Associations between Maternal Exposure to Bisphenol A or Triclosan and Gestational Hypertension and Preeclampsia: The MIREC Study

2018 ◽  
Vol 36 (11) ◽  
pp. 1127-1135
Author(s):  
Louopou Rosalie Camara ◽  
Tye Elaine Arbuckle ◽  
Helen Trottier ◽  
William Donald Fraser
Keyword(s):  
Bisphenol A ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Environmental Chemicals ◽  
Multinomial Regression ◽  
Hypertension In Pregnancy ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Multiparous Women ◽  
Liquid Chromatography Tandem Mass

Background Little is known about the association between bisphenol A (BPA) or triclosan (TCS) exposure and hypertension in pregnancy. Objective To investigate potential associations between maternal urinary concentrations of BPA or TCS and gestational hypertension (GH) and preeclampsia. Study Design Among 1,909 pregnant women participating in the maternal-infant research on environmental chemicals (MIREC) study, urinary concentrations of BPA and TCS were measured in the first trimester by liquid chromatography-tandem mass spectrometry using isotope dilution. Blood pressure was measured during each trimester. Multinomial regression was performed to estimate the adjusted odds ratio (aOR) and 95% confidence intervals (CI) for the associations between these phenols and GH and preeclampsia. Results BPA and TCS were not associated with GH or preeclampsia. However, in multiparous women, BPA (0.50–1.30 µg/L) was associated with decreased risk of GH (aOR =0.45; 95%CI: 0.21–0.98) while among nulliparous women, TCS was associated with an increased risk of GH (3.60–32.60 µg/L; aOR = 2.58; 95% CI: 1.09–6.13 and > 32.60 µg/L: aOR = 2.74; 95% CI: 1.15–6.51). Conclusion BPA and TCS urinary concentrations were not associated with GH or preeclampsia; however, our results suggest an association between TCS and GH in nulliparous women. Additional studies are required to confirm our results.

scholarly journals JAK2V617F-positive clonal hematopoiesis of indeterminate potential in pregnant women

2019 ◽  
Vol 13 (3) ◽  
pp. 204-210
Author(s):  
I. A. Olkhovskiy ◽  
J. G. Garber ◽  
A. S. Gorbenko ◽  
M. A. Stolyar ◽  
O. M. Miller ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Lymphoblastic Leukemia ◽  
Venous Blood ◽  
First Trimester ◽  
Polymerase Chain Reaction Test ◽  
Routine Laboratory ◽  
Jak2 Mutation ◽  
Blood Samples ◽  
Increased Risk

Aim: to assess the prevalence of V617F somatic mutation of the JAK2 gene in pregnant women.Materials and methods. This non-interventional study was performed in the framework of routine clinical practice and included 1532 samples of venous blood from pregnant women who applied for medical assistance at Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare. We used blood samples left after all routine laboratory tests had been done. These leftovers were pooled in the way that ensured an equal ratio of nucleated cells. Each pool contained 7 separate blood samples. The unused samples that remained after the pooling were frozen and stored at –20°C until the end of entire testing procedure. The V617F JAK2 mutation was detected by the real-time allele-specific polymerase chain reaction test.Results. Among the examined pregnant women, 6 (0.4 %) were identified as carriers of V617F JAK2 mutation. Three women with this mutation suffered from infertility for 4, 5, and 10 years; two of them had repeated miscarriages in the first trimester of pregnancy. The 6 women – carriers of this mutations had no concomitant genetic polymorphisms typical of thrombophilia (factors FII, FV), and no abnormal coagulation characteristics. Analysis of their medical records showed that in the past, two of these women had gestational hypertension, one developed a clinical picture of preeclampsia, and another one (with the maximum presence of the mutant allele) had a history of acute lymphoblastic leukemia followed by stable remission.Conclusion. The routine laboratory detection of the V617F JAK2 mutation can facilitate timely identification of the increased risk of pregnancy pathology, as well as timely diagnosis of hematological cancer.

scholarly journals Elderly Great Grand Multipara with Gestational Hypertension and Anemia Managed in a Rural Tertiary Hospital: A Case Report

2019 ◽  
Vol 41 (2) ◽  
pp. 67-69
Author(s):  
Uma Shrestha
Keyword(s):  
Perinatal Mortality ◽  
Elderly Women ◽  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Labor Dystocia ◽  
Grand Multiparity ◽  
Emergency Cesarean ◽  
Increased Risk ◽  
Multiparous Women

