358. Risk factors associated with hypertensive disorders of pregnancy within an urban indigenous population in South Western Sydney

Abstract Background Hypertension is the most common medical problem encountered in pregnancy and is a leading cause of perinatal and maternal morbidity and mortality. However, its magnitude and risk factors yet not adequately assessed at the study area. Methods Facility-based retrospective unmatched case-control study was conducted to identify risk factors associated with Hypertensive disorders of pregnancy in Nekemte Referral Hospital just two years back from study period July 1, 2015, to June 30, 2017. Bivariate logistic regression was considered for inclusion in to the multivariate logistic regression. Finally, multi varaite analysis were done to identify risk factors of hypertensive disorders of pregnancy. Results Among 6826 total delivery records from July 2015 –June 2017, 199 women developed hypertension during pregnancy. Among 199 women 153(76.9%) were pre-eclampsia/eclampsia,28(14.1%) were gestational hypertension, 14(0.7%) were superimposed hypertension and 4 (2.9%) were chronic hypertension. Age ≥ 35 (AOR: 2.51, 95% CI: 1.08, 5.83), rural residential area (AOR: 1.79, 95% CI: 1.150, 2.799), prim gravida (AOR: 3.39, 95% CI: 2.16, 5.33), null parity (AOR: 4.35, 95% CI: 2.36, 8.03), positive history of abortion (AOR: 4.39, 95% CI: 1.64, 11.76), twin pregnancy (AOR: 3.78, 95% CI: 1.52, 9.39), lack of ANC follow up (AOR: 3.05, 95% CI: 1.56, 5.96) as well as positive pre-existing hypertension (AOR: 3.81, 95% CI: 1.69, 8.58), positive family history of hypertension (AOR: 5.04, 95% CI: 2.66, 9.56) and positive history of diabetes mellitus (AOR: 5.03, 95% CI: 1.59, 15.89) were risk factors for hypertensive disorders during pregnancy. Conclusion This study found that Women with hypertension during pregnancy have a greater risk of developing adverse pregnancy outcome as compared to normotensive pregnant women. so, identification of these risk factors would be useful for early diagnosis of hypertension disorders during pregnancy to give appropriate clinical monitoring and treatments and timely managing maternal and perinatal complications.

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Considering environmental exposures to per- and polyfluoroalkyl substances (PFAS) as risk factors for hypertensive disorders of pregnancy

Environmental Research ◽

10.1016/j.envres.2021.111113 ◽

2021 ◽

Vol 197 ◽

pp. 111113

Author(s):

Abigail Erinc ◽

Melinda B. Davis ◽

Vasantha Padmanabhan ◽

Elizabeth Langen ◽

Jaclyn M. Goodrich

Keyword(s):

Risk Factors ◽

Environmental Exposures ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Polyfluoroalkyl Substances

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Prevention of Hypertensive Disorders of Pregnancy—Is There a Place for Metformin?

Journal of Clinical Medicine ◽

10.3390/jcm10132805 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2805

Author(s):

Elżbieta Poniedziałek-Czajkowska ◽

Radzisław Mierzyński ◽

Dominik Dłuski ◽

Bożena Leszczyńska-Gorzelak

Keyword(s):

Risk Factors ◽

Risk Groups ◽

Trophoblast Invasion ◽

Pregnancy Induced Hypertension ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Induced Hypertension ◽

Endothelium Function ◽

Hypoglycemic Drug ◽

The Ideal

The possibility of prophylaxis of hypertensive disorders of pregnancy (HDPs) such as preeclampsia (PE) and pregnancy-induced hypertension is of interest due to the unpredictable course of these diseases and the risks they carry for both mother and fetus. It has been proven that their development is associated with the presence of the placenta, and the processes that initiate it begin at the time of the abnormal invasion of the trophoblast in early pregnancy. The ideal HDP prophylaxis should alleviate the influence of risk factors and, at the same time, promote physiological trophoblast invasion and maintain the physiologic endothelium function without any harm to both mother and fetus. So far, aspirin is the only effective and recommended pharmacological agent for the prevention of HDPs in high-risk groups. Metformin is a hypoglycemic drug with a proven protective effect on the cardiovascular system. Respecting the anti-inflammatory properties of metformin and its favorable impact on the endothelium, it seems to be an interesting option for HDP prophylaxis. The results of previous studies on such use of metformin are ambiguous, although they indicate that in a certain group of pregnant women, it might be effective in preventing hypertensive complications. The aim of this study is to present the possibility of metformin in the prevention of hypertensive disorders of pregnancy with respect to its impact on the pathogenic elements of development

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P-082. A systematic review of cardiovascular disease prevention targeting lifestyle risk factors in women. Can the evidence inform post-partum health care after hypertensive disorders of pregnancy?

Pregnancy Hypertension ◽

10.1016/j.preghy.2021.07.117 ◽

2021 ◽

Vol 25 ◽

pp. e55-e56

Author(s):

Kaylee Slater ◽

Rachael Taylor ◽

Clare Collins ◽

Melinda Hutchesson

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Cardiovascular Disease ◽

Health Care ◽

Disease Prevention ◽

Post Partum ◽

Hypertensive Disorders Of Pregnancy ◽

Lifestyle Risk Factors ◽

Hypertensive Disorders ◽

Lifestyle Risk

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Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽

10.1212/wnl.0000000000011990 ◽

2021 ◽

pp. 10.1212/WNL.0000000000011990

Author(s):

Liisa Karjalainen ◽

Minna Tikkanen ◽

Kirsi Rantanen ◽

Karoliina Aarnio ◽

Aino Korhonen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Postpartum Period ◽

First Trimester ◽

Class Iii ◽

Hypertensive Disorders Of Pregnancy ◽

Risk Factor Management ◽

Incidence Trends ◽

Hypertensive Disorders ◽

Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

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