470 Maternal Habitual Snoring and Blood Pressure Trajectories in Pregnancy

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A185-A185
Author(s):  
Galit Levi Dunietz ◽  
Wei Hao ◽  
Kerby Shedden ◽  
Claudia Holzman ◽  
Ronald Chervin ◽  
...  

Abstract Introduction Habitual snoring has been associated with hypertensive disorders of pregnancy. However, exactly when blood pressure (BP) trajectories diverge between pregnant women with and without habitual snoring is unknown. Moreover, the potentially differential impact of chronic versus pregnancy-onset habitual snoring on maternal BP trajectories during pregnancy has not been examined. Methods In a cohort study of 1,305 pregnant women from a large Midwestern medical center, participants were asked about habitual snoring (≥3 nights/week) and whether their symptoms began prior to or during pregnancy. Demographic and BP data throughout pregnancy, systolic (SBP) and diastolic (DBP) were abstracted from medical charts. Linear mixed models were used to examine associations between habitual snoring-onset and pregnancy BP trajectories. Results Thirty percent of women reported snoring before pregnancy (chronic snoring) and an additional 23% reported pregnancy-onset snoring. Overall, women with pregnancy-onset snoring had higher mean SBP and DBP compared to those with chronic habitual snoring or controls (non-habitual snoring). In gestational week-specific comparisons with controls, SBP became significantly higher around 20 weeks’ gestation among women with pregnancy-onset snoring and in the third trimester among women with chronic snoring. Pairwise mean differences in DBP were significant only among women with pregnancy-onset snoring relative to controls, after 15 weeks’ gestation. Conclusion In a large cohort of pregnant women, those with pregnancy-onset or chronic habitual snoring had significantly elevated systolic BP in comparison to non-habitual snoring controls, in the second and third trimester, respectively. The findings of divergent BP trajectories suggest the two groups of women with habitual snoring in pregnancy should be considered separately when evaluating gestational ‘windows’ for increased BP monitoring and provide insight into pathophysiologic changes. Support (if any) Dr. Dunietz was supported by an F32 National Research Service Award from the National Institute of Child Health and Development (NIH/NICHD F32 HD091938); Dr. O’Brien was supported by the following during the course of this study: the Gene and Tubie Gilmore Fund for Sleep Research, the University of Michigan Institute for Clinical and Health Research (MICHR) grants UL1RR024986 and UL1TR000433, MICHR seed pilot grant F021024, the National Heart, Lung, and Blood Institute (R21 HL089918 and K23 HL095739) and in part by R21 HL087819.

2020 ◽  
Author(s):  
Wanhua Xie ◽  
Yunhe Gao ◽  
Weichi Tan

BACKGROUND In the conventional method, the blood pressure values of pregnant women were measured by nurses in the obstetrics outpatient clinics, and then were entered into the computer system.The pregnant women should wait for long time to complete this process.We hypothesized that the self-service blood pressure measurement by pregnant women could be a better option rather than measuring the blood pressure by nurses. OBJECTIVE This study aimed to analyze the effect of self-service blood pressure measurement in obstetrical outpatient clinic on waiting time, satisfaction of pregnant women and outpatient volume, and provide reference for the optimization of outpatient service processes. METHODS This was a cross-sectional study. The waiting time and satisfaction degree of pregnant women, as well as the outpatient volume in the Obstetrics Outpatient Clinic were compared on the use of self-service blood pressure measurement system with the conventional method. A total of 519 pregnant women in the obstetrics outpatient clinics of Guangzhou Women and Children’s Medical Center in China participated in the satisfaction survey. The sample means were compared with t-test. RESULTS Compared to wait a longer queue for blood pressure measured by nurses, after using the self-service blood pressure measurement system, the waiting time of pregnant women for blood pressure measurement was significantly reduced from (18.57±9.68) min to (2.39±1.96) min (P<0.001). In addition, the satisfaction degree of pregnant women was significantly increased (P<0.001), and the monthly outpatient volume was significantly increased (P=0.02,P<0.05). CONCLUSIONS This study showed that after implementation of self-service blood pressure measurement, the waiting time of the pregnant women for blood pressure measurement was decreased significantly, while the satisfactory degree and outpatient flow were increased significantly, improving the cost-effectiveness.Therefore, this method is worth to be popularized in clinical practices. Relevance to clinical practice: How to use medical intelligence in clinical practices, replace manual works by self-service devices to address the high outpatient flow, high work load of medical personnel, and improve the experience of patients in seeking medical services are the most concerned issues by both patients as well as hospital managers.This study demonstrated that the self-service blood pressure measurement as a promising strategy in clinical practices and provided reference for the optimization of outpatient service processes. CLINICALTRIAL This study was approved by the Ethics Committee of the Guangzhou Women and Children’s Medical Center (approval number:SFE-KL-46401; Supplementary file 4). All the pregnant women included in this study signed the informed consent form.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Delgado ◽  
M Delgado-Lelievre ◽  
D Lelievre ◽  
A Delgado-Almeida