Parity more than five is grand multiparty and more than 10 is great grand multiparity. Women with high birth order are at increased risk for adverse obstetric outcomes. The risk is even higher for great grand multiparous women than grand multiparous women. Grand and Great grand multiparity predispose for adverse maternal and prenatal outcomes such as malpresentation, labor dystocia, caesarean delivery, postpartum hemorrhage, maternal anemia, congenital malformations and perinatal mortality. Grand and Great grand multiparty is also independent risk factor for labor dystocia and perinatal mortality. However, most of the adverse outcomes that have been associated with grand multiparity may actually be confounded by advanced age, less antenatal care and low socioeconomic level. Although pregnancy hypertension is more commonly seen among youngprimigravidas, hypertension is equally common in elderly women. This is a unique case of elderly great grandmultiparous women with moderate anemia who developed gestational hypertension and underwent emergency cesarean section resulting into normal maternal and fetal outcome.

First-trimester placental vascular development in multiparous women differs from that in nulliparous women

2017 ◽  
Vol 31 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Gea Ballering ◽  
Janneke Leijnse ◽  
Niels Eijkelkamp ◽  
Louis Peeters ◽  
Roel de Heus
Keyword(s):  
Vascular Development ◽  
First Trimester ◽  
Nulliparous Women ◽  
Multiparous Women

scholarly journals Hipertensi pada Kehamilan

2019 ◽  
Vol 2 (2) ◽  
pp. 27
Author(s):  
Haidar Alatas
Keyword(s):  
Gestational Hypertension ◽  
Organ Damage ◽  
Antihypertensive Drug Therapy ◽  
Chronic Hypertension ◽  
First Line ◽  
Hypertension In Pregnancy ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Hipertensi pada kehamilan sering terjadi (6-10 %) dan meningkatkan risiko morbiditas dan mortalitas pada ibu, janin dan perinatal. Pre-eklampsia/eklampsia dan hipertensi berat pada kehamilan risikonya lebih besar. Hipertensi pada kehamilan dapat digolongkan menjadi pre-eklampsia/ eklampsia, hipertensi kronis pada kehamilan, hipertensi kronis disertai pre-eklampsia, dan hipertensi gestational. Pengobatan hipertensi pada kehamilan dengan menggunakan obat antihipertensi ternyata tidak mengurangi atau meningkatkan risiko kematian ibu, proteinuria, efek samping, operasi caesar, kematian neonatal, kelahiran prematur, atau bayi lahir kecil. Penelitian mengenai obat antihipertensi pada kehamilan masih sedikit. Obat yang direkomendasikan adalah labetalol, nifedipine dan methyldopa sebagai first line terapi. Penatalaksanaan hipertensi pada kehamilan memerlukan pendekatan multidisiplin dari dokter obsetri, internis, nefrologis dan anestesi. Hipertensi pada kehamilan memiliki tingkat kekambuhan yang tinggi pada kehamilan berikutnya. Hypertension complicates 6% to 10% of pregnancies and increases the risk of maternal, fetal and perinatal morbidity and mortality. Preeclampsia / eclampsia and severe hypertension in pregnancy are at greater risk. Four major hypertensive disorders in pregnancy have been described by the American College of Obstetricians and Gynecologists (ACOG): chronic hypertension; preeclampsia-eclampsia; chronic hypertension with superimposed preeclampsia; and gestational hypertension. The current review suggests that antihypertensive drug therapy does not reduce or increase the risk of maternal death, proteinuria, side effects, cesarean section, neonatal and birth death, preterm birth, or small for gestational age infants. The quality of evidence was low. Recommendations for treatment of hypertension in pregnancy are labetalol, nifedipine and methyldopa as first line drugs therapy. Although the obstetrician manages most cases of hypertension during pregnancy, the internist, cardiologist, or nephrologist may be consulted if hypertension precedes conception, if end organ damage is present, or when accelerated hypertension occurs. Women who have had preeclampsia are also at increased risk for hypertension in future pregnancies.

scholarly journals High blood pressure in pregnancy // Hipertenzija u trudnoći

2018 ◽  
Vol 5 (1) ◽  
pp. 28
Author(s):  
Marijana Bucalo ◽  
Anastasija Stojšić Milosavljević ◽  
Bojana Babin
Keyword(s):  
Blood Pressure ◽  
Literature Review ◽  
High Blood Pressure ◽  
Gestational Hypertension ◽  
Morbidity And Mortality ◽  
Significant Problem ◽  
Hypertension In Pregnancy ◽  
Gynecology And Obstetrics ◽  
Increased Risk ◽  
In Pregnancy

