scholarly journals Influence of Maternal Gestational Hypertensive Disorders on Microvasculature in School-Age Children

2016 ◽  
Vol 184 (9) ◽  
pp. 605-615 ◽  
Author(s):  
Gizem Dilan Yesil ◽  
Olta Gishti ◽  
Janine F. Felix ◽  
Irwin Reiss ◽  
Mohammad Kamran Ikram ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Standard Deviation Score ◽  
Maternal Blood ◽  
Deviation Score ◽  
Hypertensive Disorders ◽  
Maternal Blood Pressure ◽  
Retinal Arteriolar

Abstract Gestational hypertensive disorders may lead to vascular changes in the offspring. We examined the associations of maternal blood pressure development and hypertensive disorders during pregnancy with microvasculature adaptations in the offspring in childhood. This study was performed as part of the Generation R Study in Rotterdam, the Netherlands (2002–2012), among 3,748 pregnant mothers and their children for whom information was available on maternal blood pressure in different periods of pregnancy and gestational hypertensive disorders. Childhood retinal arteriolar and venular calibers were assessed at the age of 6 years. We found that higher maternal systolic and diastolic blood pressures in early pregnancy were associated with childhood retinal arteriolar narrowing (P < 0.05). Higher maternal systolic blood pressure in late pregnancy, but not in middle pregnancy, was associated with childhood narrower retinal venular caliber (standard deviation score per standardized residual increase in systolic blood pressure: −0.05; 95% confidence interval: −0.08, −0.01). Paternal blood pressure was not associated with childhood retinal vessel calibers. Children of mothers with gestational hypertensive disorders tended to have narrower retinal arteriolar caliber (standard deviation score: −0.13, 95% confidence interval: −0.27, 0.01). Our results suggest that higher maternal blood pressure during pregnancy is associated with persistent microvasculature adaptations in their children. Further studies are needed to replicate these observations.

Data from the StEP TWO programme showing the effect on blood pressure and different parameters for obesity in overweight and obese primary school children

2005 ◽  
Vol 15 (3) ◽  
pp. 291-298 ◽  
Author(s):  
Christine Graf ◽  
Sylvia V. Rost ◽  
Benjamin Koch ◽  
Sandy Heinen ◽  
Gisa Falkowski ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Standard Deviation ◽  
Diastolic Blood Pressure ◽  
Body Mass ◽  
Primary Schools ◽  
Standard Deviation Score ◽  
Overweight And Obesity ◽  
Obese Children ◽  
Deviation Score

Obesity in childhood, which is associated with cardiovascular risk factors such as hypertension, is on the increase. Countermeasures are necessary. In this paper, we present the baseline and final data from the StEP TWO programme, a prospective study to prevent overweight and obesity in primary schools. Methods: We recorded and calculated, from 1689 children, anthropometric data, including analyses of bioelectric impedance, waist and hip circumferences, body mass index and its standard deviation, and the ratio of waist to hip. Blood pressure was measured after 5 minutes at rest. From the three schools involved in a programme of intervention, 121 children were invited to take part, and 40 (33.1 per cent) completed the programme. The effect was compared with 155 overweight and obese children identified at the 4 control schools. Results: 830 (49.5 per cent) boys and 848 girls (50.5 per cent) took part. Their mean age was 8.2 plus or minus 1.3 years, their height was 1.31 plus or minus 0.09 metres, they weighed 30.0 plus or minus 8.2 kilograms, and their mean index of body mass was 17.1 plus or minus 2.9 kilograms per metre squared. Of the children, 7.3 per cent were obese, 10.4 per cent were overweight, 75.7 per cent had normal weights, and 6.6 per cent were underweight. Resting hypertension was observed in 2.3 per cent of the children. Increased blood pressure was associated with a higher body weight, body mass index, standard deviation score for body mass index, and waist and hip circumferences (each p < 0.001), but not with the ratio of waist to hip. Hypertension at rest was also found in 11.0 per cent of obese children, 4.4 per cent of those who were overweight, 1.2 per cent of those with normal weight, and 1.0 per cent of underweight children (p < 0.001). After the intervention, the increase of the body mass index tended to be lower in those in whom we had intervened (p = 0.069), and in these the decrease of the standard deviation score for body mass index was significantly higher (p = 0.028). Systolic blood pressure was reduced by about 10 millimetres of mercury in those in whom we had intervened (p = 0.002), while there were no changes in the control group. Diastolic blood pressure was lowered by 3 millimetres of mercury, but this was not significant. Conclusion: Obese children had the highest values for systolic and diastolic blood pressure. Increased levels of blood pressure are associated with other parameters of obesity, such as the circumference of the waist and hip. Early preventive measurements in childhood are necessary, and appropriate intervention appears to be effective.

