo Red urine devise for assessing preeclampsia risk.</div><div>Study design: Prospective non-intervention study among women presenting with clinical suspicion of preeclampsia. The devise was used at the time of enrolment and, depending on gestation, on 1–3 later occasions.</div><div>Outcome measures: Abnormal diffusion patterns classified as positive or negative, in relation to subsequent confirmation of preeclampsia (detection and false-positive rates, and predictive value) and the probability of diagnosis within a fixed time period (rule-in and rule-out).</div></div><div><h3>Results</h3><div>600 women were enrolled in the study and follow-up information was available on 538, of whom 95 had preeclampsia at delivery and 443 did not. At enrolment the detection rate was 18 % and the false-positive rate 3.2 %; positive predictive value – probability of positive result being associated with preeclampsia – was 55 % and negative predictive value – probability of negative result not being preeclampsia – was 85 %. A positive test ruled-in delivery with preeclampsia within 28 days among 35 % and ruled-out preeclampsia with 7 days among 98 %. Repeat testing after enrolment yielded similar results to the initial sample.</div></div><div><h3>Conclusion</h3><div>The test has screening potential although published studies differ in the observed detection rate. Using the test to rule-out preeclampsia within 7 days can provide a significant management advantage especially for triaging patients and selecting those who can be managed at the peripheral centres.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101167"},"PeriodicalIF":2.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1016/j.preghy.2024.101160
A. Hennessy , S. Heffernan , S. Pears , N. Roshan , A.B. Romano , A. Karumanchi , J. Hyett , R. Waugh , J. Iliopoulos , A. Makris
Animal models for preeclampsia are mostly determined by the experimental induction of hypertension, proteinuria and latterly, endogenous production of anti-angiogenic factors (sFlt-1). The focus on maternal outcome measures is more immediately obvious, with comparative and sequential data of blood pressure and urine protein excretion. In non-human primates, the data concerning birthweight requires a greater number of observations and thus will be accumulated over a longer period of time and a greater number of experimental protocols. The following represents the outcome of over 20 years of experimental preeclampsia (EPE) compared with normal pregnancy outcome data in baboons.
MethodsThis data represents the outcomes from 91 pregnancies over the last 25 years at the Australian National Baboon Colony. These pregnancies are attributed to females who had experimental preeclampsia (EPE) and those within the general colony. EPE was induced at day 130 (of 182 days gestation length), and in some protocols, treatments such as inhibitory RNA or placental growth factor (PlGF) were tested. All studies were approved by the institutional Animal Welfare Committee.
Results
The overall neonatal birthweight was 697 g ± 115 g. The average birthweight for normal males was 770 ± 105 g; and for male offspring of animals with EPE, 680 ± 113 g; for normal females was 640 ± 95 g and females from EPE pregnancies, 690 ± 43 g. There was only a significant difference in weight for females compared to males overall (p = 0.002), and there was no significant difference in birthweight for males or females subjected to EPE. Correction for treated EPE did not change the outcome.
Conclusions
These data indicate that in a non-human primate model of placental dysfunction through late pregnancy acute ischaemia, there is no measurable effect on baby birthweight compared to normal pregnancy, and no impact from a number of current experimental treatment strategies.
{"title":"Birthweight in a non-human primate model of placental ischaemia","authors":"A. Hennessy , S. Heffernan , S. Pears , N. Roshan , A.B. Romano , A. Karumanchi , J. Hyett , R. Waugh , J. Iliopoulos , A. Makris","doi":"10.1016/j.preghy.2024.101160","DOIUrl":"10.1016/j.preghy.2024.101160","url":null,"abstract":"<div><div>Animal models for preeclampsia are mostly determined by the experimental induction of hypertension, proteinuria and latterly, endogenous production of anti-angiogenic factors (sFlt-1). The focus on maternal outcome measures is more immediately obvious, with comparative and sequential data of blood pressure and urine protein excretion. In non-human primates, the data concerning birthweight requires a greater number of observations and thus will be accumulated over a longer period of time and a greater number of experimental protocols. The following represents the outcome of over 20 years of experimental preeclampsia (EPE) compared with normal pregnancy outcome data in baboons.</div><div>MethodsThis data represents the outcomes from 91 pregnancies over the last 25 years at the Australian National Baboon Colony. These pregnancies are attributed to females who had experimental preeclampsia (EPE) and those within the general colony. EPE was induced at day 130 (of 182 days gestation length), and in some protocols, treatments such as inhibitory RNA or placental growth factor (PlGF) were tested. All studies were approved by the institutional Animal Welfare Committee.</div></div><div><h3>Results</h3><div>The overall neonatal birthweight was 697 g ± 115 g. The average birthweight for normal males was 770 ± 105 g; and for male offspring of animals with EPE, 680 ± 113 g; for normal females was 640 ± 95 g and females from EPE pregnancies, 690 ± 43 g. There was only a significant difference in weight for females compared to males overall (<em>p</em> = 0.002), and there was no significant difference in birthweight for males or females subjected to EPE. Correction for treated EPE did not change the outcome.</div></div><div><h3>Conclusions</h3><div>These data indicate that in a non-human primate model of placental dysfunction through late pregnancy acute ischaemia, there is no measurable effect on baby birthweight compared to normal pregnancy, and no impact from a number of current experimental treatment strategies.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101160"},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-16DOI: 10.1016/j.preghy.2024.101164
Shinta L. Moes , Lieke van de Kam , A. Titia Lely , Mireille N. Bekker , Martine Depmann
Background
Hypertensive disorders of pregnancy occur in 5–10 % of pregnancies and are associated with an increased risk of adverse perinatal outcomes.