High blood pressure in pregnancy is a significant problem and has long been causing the attention of perinatologists. Hypertensive disorders in pregnancy are the leading cause of morbidity and mortality of mothers and fetuses. About 8% of pregnancies complicate high blood pressure. It is estimated that 192 women die daily due to hypertensive complications during pregnancy. Hypertension in pregnancy is not a single entity but it includes: pre-existing hypertension; gestational hypertension; pre-pregnancy existing hypertension complicated by gestational hypertension with proteinuria; prenatally unclassified hypertension. The aim of this paper is to point to the problem of hypertension in pregnancy and the importance of its early detection.It’s a literature review. The literature review period is from 2003-2013. The literature review was carried out in the Hinari, Pubmed and Google Scholar databases.A total of 50 scientific and professional papers in English and Serbian have been examined, of which work is included. 17. By reviewing the summary of each paper, all articles that did not report hypertension in pregnancy were excluded. Through research that was conducted, it was concluded that pregnancy is a significant problem in pregnancy and is therefore the leading cause of morbidity and mortality of both mothers and fetuses. However, the decision to introduce antihypertensive therapy and the choice of an adequate drug during pregnancy should be based on the assessment of the benefits and risks for each pregnant woman individually. Thus, the role of the health care nurse in gynecology and obstetrics has the primary goal and task to preserve and improve the health of women through a series of preventive-promotional activities, all of which are covered through primary, secondary, and tertiary prevention.A literature review lists the risk factors that can cause hypertension in pregnancy, including: age of the patient - under 20 and over 35 years, vascular and renal pathology, gestational diabetes, obesity or malnutrition, pheochromocytoma, systemic lupus, poor living conditions, there is and increased risk in first-born patients. Women who have been hypertensive during their first pregnancy have a higher risk of subsequent pregnancy.

scholarly journals The Association between Advanced Maternal Age and Diagnosis of Small for Gestational Age

2019 ◽  
Vol 37 (01) ◽  
pp. 037-043 ◽  
Author(s):  
Anna Palatnik ◽  
Sarah De Cicco ◽  
Liyun Zhang ◽  
Pippa Simpson ◽  
Judith Hibbard ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
The United States ◽  
Age Group ◽  
Nulliparous Women ◽  
Increased Risk ◽  
Multiparous Women ◽  
Multivariable Analyses

Abstract Objectives To identify whether advanced maternal age (AMA), defined as age ≥35 years old, is independently associated with small for gestational age (SGA). Study Design This was a retrospective cohort of births from the National Vital Statistics System in the United States from 2009 to 2013. Women were categorized based on four age groups at the time of delivery: 20 to 29, 30 to 34, 35 to 39, and ≥40 years old. The primary outcome of SGA < 10th and SGA < 5th percentiles was compared between the four groups using both univariable and multivariable analyses to determine whether maternal age was associated with SGA independent of parity. Results A total of 17,031,005 births were eligible for analysis, with 2,705,501 births to AMA women. In multivariable analyses, maternal age of 30 to 34, compared with 20 to 29, was associated with lower rates of SGA < 10th and <5th percentiles (adjusted odds ratio [aOR] = 0.95; 95% confidence interval [CI]: 0.95–0.96 and aOR = 0.97; 95% CI: 0.96–0.98, respectively). The AMA of 35 to 39, compared with 20 to 29, was associated with lower rates of SGA < 10th percentile and unchanged rates of SGA < 5th percentile (aOR = 0.97; 95% CI: 0.96–0.98 and aOR = 1; 95% CI: 0.99–1.01, respectively). In contrast, AMA of ≥40, compared with age 20 to 29, was associated with higher rates of both SGA < 10th and <5th percentiles (aOR = 1.06; 95% CI: 1.04–1.07 and aOR = 1.14; 95% CI: 1.12–1.16, respectively). A significant association was found between maternal age and parity toward the risk of SGA (p < 0.001). Nulliparous women ≥30 years old but not multiparous women had higher rates of SGA < 10th and SGA < 5th percentiles compared with nulliparous women in the age group of 20 to 29. In contrast, both nulliparous and multiparous women age ≥40 years old had an increased risk for SGA < 5th percentile compared with all women in the age group of 20 to 29. Conclusion Nulliparous women aged 30 years and older have higher risk of SGA < 10th and SGA < 5th percentiles compared with nulliparous women age 20 to 29. In contrast, both nulliparous and multiparous women age 40 years and older have an increased risk of SGA < 5th percentile compared with all women in the age group of 20 to 29.