Abstract Introduction The sodium voltage-gated channel alpha subunit 7 (SCN7A) has been associated to renal Na regulation and hypertension. This study explores the relationship between blood pressure (BP) and urinary overnight Na/K ratio (UONaK) in hypertensives (HT) and normotensive (NT) subjects from from National Heart, Lung and Blood Institute funded, Family Blood Pressure Program (FBPP) that were genotyped for 3 SNPs for SCN7A: CV2161217, CV 356958 and CV433036. Hypothesis Genetic variations in the SCNA7 are differently associated to BP and UONaK in HT and NT. Methods 1,749 subjects genotyped for SCN7A SNPs CV2161217, CV 356958 and CV433036 were analyzed from FBPP. Subjects with diastolic BP (DBP) ≥80 or systolic BP (SBP) ≥130 mmHg were classified HTN; subjects with SBP &lt;130 and DBP &lt;80 mmHg were classified as NT. UONAK was calculated by dividing overnight Na by K concentration. Correlation analysis done with partial variables (use of antihypertensive drug, use of diuretics, overnight urine creatinine). Results For the CV2161217, HTN group (n=1,030), 52% had C/C, 39% C/T and 9% T/T. In NT group (n=719), 52% had C/C, 38% C/T and 10% T/T. In the HT group, subjects with CC genotype showed strong correlation between DBP and UONaK (Fig 1a) while no significant correlation with SBP. Those with CT genotype maintained the correlation between SBP and UONaK (r=0.10, p=0.03) with no correlation with SBP. The TT showed no correlation between UONaK and SBP or DBP. In the NT, subjects with TT genotype showed strong correlation between DBP and UONaK (Fig 1b) and with SB (r=0.256, p=0.03). Those with CT or TT genotypes showed no correlation between UONaK and SBP or DBP. Similar finding were obtained for CV356958 SNP; no similar association was observed in the CV433036 SNP. Conclusions Subjects with the genetic variations in the SCNA7, such as CV2161217 and CV 356958 SNPs, showed significant correlation between blood pressure and overnight urinary sodium potassium. This finding could have important implications in non dipping status observed in some hypertensive patients. Funding Acknowledgement Type of funding source: None


PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 459-460
Author(s):  
MYUNG K. PARK

To the Editor.— Recently the National Heart, Lung, and Blood Institute Task Force on Blood Pressure Control in Children published revised normal BP standards and guidelines for children.1 I welcome this effort, as reliable normative data have been unavailable but are prerequisite for the early detection of hypertension and its proper treatment. The guidelines published by the Task Force for the detection of hypertension, the diagnostic evaluation, follow-up laboratory testing, and treatment are, in my opinion, excellent.