Abstract 025: Urine Angiotensinogen and Salt-Sensitivity of Blood Pressure: The GenSalt Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Casey M Rebholz ◽  
Jing Chen ◽  
Qi Zhao ◽  
Dongfeng Gu ◽  
Jichun Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Salt Sensitivity ◽  
Angiotensin System ◽  
High Sodium ◽  
Low Sodium ◽  
Study Participants ◽  
Urine Levels

Urine excretion of angiotensinogen (AGT) has been proposed as a biomarker of intrarenal renin-angiotensin system activity, and therefore as a proxy for blood pressure regulation and sodium homeostasis. The association between urine levels of AGT and blood pressure response to dietary sodium intake has not been previously examined in the general population. We assessed the hypothesis that there is a direct relationship between urine levels of AGT and salt-sensitivity of blood pressure among participants of the Genetic Epidemiology Network of Salt Sensitivity (GenSalt) replication study. A 7-day low-sodium intervention, followed by a 7-day high-sodium intervention was carried out among 698 GenSalt-replication study participants from rural areas of north China. Absolute urine AGT excretion (μg/24 hours) and AGT-to-creatinine ratio (AGT/Cr, μg/g) were estimated at baseline for a random sample of 100 study participants. Nine blood pressure measurements were obtained at baseline and on the last three days of each intervention period. The absolute and percent changes in mean blood pressure from low-sodium to high-sodium intervention were used to assess salt-sensitivity. Median AGT and AGT/Cr were significantly (both p=0.01) reduced during the low-sodium intervention (AGT: 7.16 μg/24 hours, AGT/Cr: 8.36 μg/g) and increased during the high-sodium intervention (AGT: 8.84 μg/24 hours, AGT/Cr: 10.92 μg/g) compared to baseline (AGT: 8.28 μg/24 hours, AGT/Cr: 9.40 μg/g). Log-transformed AGT and AGT/Cr ratio at baseline was significantly and positively associated with blood pressure at baseline and at the end of each intervention. For example, one standard deviation higher log-transformed AGT/Cr ratio (1.2 μg/g) was associated with a 4.0 mm Hg (95% confidence interval: 1.3, 6.7) higher systolic blood pressure level at the end of the high-sodium intervention (p=0.004). One standard deviation higher log-transformed AGT/Cr ratio was associated with 1.58-times increased odds of high salt-sensitivity (≥5% change) of blood pressure (95% confidence interval: 1.00, 2.50; p=0.049). Log-transformed AGT/Cr ratio at baseline was positively associated with absolute and percent systolic blood pressure change from low- to high-sodium interventions (absolute: r=0.23, p=0.02; percent: r=0.20, p=0.047). In conclusion, elevated levels of urine AGT are associated with sodium-sensitivity of blood pressure. Augmentation of renal-angiotensin system activity may play an important role in the development of salt-sensitive hypertension.