First Trimester Dietary Intake, Biochemical Measures, and Subsequent Gestational Hypertension Among Nulliparous Women

2013 ◽  
Vol 58 (4) ◽  
pp. 423-430 ◽  
Author(s):  
Desiree L. Tande ◽  
Jody L. Ralph ◽  
LuAnn K. Johnson ◽  
Angela J. Scheett ◽  
Bonita S. Hoverson ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Nulliparous Women

Abstract 285: Bisphenol A Increases Atherosclerosis Mediated by the Human Pregnane X Receptor

2014 ◽  
Vol 34 (suppl_1) ◽  
Author(s):  
Yipeng Sui ◽  
Se-Hyung Park ◽  
Robert N Helsley ◽  
Changcheng Zhou
Keyword(s):  
Bisphenol A ◽  
Large Scale ◽  
Plasma Lipid ◽  
Pregnane X Receptor ◽  
Consumer Products ◽  
Environmental Chemicals ◽  
Cvd Risk ◽  
Humanized Mouse Model ◽  
Increased Risk ◽  
Underlying Mechanisms

Objective: Bisphenol A (BPA) is a base chemical used extensively in many consumer products. BPA has recently been associated with increased risk of cardiovascular disease (CVD) in multiple large-scale human population studies but the underlying mechanisms remain elusive. We previously reported that BPA activates the pregnane X receptor (PXR) which acts as a xenobiotic sensor to regulate xenobiotic metabolism and has pro-atherogenic effects in animal models upon activation. BPA is a potent agonist of human PXR but has no effects on mouse or rat PXR activity, which confounds the use of rodent models to evaluate mechanisms of BPA-mediated CVD risk. This study aims to investigate the atherogenic mechanism of BPA using a novel PXR-humanized mouse model. Approach and Results: We generated PXR-humanized ApoE deficient (huPXR•ApoE -/- ) mice that respond to human PXR ligands and therefore constitute a model to study the atherogenic effects of BPA. Feeding studies were performed to determine the effects of BPA exposure on atherosclerosis development. We found that exposure to BPA increased atherosclerosis in huPXR•ApoE -/- mice but not their control littermates. BPA exposure did not affect plasma lipid levels but increased CD36 expression and lipid accumulation in macrophages of huPXR•ApoE -/- mice. Conclusions: Our findings provide a molecular mechanism linking BPA exposure to increased risk of CVD in exposed individuals. PXR is therefore a relevant target for future risk assessment of BPA and related environmental chemicals in humans.

scholarly journals Cytokine Patterns in Maternal Serum From First Trimester to Term and Beyond

2021 ◽  
Vol 12 ◽  
Author(s):  
Anders Hagen Jarmund ◽  
Guro Fanneløb Giskeødegård ◽  
Mariell Ryssdal ◽  
Bjørg Steinkjer ◽  
Live Marie Tobiesen Stokkeland ◽  
...  
Keyword(s):  
Maternal Obesity ◽  
Serum Levels ◽  
First Trimester ◽  
Maternal Serum ◽  
Serum Samples ◽  
Female Fetus ◽  
Reactive Protein ◽  
Nulliparous Women ◽  
Cytokine Levels ◽  
Multiparous Women

Pregnancy implies delicate immunological balance between two individuals, with constant changes and adaptions in response to maternal capacity and fetal demands. We performed cytokine profiling of 1149 longitudinal serum samples from 707 pregnant women to map immunological changes from first trimester to term and beyond. The serum levels of 22 cytokines and C-reactive protein (CRP) followed diverse but characteristic trajectories throughout pregnancy, consistent with staged immunological adaptions. Eotaxin showed a particularly robust decrease throughout pregnancy. A strong surge in cytokine levels developed when pregnancies progressed beyond term and the increase was amplified as labor approached. Maternal obesity, smoking and pregnancies with large fetuses showed sustained increase in distinct cytokines throughout pregnancy. Multiparous women had increased cytokine levels in the first trimester compared to nulliparous women with higher cytokine levels in the third trimester. Fetal sex affected first trimester cytokine levels with increased levels in pregnancies with a female fetus. These findings unravel important immunological dynamics of pregnancy, demonstrate how both maternal and fetal factors influence maternal systemic cytokines, and serve as a comprehensive reference for cytokine profiles in normal pregnancies.

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