VERY PREMATURE BIRTH INFLUENCES BLOOD PRESSURE AND SUBCLINICAL ORGAN DAMAGE IN YOUNG MEN BORN SMALL FOR GESTATIONAL AGE

Preeclampsia is a heterogeneous disease characterized by new onset of hypertension along with signs of organ damage, affects 2% to 8% of pregnancies, and can result in serious complications to the mother and her child. There is little empirical evidence on the clinical importance of differences in blood pressure trajectories over the course of pregnancy, particularly in pregnancies affected by preeclampsia. We undertook an investigation of longitudinal changes in gestational blood pressure in a nested case-control study of preeclampsia in MoBa (Norwegian Mother, Father and Child Cohort Study). We included 1906 validated preeclampsia cases and 1413 validated controls. We derived blood pressure trajectory clusters using longitudinal k-means clustering and examined demographic and early-pregnancy predictors and birth outcomes, in relation to clusters. Maternal age, prepregnancy body mass index, and parity were substantially different across blood pressure clusters of cases. Pregnancy outcomes, including preterm birth, small for gestational age, and birthweight Z score, were meaningfully worse for individuals with a more rapid increase in blood pressure, as well as for individuals with a high starting blood pressure. For example, risk of preterm birth was 11-fold to 35-fold higher for steep and high trajectory clusters, and risk of small for gestational age was 2-fold higher compared with the reference cluster. Future studies may leverage these trajectories to differentiate preeclampsia cases in relation to circulating biomarkers, which may help in the development of preeclampsia prediction tools.

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Premature birth, low birth weight, small for gestational age and chronic non-communicable diseases in adult life: A systematic review with meta-analysis

Early Human Development ◽

10.1016/j.earlhumdev.2020.105154 ◽

2020 ◽

Vol 149 ◽

pp. 105154 ◽

Cited By ~ 4

Author(s):

Elaine Luiza Santos Soares de Mendonça ◽

Mateus de Lima Macêna ◽

Nassib Bezerra Bueno ◽

Alane Cabral Menezes de Oliveira ◽

Carolina Santos Mello

Keyword(s):

Systematic Review ◽

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Small For Gestational Age ◽

Premature Birth ◽

Meta Analysis ◽

Adult Life ◽

Communicable Diseases ◽

Non Communicable Diseases

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The Joint Association of Small for Gestational Age and Nighttime Sleep with Blood Pressure in Childhood

Scientific Reports ◽

10.1038/s41598-018-27815-1 ◽

2018 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Hongjian Wang ◽

Noel Mueller ◽

Guoying Wang ◽

Xiumei Hong ◽

Ting Chen ◽

...

Keyword(s):

Blood Pressure ◽

Gestational Age ◽

Small For Gestational Age ◽

Nighttime Sleep

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Colloid Osmotic Pressure in Newborn Infants: Variations with Birth Weight, Gestational Age, Total Serum Solids, and Mean Arterial Pressure

PEDIATRICS ◽

10.1542/peds.68.6.814 ◽

1981 ◽

Vol 68 (6) ◽

pp. 814-819

Author(s):

Paul Y. K. Wu ◽

Gary Rockwell ◽

Linda Chan ◽

Shu-Mei Wang ◽

Vikram Udani

Keyword(s):

Blood Pressure ◽

Birth Weight ◽

Osmotic Pressure ◽

Gestational Age ◽

Small For Gestational Age ◽

Newborn Infants ◽

Colloid Osmotic Pressure ◽

Large For Gestational Age ◽

Total Serum ◽

Arterial Blood

Colloid osmotic pressure (COP) of blood was measured directly at birth with the Wescor membrane colloid osmometer (model 4100) in 91 appropriately grown, 11 large, and nine small for gestational age "well" newborn infants. COP correlated directly with birth weight (r = .726, P < .00001) and gestational age (r = .753, P < .00001). COP values for small for gestational age (SGA) and large for gestational age (LGA) infants were found to fall within the 95% prediction interval with regard to birth weight and gestational age for appropriate for gestational age (AGA) infants. Simultaneous measurements of COP, total serum solids, and central arterial mean blood pressure were made. The results showed that COP correlated directly with total serum solids (r = .89, P < .0001) and mean arterial blood pressure (r = .660, P < .001). Among the factors evaluated, total serum solids was the best predictor of COP.

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Impact of the 2017 ACC/AHA Guideline for High Blood Pressure on Evaluating Gestational Hypertension–Associated Risks for Newborns and Mothers

Circulation Research ◽

10.1161/circresaha.119.314682 ◽

2019 ◽

Vol 125 (2) ◽

pp. 184-194 ◽

Cited By ~ 16

Author(s):

Jie Hu ◽

Yuanyuan Li ◽

Bin Zhang ◽

Tongzhang Zheng ◽

Jun Li ◽

...

Keyword(s):

Blood Pressure ◽

Preterm Delivery ◽

High Blood Pressure ◽

Gestational Age ◽

Small For Gestational Age ◽

Gestational Hypertension ◽

Blood Pressure Elevation ◽

Early Term ◽

Term Delivery ◽

The Impact

Rationale: In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) released a new hypertension guideline for nonpregnant adults, using lower blood pressure values to identify hypertension. However, the impact of this new guideline on the diagnosis of gestational hypertension and the associated maternal and neonatal risks are unknown. Objective: To estimate the impact of adopting the 2017 ACC/AHA guideline on detecting gestational blood pressure elevations and the relationship with maternal and neonatal risk in the perinatal period using a retrospective cohort design. Methods and Results: This study included 16 345 women from China. Systolic and diastolic blood pressures of each woman were measured at up to 22 prenatal care visits across different stages of pregnancy. Logistic and linear regressions were used to estimate associations of blood pressure categories with the risk of preterm delivery, early-term delivery, and small for gestational age, and indicators of maternal liver, renal, and coagulation functions during pregnancy. We identified 4100 (25.1%) women with gestational hypertension using the 2017 ACC/AHA guideline, compared with 4.2% using the former definition. Gestational hypertension, but not elevated blood pressure (subclinical blood pressure elevation), was significantly associated with altered indicators of liver, renal, and coagulation functions during pregnancy for mothers and increased risk of adverse birth outcomes for newborns; adjusted odds ratios (95% CIs) for gestational hypertension stage 2 were 2.23 (1.18–4.24) for preterm delivery, 2.05 (1.67–2.53) for early-term delivery, and 1.43 (1.13–1.81) for small for gestational age. Conclusions: Adopting the 2017 ACC/AHA guideline would result in a substantial increase in the prevalence of gestational hypertension; subclinical blood pressure elevations during late pregnancy were not associated with increased maternal and neonatal risk in this cohort. Therefore, the 2017 ACC/AHA guideline may improve the detection of high blood pressure during pregnancy and the efforts to reduce maternal and neonatal risk. Replications in other populations are required.

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