2021 ◽  
Vol 45 (6) ◽  
pp. 956-970
Author(s):  
Bethany Barone Gibbs ◽  
Melissa A. Jones ◽  
Kara M. Whitaker ◽  
Sharon Taverno Ross ◽  
Kelliann K. Davis

Objective: Our objective was to develop, validate, and describe findings from an instrument to measure barriers, attitudes, and outcome expectations of sitting less in pregnant women. Methods: This validation (sub-study 1) and descriptive study (sub-study 2) evaluated a new questionnaire measuring sedentary time in pregnant women (N=131) in each trimester. Results: In sub-study 1, construct validity was supported by associations between device-measured sedentary time and questionnaire scores. An optimized questionnaire removed infrequently reported and non-correlated items. The original and optimized questionnaires with scoring instructions are provided. In sub-study 2, physical symptoms and work were most commonly reported as major reasons for sitting in pregnancy, followed by leisure, family, and social activities. Some women reported limiting sitting due to boredom/restlessness, to improve energy or health, and to control weight. In the third trimester, some women reported sitting more/less due to pain and encouragement from family, friends, and co-workers. Few women reported household chores or pregnancy risks as reasons to sit, felt sitting was healthy or necessary during pregnancy, or were encouraged to sit by healthcare providers. Conclusions: The developed questionnaire demonstrated validity and identified barriers to and expectations of sitting less during pregnancy. Prenatal interventions to reduce sitting should address general and pregnancy-specific barriers.


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.


2020 ◽  
Vol 1 (2) ◽  
Author(s):  
Selfesina Sikoway ◽  
Yanti Mewo ◽  
Youla Assa

Abstract: Hemoglobin (Hb) is a parameter used to determine anemia prevalence. The average level of normal Hb at the end of pregnancy is around 12.5 g/dL, meanwhile, aproximately 5% of pregnant women have Hb level less than 11.0 g/dL. To date, Hb level below 11.0 g/dL especially at the end of pregnancy should be considered as an abnormal phenomenon and is usually caused by iron deficiency and not by hypervolemia which is commonly found in pregnancy. This study was aimed to determine the hemoglobin level of third semester pregnant women in Robert Wolter Mongisidi Hospital Manado. This was a descriptive study with a cross sectional design. Subjects were 39 third semester pregnant women who visited the Obstetric Department of Robert Wolter Mongisidi Hospital and fulfilled the inclusion criteria. The results showed that 25 subjects (64.1%) had low hemoglobin levels and 14 subjects (35.9%) had normal level of hemoglobin. In conclusion, most third semester pregnant women had low hemoglobin levels.Keywords: hemoglobin rate, third trimester pregnant women, anemia Abstrak: Hemoglobin (Hb) darah merupakan parameter yang digunakan untuk menetapkan prevalensi anemia. Nilai normal Hb pada akhir kehamilan rata-rata 12,5 g/dL, dan sekitar 5% wanita hamil konsentrasinya kurang dari 11,0 g/dL. Nilai Hb dibawah 11,0 g/dL terutama pada akhir kehamilan perlu dianggap abnormal dan biasanya disebabkan oleh defisiensi besi dan bukan karena hipervolemia yang umumnya ditemukan pada kehamilan. Penelitian ini bertujuan untuk mengetahui kadar hemoglobin pada ibu hamil trimester III di Rumah Sakit Robert Wolter Mongisidi Manado. Jenis penelitian ialah deskriptif dengan menggunakan desain potong lintang. Subyek penelitian ialah 39 ibu hamil trimester III yang berkunjung di Poliklinik Kebidanan di Rumah Sakit Robert Wolter Mongisidi Manado yang memenuhi kriteria inklusi. Hasil penelitian menunjukkan 25 subyek (64,1%) memiliki kadar hemoglobin rendah dan 14 subyek (35,9%) memiliki kadar hemoglobin normal. Simpulan penelitian ini ialah sebagian besar ibu hamil trimester III memiliki kadar hemoglobin rendah.Kata kunci: kadar hemoglobin, ibu hamil trimester III, anemia


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.


2018 ◽  
Vol 6 (2) ◽  
pp. 16
Author(s):  
Mezzi Wulandari Arenza ◽  
Ni Wayan Tianing ◽  
I Putu Adiartha Griadhi

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.


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