Rates of hypertensive disorders of pregnancy in group versus individual prenatal care: CRADLE secondary analysis

2022 ◽  
Vol 226 (1) ◽  
pp. S459-S460
Author(s):  
Katelyn Pratt ◽  
Amy H. Crockett ◽  
Jessica Britt ◽  
Emily Doherty ◽  
Moonseong Heo ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Secondary Analysis ◽  
Group Versus ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals Frequent Placental SARS-CoV-2 in Patients with COVID-19-Associated Hypertensive Disorders of Pregnancy

2021 ◽  
pp. 1-11
Author(s):  
Marta Fabre ◽  
Pilar Calvo ◽  
Sara Ruiz-Martinez ◽  
Maria Peran ◽  
Daniel Oros ◽  
...  
Keyword(s):  
Viral Load ◽  
Gestational Hypertension ◽  
Group Versus ◽  
Control Group ◽  
Hypertensive Disorders Of Pregnancy ◽  
Rt Pcr ◽  
Third Trimester ◽  
Hypertensive Disorders ◽  
The Moment ◽  
The Relationship

<b><i>Introduction:</i></b> Studies described an increased frequency of hypertensive disorders of pregnancy (HDP) after a COVID-19 episode. There is limited evidence about SARS-CoV-2 viral load in placenta. This study aimed to investigate the relationship between SARS-CoV-2 viral load in the placenta and clinical development of HDP after COVID-19 throughout different periods of gestation. <b><i>Methods:</i></b> This is a case-control study in women with and without gestational hypertensive disorders after SARS-CoV-2 infection diagnosed by RT-PCR during pregnancy. Patients were matched by gestational age at the moment of COVID-19 diagnosis. We performed an analysis of SARS-CoV-2 RNA levels in placenta. <b><i>Results:</i></b> A total of 28 women were enrolled. Sixteen patients were diagnosed with COVID-19 during the third trimester and the remaining 12 patients in the other trimesters. Ten placentas (35.7%) were positive for SARS-CoV-2, 9 of them (9/14, 64.3%) belonged to the HDP group versus 1 (1/14, 7.2%) in the control group (<i>p</i> = 0.009). Those cases with the highest loads of viral RNA developed severe preeclampsia (PE). <b><i>Conclusion:</i></b> Among women diagnosed with COVID-19 during pregnancy, the presence of SARS-CoV-2 in the placenta was more frequent among women suffering from PE or gestational hypertension. Furthermore, the most severe cases of HDP were associated with high placental viral load, not necessarily associated with a positive nasopharyngeal RT-PCR at delivery. Our data suggest that SARS-CoV-2 infection during pregnancy could trigger gestational hypertensive disorders through persistent placental infection and resulting placental damage.

Association between hypertensive disorders of pregnancy and long-term neurodevelopmental outcomes in the offspring

2021 ◽  
Author(s):  
Anna Palatnik ◽  
Brian M Casey ◽  
Michael Varner ◽  
Yoram Sorokin ◽  
Uma M. Reddy ◽  
...  
Keyword(s):  
Child Behavior Checklist ◽  
Rating Scales ◽  
Gestational Hypertension ◽  
Secondary Analysis ◽  
Language Delay ◽  
Hypertensive Disorders Of Pregnancy ◽  
Neurodevelopmental Outcomes ◽  
Thyroxine Therapy ◽  
Hypertensive Disorders

Objective: The long-term impact of hypertensive disorders of pregnancy (HDP) exposure on offspring health is an emerging research area. The objective of this study was to evaluate the association between a maternal diagnosis of HDP (gestational hypertension and preeclampsia) and adverse neurodevelopmental outcomes in the offspring. Study Design: A secondary analysis of two parallel multicenter clinical trials of thyroxine therapy for subclinical hypothyroid disorders in pregnancy. Women with singleton non-anomalous gestations diagnosed with subclinical hypothyroidism or hypothyroxinemia were randomized to thyroxine therapy or placebo. The primary outcome was child intelligence quotient (IQ) at 5 years of age. Secondary outcomes were Bayley-III cognitive, motor and language scores at 12 and 24 months, DAS-II scores at 36 months, the Conners’ Rating Scales-Revised at 48 months, and scores from the Child Behavior Checklist at 36 and 60 months. Associations between neurodevelopment outcomes and maternal HDP were examined using univariable and multivariable analyses. Results: A total of 112 woman-child dyads with HDP were compared with 1067 woman-child dyads without HDP. In univariable analysis, mean maternal age (26.7±5.9 vs. 27.8±5.7 years, p=0.032) and nulliparity (45.5% vs. 31.0%, p=0.002) differed significantly between the two groups. Maternal socioeconomic characteristics did not differ between the groups. After adjusting for potential confounders, there were no significant differences in primary or secondary neurodevelopment outcome between offspring exposed to HDP and those unexposed. However, when dichotomized as low or high scores, we found higher rates of language delay (language scores <85: -1 standard deviation) at two years of age among offspring exposed to HDP compared with those unexposed (46.5% versus 30.5%, adjusted odds ratio 2.22, 95% CI 1.44 - 3.42). Conclusions: In this cohort of pregnant women, HDP diagnosis was associated with language delay at 2 years of age. However, other long-term neurodevelopmental outcomes in offspring were not associated with HDP.

Effect of Maternal Age and Fetal Number on the Risk of Hypertensive Disorders of Pregnancy

2017 ◽  
Vol 35 (03) ◽  
pp. 311-316 ◽  
Author(s):  
Audrey Merriam ◽  
Julley Jung ◽  
Cynthia Gyamfi-Bannerman ◽  
Devin Smith
Keyword(s):  
Maternal Age ◽  
Reference Group ◽  
Secondary Analysis ◽  
Primary Objective ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Comparison Groups ◽  
Primary Cesarean Delivery ◽  
Differential Contribution

Objective Our primary objective was to compare the differential contribution of fetal number and maternal age to the risk of hypertensive disorders of pregnancy (HDP). Study Design This was a secondary analysis of a large study of primary cesarean delivery. Women with singleton, twin, or triplet gestations were included. Women were divided into groups based on fetal number and maternal age. The primary outcome was HDP. A logistic regression model was fit to adjust for confounders. The incidence of HDP was compared with the reference group and within exposure groups. Results Of the 70,417 women included, HDP occurred in 8,079 (12%) women. The frequency of HDP among the comparison groups ranged from 11 to 38%. Nearly all groups had significantly increased risk of HDP compared with young maternal age singletons. Twin and triplet gestations increased the risk of HDP over singletons irrespective of maternal age after adjusting for baseline disease and race. The risk of HDP did not significantly increase with maternal age when fetal number was similar. Conclusion Fetal number significantly increased the risk of HDP and contributed more to that risk than maternal age. Maternal age became significant in groups with age greater than 40 years.

scholarly journals Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care

2015 ◽  
Vol 9 (4) ◽  
pp. 140-146 ◽  
Author(s):  
Isabela Roberta Cruz Barbosa ◽  
Wesley Bruno Merencio Silva ◽  
Grace Sanches Gutierrez Cerqueira ◽  
Neil Ferreira Novo ◽  
Fernando Antonio Almeida ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Fetal Outcome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
The Impact
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