Objectives
This review investigates the association between first trimester blood pressure (BP), mid-pregnancy BP drop, and BP-trajectories during pregnancy and adverse perinatal outcomes, exploring the fit of prediction and prevention.
Search strategy
Observational studies published before September 2023, reporting on desired determinants of BP and outcomes (preeclampsia (PE), severe hypertension, small for gestational age (SGA), fetal growth restriction (FGR)) were identified in MEDLINE, Embase and Cochrane.
Data collection and analysis
Data were collected in Excel. Results were analysed per BP-determinant. Meta analysis was performed for first trimester BP.
Main results
Ten studies met selection criteria. A great variety of cut-off values were used for BP categorization. Pooled analysis of 6 studies showed that women with borderline or hypertensive first trimester BP had a higher risk of PE compared to normotensive BP, OR 3.23 (95 % CI 1.99–5.26) and 7.86 (95 % CI 1.28–48.31), respectively. Additionally, first trimester hypertension correlated with a higher risk of SGA neonate (pooled OR of 1.87 (95 % CI 1.17–2.99)) compared to normotension or borderline hypertension. Throughout pregnancy, prehypertension, hypertension, elevated and high stable trajectories increased PE risk. High-stable trajectory increased SGA neonate risk.
Conclusions
The findings suggest that women with borderline and hypertensive BP in the first trimester are at increased risk for PE and SGA. However, standardization of cut-off values and BP measurement is necessary to estimate outcome risks more accurately.
背景5-10%的妊娠会发生妊娠高血压疾病，并与不良围产期结局风险的增加有关。目的本综述调查了妊娠头三个月血压（BP）、妊娠中期血压下降、妊娠期血压轨迹与不良围产期结局之间的关联，探讨了预测和预防的适宜性。检索策略在 MEDLINE、Embase 和 Cochrane 中查找 2023 年 9 月之前发表的观察性研究，这些研究报告了所需的血压决定因素和结果（子痫前期 (PE)、严重高血压、胎龄小 (SGA)、胎儿生长受限 (FGR)）。结果按血压决定因素进行分析。主要结果十项研究符合筛选标准。用于血压分类的临界值多种多样。对 6 项研究进行的汇总分析表明，与血压正常的孕妇相比，妊娠头三个月血压处于边缘或高血压水平的孕妇发生 PE 的风险更高，OR 分别为 3.23（95 % CI 1.99-5.26）和 7.86（95 % CI 1.28-48.31）。此外，与正常血压或边缘性高血压相比，妊娠头三个月高血压与 SGA 新生儿的高风险相关（汇总 OR 为 1.87 (95 % CI 1.17-2.99)）。在整个孕期，高血压前期、高血压、血压升高和高稳定血压都会增加 PE 风险。结论：研究结果表明，妊娠前三个月血压处于边缘水平和高血压的妇女发生 PE 和 SGA 的风险增加。然而，为了更准确地估计结果风险，有必要对临界值和血压测量进行标准化。
{"title":"The association between first trimester blood pressure, blood pressure trajectory, mid-pregnancy blood pressure drop and maternal and fetal outcomes: A systematic review and meta-analysis","authors":"Shinta L. Moes , Lieke van de Kam , A. Titia Lely , Mireille N. Bekker , Martine Depmann","doi":"10.1016/j.preghy.2024.101164","DOIUrl":"10.1016/j.preghy.2024.101164","url":null,"abstract":"<div><h3>Background</h3><div>Hypertensive disorders of pregnancy occur in 5–10 % of pregnancies and are associated with an increased risk of adverse perinatal outcomes.</div></div><div><h3>Objectives</h3><div>This review investigates the association between first trimester blood pressure (BP), mid-pregnancy BP drop, and BP-trajectories during pregnancy and adverse perinatal outcomes, exploring the fit of prediction and prevention.</div></div><div><h3>Search strategy</h3><div>Observational studies published before September 2023, reporting on desired determinants of BP and outcomes (preeclampsia (PE), severe hypertension, small for gestational age (SGA), fetal growth restriction (FGR)) were identified in MEDLINE, Embase and Cochrane.</div></div><div><h3>Data collection and analysis</h3><div>Data were collected in Excel. Results were analysed per BP-determinant. Meta analysis was performed for first trimester BP.</div></div><div><h3>Main results</h3><div>Ten studies met selection criteria. A great variety of cut-off values were used for BP categorization. Pooled analysis of 6 studies showed that women with borderline or hypertensive first trimester BP had a higher risk of PE compared to normotensive BP, OR 3.23 (95 % CI 1.99–5.26) and 7.86 (95 % CI 1.28–48.31), respectively. Additionally, first trimester hypertension correlated with a higher risk of SGA neonate (pooled OR of 1.87 (95 % CI 1.17–2.99)) compared to normotension or borderline hypertension. Throughout pregnancy, prehypertension, hypertension, elevated and high stable trajectories increased PE risk. High-stable trajectory increased SGA neonate risk.</div></div><div><h3>Conclusions</h3><div>The findings suggest that women with borderline and hypertensive BP in the first trimester are at increased risk for PE and SGA. However, standardization of cut-off values and BP measurement is necessary to estimate outcome risks more accurately.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101164"},"PeriodicalIF":2.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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