Effect of Epidural Epinephrine on the Minimum Local Analgesic Concentration of Epidural Bupivacaine in Labor

2002 ◽  
Vol 96 (5) ◽  
pp. 1123-1128 ◽  
Author(s):  
Linda S. Polley ◽  
Malachy O. Columb ◽  
Norah N. Naughton ◽  
Deborah S. Wagner ◽  
Cosmas J. M. van de Ven
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Confidence Interval ◽  
Epidural Analgesia ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Maternal Blood ◽  
Double Blind ◽  
Clinically Significant ◽  
Maternal Blood Pressure

Background The minimum local analgesic concentration (MLAC) has been defined as the median effective local analgesic concentration in a 20-ml volume for epidural analgesia in the first stage of labor. The aim of this study was to determine the local anesthetic-sparing efficacy of epidural epinephrine by its effect on the MLAC of bupivacaine. Methods In this double-blind, randomized, prospective study, 70 parturients who were at 7 cm or less cervical dilation and who requested epidural analgesia were allocated to one of two groups. After lumbar epidural catheter placement, 20 ml bupivacaine (n = 35) or bupivacaine with epinephrine 1:300,000 (n = 35) was administered. The concentration of bupivacaine was determined by the response of the previous patient in that group to a higher or lower concentration using up-down sequential allocation. Analgesic efficacy was assessed using 100-mm visual analog pain scores, with 10 mm or less within 30 min defined as effective. Results The MLAC of bupivacaine alone was 0.091% wt/vol (95% confidence interval, 0.081-0.102). The addition of epinephrine 1:300,000 (66.7 microg) resulted in a significant reduction (P &lt; 0.01) in the MLAC of bupivacaine to 0.065% wt/vol (95% confidence interval, 0.047-0.083). The lowest maternal blood pressure was significantly lower in the bupivacaine-epinephrine group (P = 0.03). There were statistically significant reductions in fetal heart rate (P = 0.011) in the bupivacaine-epinephrine group that were not clinically significant. Conclusions The addition of epidural epinephrine 1:300,000 (66 microg) resulted in a significant 29% reduction in the MLAC of bupivacaine. Coincident reductions in fetal heart rate and maternal blood pressure were also observed that were not clinically significant.

scholarly journals Maternal blood pressure and hypertensive disorders during pregnancy and childhood respiratory morbidity: the Generation R Study

2018 ◽  
Vol 52 (5) ◽  
pp. 1800378 ◽  
Author(s):  
Freke A. Wilmink ◽  
Herman T. den Dekker ◽  
Johan C. de Jongste ◽  
Irwin K.M. Reiss ◽  
Vincent W.V. Jaddoe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lung Function ◽  
Maternal Blood ◽  
Respiratory Morbidity ◽  
Current Asthma ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Lower Lung ◽  
Asthma In Children ◽  
Maternal Blood Pressure

Pre-eclampsia is associated with an increased risk of bronchopulmonary dysplasia, wheezing and asthma in later childhood. Currently, there are no studies available investigating maternal blood pressure measurements during multiple time-points in pregnancy and respiratory outcome measures in the child.We examined the associations of maternal blood pressure and hypertensive disorders with the risk of lower lung function, wheezing and asthma in children aged 10 years. This study among 4894 children was embedded in a population-based prospective cohort study. We used multivariate analyses, taking lifestyle and socioeconomic factors into account.We observed consistent associations per 5 mmHg higher maternal blood pressure in early pregnancy with a lower forced expiratory volume in 1 s/forced vital capacity ratio (z-score −0.03 (95% CI −0.05– −0.01)) and per 5 mmHg higher blood pressure in late pregnancy with a higher risk for current wheezing and current asthma (OR 1.07 (95% CI 1.02–1.12) and 1.06 (95% CI 1.00–1.11), respectively). We found no associations of maternal hypertensive disorders during pregnancy with child lung function, current wheezing or current asthma.Our results suggest that higher blood pressure in pregnant women is associated with lower lung function and increased risks of current wheezing and current asthma in children. The associations may be trimester specific.

