Dose-response relationship between maternal blood pressure in pregnancy and risk of adverse birth outcomes: Ma’anshan birth cohort study

Abstract Objectives It is unknown whether prenatal lipid-based nutrient supplements (LNS) affect blood pressure. The cutoffs to define high blood pressure have recently changed and little research has examined the association between the newly proposed blood pressure cutoffs and birth outcomes. Our objectives were to assess 1) the impact of LNS on maternal blood pressure; and 2) the association between blood pressure and birth outcomes. Methods In total, 1320 pregnant women ≤ 20 wk gestation in Ghana were randomized to receive daily either: 1) iron and folic acid (IFA), 2) multiple micronutrients (MMN), or 3) LNS. Blood pressure was measured at enrollment and 36 wk gestation. Gestational age was determined by ultrasound and newborn anthropometry included weight, length, and head circumference. The effect of LNS on maternal blood pressure was analyzed using ANOVA and associations between maternal blood pressure and birth outcomes were examined by linear and logistic regressions. Results Mean (± SD) systolic and diastolic blood pressure (SBP and DBP) at 36 wk gestation were 110 ± 11 and 63 ± 8 mmHg, respectively, and did not differ by supplementation group (P > 0.05). At enrollment, higher DBP was associated with lower birth weight and shorter pregnancy duration; 6.6% of women had high SBP (≥ 130 mmHg) and 3.6% had high DBP (≥ 80 mmHg), and women with high DBP had greater odds of low birth weight (adjusted OR = 2.99 (95% CI = 1.04, 8.62)) and preterm birth (3.99 (1.46, 10.86)) but there were no significant associations with SBP. At 36 wk, higher SBP was associated with a lower birth weight, birth length, newborn head circumference, and a shorter pregnancy duration and higher DBP was associated with a lower birth weight and length; 4.3% of women had high SBP and 2.4% had high DBP and women with high DBP had greater odds of low birth weight (4.14 (1.26, 13.62)) but high SBP (≥ 130 mmHg) was not associated with any birth outcomes. Conclusions Daily LNS during pregnancy did not have a significant effect on maternal blood pressure compared with IFA or MMN in this setting. Both higher SBP and higher DBP were associated with a shorter pregnancy duration and birth size; however, only high DBP was associated with adverse birth outcomes. It is unclear whether the new cutoff for high SBP is useful for identifying pregnancies at risk for adverse birth outcomes. Funding Sources Funded through a grant from the Bill & Melinda Gates Foundation to the University of California, Davis.

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Associations of maternal ozone exposures during pregnancy with maternal blood pressure and risk of hypertensive disorders of pregnancy: A birth cohort study in Guangzhou, China

Environmental Research ◽

10.1016/j.envres.2020.109207 ◽

2020 ◽

Vol 183 ◽

pp. 109207

Author(s):

Wenjun Cao ◽

Moran Dong ◽

Xiaoli Sun ◽

Xin Liu ◽

Jianpeng Xiao ◽

...

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Birth Cohort ◽

Maternal Blood ◽

Birth Cohort Study ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders ◽

Exposures During Pregnancy ◽

Maternal Blood Pressure

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Dose-response Relationship Between Maternal Blood Pressure in Pregnancy and Preterm Birth: Based on the Monitoring Data of 212,941 Pregnant Women in China

10.21203/rs.3.rs-646443/v1 ◽

2021 ◽

Author(s):

Wei Zhao ◽

Jiangli Di ◽

Xiao Gong ◽

Aiqun Huang ◽

Qi Yang ◽

...

Keyword(s):

Blood Pressure ◽

Preterm Birth ◽

Pregnant Women ◽

Dose Response ◽

Health Monitoring ◽

Maternal Blood ◽

Monitoring Data ◽

Response Relationship ◽

Dose Response Relationship ◽

Maternal Blood Pressure

Abstract Background: Hypertensive disorders of pregnancy (HDP) is a generally accepted risk factor of preterm birth (PTB). Most related studies focus on the effects of various HDP on pregnancy outcomes. Based on large-scale maternal health monitoring data, this study analyzes the dose-response relationship between maternal Blood pressure (BP) in different trimesters and PTB.Methods: Through the Maternal and Newborn Health Monitoring System in China, a total of 212,941 single-fetus pregnant women who delivered during 2014-2018 in 13 counties of 6 provinces in China were included in this study. BP level, distribution and changes in each trimester were described with linear trend test. Multivariate logistic regression analysis was performed to estimate the associations between BP groups in different gestational trimesters and PTB. Then a restricted cubic spline (RCS) was used to delineate the dose-response relationships between BP (both diastolic and systolic) during each trimester and PTB.Results: The overall incidences of HDP and PTB were 7.07% and 4.04% respectively. The detection rates of HDP in the 1st, 2nd and 3rd trimesters were 1.03%, 2.06% and 6.23% respectively. Taking the group of normal BP as reference, the odds ratios(OR) of PTB for the groups of hypertension in the 1st, 2nd and 3rd trimesters was 3.23, 2.70 and 2.05 respectively (P<0.001). Hypotension in 3rd trimester was associated with a 1.5-fold higher risk of PTB (P<0.001). OR of PTB had a nonlinearly U-shaped association with SBP and DBP in the 1st, 2nd and 3rd trimesters.Conclusions: The risks of PTB varied among pregnant women with the same BP in different trimesters. An increase of BP within the normal range during pregnancy could prevent PTB. Hypotension in 3rd trimester was associated with a high risk of PTB.

