scholarly journals Blood pressure change across pregnancy in white British and Pakistani women: analysis of data from the Born in Bradford cohort

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Diane Farrar ◽  
Gillian Santorelli ◽  
Debbie A. Lawlor ◽  
Derek Tuffnell ◽  
Trevor A. Sheldon ◽  
...  

Abstract The incidence of gestational hypertension (GH) and pre-eclampsia (PE) is increasing. Use of blood pressure (BP) change patterns may improve early detection of BP abnormalities. We used Linear spline random-effects models to estimate BP patterns across pregnancy for white British and Pakistani women. Pakistani women compared to white British women had lower BP during the first two trimesters of pregnancy, irrespective of the development of GH or PE or presence of a risk factor. Pakistani compared to white British women with GH and PE showed steeper BP increases towards the end of pregnancy. Pakistani women were half as likely to develop GH, but as likely to develop PE than white British women. To conclude; BP trajectories differ by ethnicity. Because GH developed evenly from 20 weeks gestation, and PE occurred more commonly after 36 weeks in both ethnic groups, the lower BP up to the third trimester in Pakistani women resulted in a lower GH rate, whereas PE rates, influenced by the steep third trimester BP increase were similar. Criteria for diagnosing GH and PE may benefit from considering ethnic differences in BP change across pregnancy.

1982 ◽  
Vol 101 (2) ◽  
pp. 273-280 ◽  
Author(s):  
E. B. Pedersen ◽  
A. B. Rasmussen ◽  
P. Johannesen ◽  
H. J. Kornerup ◽  
S. Kristensen ◽  
...  

Abstract. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), and blood pressure were determined in the third trimester in pregnancy, 5 days and 6 months after delivery in pre-eclampsia, essential and transient hypertension in pregnancy and in normotensive pregnant and non-pregnant control subjects. PRC and PAC were elevated several fold above non-pregnant level in all groups during pregnancy. In pre-eclampsia PRC and PAC were 220 and 160%, respectively, above the levels 6 months after delivery, and thus lower than the corresponding values, 360 and 402%, in normotensive pregnancy. In essential and transient hypertension PRC and PAC increased to the same degree as during normotensive pregnancy. Urinary sodium excretion, serum sodium and creatinine clearance were reduced in pre-eclampsia, but not in essential and transient hypertension when compared to normotensive pregnant controls. All the parameters determined were the same as in non-pregnant controls 6 months after delivery in all groups. There were no correlations between blood pressure and PRC or PAC in any of the groups neither in pregnancy nor after delivery. It is concluded that the renin-aldosterone system is stimulated in lesser degree in pre-eclampsia than in both essential hypertension, transient hypertension and normotensive pregnancy, and there was no evidence for a causal relationship between the renin-aldosterone system and blood pressure neither in normotensive nor hypertensive pregnancy.


2019 ◽  
Vol 28 (5) ◽  
pp. 345-355 ◽  
Author(s):  
Kimie Okada ◽  
Izumi Saito ◽  
Chihiro Katada ◽  
Takeshi Tsujino

Author(s):  
Rachel J. Skow ◽  
Andrew R. Steele ◽  
Graham M. Fraser ◽  
Margie H. Davenport ◽  
Craig D. Steinback

Isometric handgrip (IHG) is used to assess sympathetic nervous system responses to exercise and may be useful at predicting hypertension in both pregnant and non-pregnant populations. We have previously observed altered sympathetic nervous system control of blood pressure in late pregnancy. Therefore, we measured muscle sympathetic nerve activity (MSNA) and blood pressure during muscle metaboreflex activation (IHG) in normotensive pregnant women in the third trimester compared to healthy non-pregnant women. Nineteen pregnant (32±3wks gestation) and fourteen non-pregnant women were matched for age, non/pre-pregnant BMI, and parity. MSNA (microneurography), heart rate (ECG), and arterial blood pressure (Finometer) were continuously recorded during ten minutes of rest, and then during two-minutes of IHG at 30% of maximal voluntary contraction, and two-minutes of post-exercise circulatory occlusion (PECO). Baseline SNA was elevated in pregnant (41±11 bursts/min) compared to non-pregnant women (27 ± 9 bursts/minute; p=0.005); however, the sympathetic baroreflex gain and neurovascular transduction were not different between groups (p=0.62 and p=0.32, respectively). During IHG and PECO there was no significant differences in the pressor response (∆MAP) during IHG and PECO was not different between groups (p=0.25, main effect of group) nor the sympathetic response (interaction effect: p=0.16, 0.25, and 0.27 for burst frequency, burst incidence, and total SNA respectively). These data suggest that pregnant women who have maintained sympathetic baroreflex and neurovascular transduction also have similar sympathetic and pressor responses during exercise.