29. Maternal blood pressure and hypertensive disorders during pregnancy and childhood respiratory morbidity. The Generation R Study

2018 ◽  
Vol 13 ◽  
pp. S58
Author(s):  
Freke Wilmink ◽  
Herman den Dekker ◽  
Johan de Jongste ◽  
Irwin Reiss ◽  
Vincent Jaddoe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Maternal Blood ◽  
Respiratory Morbidity ◽  
Hypertensive Disorders ◽  
Maternal Blood Pressure

scholarly journals Hubungan Tekanan Darah Dengan Pernafasan Bayi Baru Lahir

2016 ◽  
Vol 9 (2) ◽  
Author(s):  
Mariah Ulfah
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
General Hospital ◽  
Gestational Hypertension ◽  
Maternal Blood ◽  
The State ◽  
Reproductive Age ◽  
Chi Square ◽  
Maternal Blood Pressure

The physiological changes that occur in neonates heaviest is the transmission of the placenta into the fetal circulation or respiration independently. Factors affecting the normal transmission of this or that increases asphyxia (state hypoxemia, hypercapnia, and acidosis) fetus will affect the adjustment of the fetus to life extrauterine Interference in breathing can occur there is a new baby is born, one of which is caused by a factor mother of them are related with blood pressure is hypotension or preeclampsia (Masyita Dea, 2014)  Based on the pre-survey conducted on February 1 until March 4, 2016 in General Hospital Cilacap shows there are 221 maternal, from record data medic there were nearly 9.95% of maternal disease associated with blood pressure that is consecutive gestational hypertension 6 cases, severe preeclampsia 12 cases, 4 cases mild pre-eclampsia, and even two cases of HELLP syndrome to be at risk of neonatal respiratory disorders (RM Hospital Cilacap, 2016)Objective of the research are : 1) Determine the incidence of maternal blood pressure in Cilacap General Hospital in 2016. 2) Determine the incidence of respiratory Newborn in Hospital Cilacap 2016. 3) Knowing Relations maternal blood pressure Systole with respiratory Newborn in Hospital Cilacap year 2016. 4) Knowing Relations diastolic blood pressure with respiratory maternal Newborn in Cilacap General Hospital in 2016. This study was an crossectional method and data were analyzed using Chi-square test The results showed 1) The highest maternal age in healthy reproductive age range (20-35) is 71.3% compared to the age of> 35 years of 20.7% and <20 years at 8%. 2) characteristics of respondents based on parity tertinggiadalah primipara (77.0%) compared with multiparous (17.2%) and Grandemultipara (5.7%) 3) The state of maternal systolic that systolic blood pressure <140 mmHg 85% higher than the systolic blood pressure of 140-159 mmHg 11.5%, systolic blood pressure>: 160 mm Hg was 3.4%. 4) The state of maternal bahwatekanan diastolic diastolic <90,, Hg is the highest compared to 69.5% diastolic blood pressure of 90-109 mm Hg (29.3%), and> 110 mmHg (1.1%). 5) The state of the newborn breathing regularly higher (58.6%) compared to the irregular breath (41.4%). 6) There is a relationship of systolic blood pressure with respiratory newborns Keyword: heart  failure, respiratory newborn baby, labour

Who benefits from intervention in, as opposed to screening of, overweight and obese children?

2006 ◽  
Vol 16 (5) ◽  
pp. 474-480 ◽  
Author(s):  
Christine Graf ◽  
Benjamin Koch ◽  
Birna Bjarnason-Wehrens ◽  
Narayanswami Sreeram ◽  
Konrad Brockmeier ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Standard Deviation ◽  
Body Mass ◽  
Standard Deviation Score ◽  
The Body ◽  
Control Group ◽  
Overweight Children ◽  
Obese Children ◽  
Deviation Score