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The Effects of Maternal Serum Lipid on Maternal Blood Pressure and Fetal Birth Weight: A Prospective Cohort Study

Gynecology & Obstetrics ◽

10.4172/2161-0932.1000276 ◽

2015 ◽

Vol 05 (02) ◽

Cited By ~ 1

Author(s):

Zalina Nusee Hoe Kah Seong

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Birth Weight ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Serum Lipid ◽

Maternal Blood ◽

Maternal Serum ◽

Fetal Birth Weight ◽

Maternal Blood Pressure

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Epigenetic Alterations and Exposure to Air Pollutants: Protocol for a Birth Cohort Study to Evaluate the Association Between Adverse Birth Outcomes and Global DNA Methylation

JMIR Research Protocols ◽

10.2196/resprot.7114 ◽

2017 ◽

Vol 6 (2) ◽

pp. e29 ◽

Cited By ~ 7

Author(s):

Zhila Maghbooli ◽

Arash Hossein-Nezhad ◽

Majid Ramezani ◽

Syamak Moattari

Keyword(s):

Dna Methylation ◽

Cohort Study ◽

Birth Cohort ◽

Birth Outcomes ◽

Air Pollutants ◽

Birth Cohort Study ◽

Global Dna Methylation ◽

Adverse Birth Outcomes ◽

Epigenetic Alterations

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The University of Zimbabwe College of Health Sciences (UZ-CHS) BIRTH COHORT study: rationale, design and methods

BMC Infectious Diseases ◽

10.1186/s12879-020-05432-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Kerina Duri ◽

◽

Felicity Z. Gumbo ◽

Privilege T. Munjoma ◽

Precious Chandiwana ◽

...

Keyword(s):

Cohort Study ◽

Amniotic Fluid ◽

Birth Cohort ◽

Birth Outcomes ◽

Early Life ◽

Health Sciences ◽

Birth Cohort Study ◽

Adverse Birth Outcomes ◽

The University ◽

University Of Zimbabwe

Abstract Background Commencing lifelong antiretroviral therapy (ART) immediately following HIV diagnosis (Option B+), has greatly improved maternal-infant health. Thus, large and increasing numbers of HIV-infected women are on ART during pregnancy, a situation concurrently increasing numbers of HIV-exposed-uninfected (HEU) infants. Compared to their HIV-unexposed-uninfected (HUU) counterparts, HEU infants show higher rates of adverse birth outcomes, mortality, infectious/non-communicable diseases including impaired growth and neurocognitive development. There is an urgent need to understand the impact of HIV and early life ART exposures, immune-metabolic dysregulation, comorbidities and environmental confounders on adverse paediatric outcomes. Methods Six hundred (600) HIV-infected and 600 HIV-uninfected pregnant women ≥20 weeks of gestation will be enrolled from four primary health centres in high density residential areas of Harare. Participants will be followed up as mother-infant-pairs at delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72 and 96 after birth. Clinical, socio-economic, nutritional and environmental data will be assessed for adverse birth outcomes, impaired growth, immune/neurodevelopment, vertical transmission of HIV, hepatitis-B/C viruses, cytomegalovirus and syphilis. Maternal urine, stool, plasma, cord blood, amniotic fluid, placenta and milk including infant plasma, dried blood spot and stool will be collected at enrolment and follow-up visits. The composite primary endpoint is stillbirth and infant mortality within the first two years of life in HEU versus HUU infants. Maternal mortality in HIV-infected versus -uninfected women is another primary outcome. Secondary endpoints include a range of maternal and infant outcomes. Sub-studies will address maternal stress and malnutrition, maternal-infant latent tuberculosis, Helicobacter pylori infections, immune-metabolomic dysregulation including gut, breast milk and amniotic fluid dysbiosis. Discussion The University of Zimbabwe-College of Health-Sciences-Birth-Cohort study will provide a comprehensive assessment of risk factors and biomarkers for HEU infants’ adverse outcomes. This will ultimately help developing strategies to mitigate effects of maternal HIV, early-life ART exposures and comorbidities on infants’ mortality and morbidity. Trial registration ClinicalTrial.gov Identifier: NCT04087239. Registered 12 September 2019.

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