2020 ◽  
Author(s):  
Sha Chen ◽  
Hong Shen ◽  
Xueya Zhao ◽  
Jun Luo ◽  
Weiwei Cheng

Abstract Background: The purpose of this study was to investigate the risk factors for elevating homocysteine during pregnancy and the relative effects on preeclampsia, so as to further understand whether Hcy had predictive value for PE.Method: This is a prospective study that only covers pregnant women with singleton who received regular prenatal care from July to September 2018 exclusively at IPMCH (N=1142). Homocysteine, folic acid and vitamin B12 were tested in the 1st trimester (10-14 weeks), 2nd trimester (24-28 weeks), and 3rd trimester (30-34 weeks), respectively, and MTHFR genes (rs1801133, rs1801131, rs17367504) were detected. Therefore, the analysis of this case includes the variation in Hcy levels during pregnancy, risk factors for elevating homocysteine and the risk factors on preeclampsia.Results: (1) Homocysteine was lowest in the 1st trimester. (2) Homocysteine was negatively correlated with folic acid (r=-0.17, p<0.001) and vitamin B12 (r=-0.15, p<0.001) in the same trimester. (3) Both of heterozygous CT (p=0.025, 95% CI 0.018, 0.275) and homozygous TT (p<0.001, 95% CI 0.185, 0.501) in MTHFR rs1801133 might be risk factors that caused an increase in Hcy. G-spot mutations in MTHFR rs17367504 might be a risk factor that caused a decline in homocysteine. (4) Homocysteine in the 3rd trimester might be significantly correlated with increasing risk of preeclampsia (OR = 1.2, 95% CI 1.01,1.42), particularly early-onset preeclampsia (OR = 3.63, 95% CI 1.71,7.71) and severe preeclampsia (OR = 3.63, 95% CI 1.71,7.71).Conclusions: The variation in homocysteine level in the third trimester might be associated with preeclampsia, especially early-onset preeclampsia and severe preeclampsia, and MTHFR, folic acid and vitamin B12 might be the three critical factors responsible for the changing homocysteine levels during pregnancy.


Author(s):  
Mariko Watanabe ◽  
Toshimi Sairenchi ◽  
Keiko Nishida ◽  
Koji Uchiyama ◽  
Yasuo Haruyama ◽  
...  

The association of gestational hypertension (GH) with future hypertension in Japanese women is unclear. Hence, this study aimed to examine the association between GH and the risk of future hypertension in middle-aged-to-older Japanese women. A case-control study was performed, including 62 hypertensive women (case) and 75 nonhypertensive women (control). GH during the first pregnancy was diagnosed on the basis of the Maternal and Child Health Handbook record. Hypertensive women were recruited from outpatients in the hospital and residents who completed an annual health check-up in a community. Hypertension was defined as blood pressure with systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, or taking antihypertensive medications. The average age (SD) of the cases and controls at the time of recruitment was 63.1 (8.4) and 57.7 (9.4), respectively. The multivariable-adjusted odds ratio of GH for hypertension in middle-aged-to-older women was 4.2 (95% confidence interval, 1.0–17.5) after adjustment for potential confounding factors such as age and body-mass index (BMI) upon recruitment, prepregnancy BMI, and age at first delivery. In conclusion, GH can be an independent risk factor for future hypertension among Japanese women.


1981 ◽  
Author(s):  
M T Reboucas Goncalves ◽  
E Coutinho ◽  
Jean M Thomson ◽  
E Coutinho ◽  
L Poller

A comparison has been performed of blood coagulation and fibrinolytic changes during the third trimester of pregnancy in a group of white Caucasian women in Manchester, UK, with a matched group of non-white women in Salvador, Brazil. The same standardised reagents and methods were used for all tests at both centres. Results show some highly significant differences between the two populations. Fibrinogen and factor VII levels were significantly higher and fibrinolytic activity was significantly lower in the Manchester women. These findings may provide a basis for the clinical impression that haemorrhage at delivery is relatively common in Salvador whereas post partum thrombosis is extremely rare.


Sign in / Sign up

Export Citation Format

Share Document