Aims: StEP TWO is a school- and family-based intervention consisting of extra lessons, healthy nutrition and physical education for overweight and obese children in primary schools, aimed at reducing body mass index by maintenance or reduction of weight, and improving motor abilities. We analysed differences in changes in anthropometric, cardiovascular and obesity parameters between children who underwent intervention, non-participants in intervention, and controls. Methods: Anthropometric data and waist circumference were recorded for 1678 children; body mass index and body mass index–standard deviation score were calculated. Blood pressure was measured after 5 minutes at rest. 121 overweight and obese children enrolled at 3 schools involved in programmes of intervention were invited to take part; 40 of them completed the programme from November 2003 to July 2004. Of these overweight children, 74 were invited, but did not take part. As controls, we enrolled 155 overweight and obese children from 4 other schools. Results: After the programme, the children involved in intervention showed a lower increase in the body mass index (0.3 plus or minus 1.3 versus 0.7 plus or minus 1.2 kilograms per metre squared) and an approximately three times higher diminution of the body mass index–standard deviation score in comparison with their controls (−0.15 plus or minus 0.26 versus 0.05 plus or minus 0.27). Systolic blood pressure was significantly lowered by 9.5 plus or minus 19.6 millimetres of mercury in those involved in intervention, but increased in the control group by 0.5 plus or minus 16.5 millimetres of mercury. Among those invited but not participating, the increase of the body mass index (0.5 plus or minus 1.3 kilograms per metre squared) was less, and the reduction of the body mass index-standard deviation score (−0.09 plus or minus 0.31) and systolic blood pressure (−5.3 plus or minus 15.6 millimetres of mercury) was higher than in the control group. Overweight but not obese children seem to benefit from a screening examination alone. Conclusions: Early preventive measures in schools are necessary and effective for overweight and obese primary school children. The screening itself seems also to have a minor positive effect, especially for overweight children. Sustainability of the observed improvements over a longer period remains to be confirmed.

Bedingungen für den Erfolg übergewichtiger und adipöser Kinder in einem ambulanten Programm zur Gewichtsreduktion durch Veränderungen des Lebensstils

2010 ◽  
Vol 38 (5) ◽  
pp. 351-360 ◽  
Author(s):  
Wilfried Pott ◽  
Georg Fröhlich ◽  
Özgür Albayrak ◽  
Johannes Hebebrand ◽  
Ursula Pauli-Pott
Keyword(s):  
Body Mass Index ◽  
Standard Deviation ◽  
Body Mass ◽  
Standard Deviation Score ◽  
Psychische Belastung ◽  
Deviation Score ◽  
Höheres Alter

Fragestellung: Es wurde der Frage nachgegangen, ob sich erfolgreiche Teilnehmer eines ambulanten familienzentrierten Gewichtskontrollprogramms durch spezifische familiäre und psychologische Charakteristiken auszeichnen. Einbezogen wurden die psychosoziale Risikobelastung der Familie, Depressivität und Bindungsstil der Hauptbezugsperson, der Body mass index (BMI) und der BMI-Standardabweichungswert («Standard deviation score», SDS) des teilnehmenden Kindes und der Familienmitglieder sowie die individuelle psychische Belastung des teilnehmenden Kindes. Methodik: Die Daten wurden per Interview und Fragebogen vor dem Behandlungsbeginn erhoben. Von 136 in das Programm aufgenommenen übergewichtigen und adipösen Kindern zwischen 7 und 15 Jahren beendeten 116 das 12-monatige Interventionsprogramm. Von diesen zeigten 100 (85,3 %) eine Reduktion des BMI-SDS und 79 (68.1 %) eine mehr als 5 %ige Reduktion des BMI-SDS. Diese «erfolgreichen» Kinder wurden mit 56 «nicht erfolgreichen» (Abbrecher und Kinder mit einer 5 %igen oder geringeren Reduktion des BMI-SDS) verglichen. Ergebnisse: Nicht erfolgreiche Kinder unterschieden sich von den erfolgreichen durch ein höheres Alter, eine höhere psychosoziale Risikobelastung, Depressivität und einen vermeidenden Bindungsstil der Mutter sowie durch das Vorhandensein adipöser Geschwister. In einer logistischen Regressionsanalyse zeigten sich mütterliche Depressivität und das Vorhandensein adipöser Geschwister als beste und voneinander unabhängige Prädiktoren. Schlussfolgerungen: Um die spezifischen Bedürfnisse der Familien zu erfüllen und einen Misserfolg zu verhindern, sollten zusätzliche Programmbausteine zur spezifischen Unterstützung von Jugendlichen mit adipösen Geschwistern und Müttern mit Depressionen und vermeidenden Bindungsstil entwickelt werden. Die Wirksamkeit dieser Module muss dann in weiteren Studien überprüft werden.

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