Prehypertension prior to or during early pregnancy is associated with increased risk for hypertensive disorders in pregnancy and gestational diabetes

The aim was to assess whether women suffering from migraine are at higher risk of developing hypertensive disorders in pregnancy. In a prospective cohort study, performed at antenatal clinics in three maternity units in Northern Italy, 702 normotensive women with singleton pregnancy at 11–16 weeks' gestation were enrolled. Women with a history of hypertensive disorders in pregnancy or presenting chronic hypertension were excluded. The presence of migraine was investigated according to International Headache Society criteria. The main outcome measure was the onset of hypertension in pregnancy, defined as the occurrence of either gestational hypertension or preeclampsia. Two hundred and seventy women (38.5%) were diagnosed with migraine. The majority (68.1%) suffered from migraine without aura. The risk of developing hypertensive disorders in pregnancy was higher in migraineurs (9.1%) compared with non-migraineurs (3.1%) [odds ratio (OR) adjusted for age, family history of hypertension and smoking 2.85, 95% confidence interval (CI) 1.40, 5.81]. Women with migraine also showed a trend to increased risk for low birth weight infants with respect to women without migraine (OR 1.97, 95% CI 0.98, 3.98). Women with migraine are to be considered at increased risk of developing hypertensive disorders in pregnancy. The diagnosis of primary headaches should be taken into account at antenatal examination.

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Hypertensive Disorders in Pregnancy

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0038-1677626 ◽

2018 ◽

Vol 03 (02/03) ◽

pp. 068-078

Author(s):

Lalita Nemani

Keyword(s):

Blood Pressure ◽

Gestational Hypertension ◽

Stress Test ◽

Later Life ◽

Chronic Hypertension ◽

Prevention Measures ◽

Hypertensive Disorders ◽

Increased Risk ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

Abstract Hypertension in pregnancy is defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg or both on two different occasions at least 6 hours apart. Severe hypertension is SBP ≥ 160 mm Hg or DBP ≥ 110 mm Hg. Hypertension is the most common medical problem in pregnancy and one of the major causes of maternal and perinatal mortality and morbidity. Hypertensive disorders in pregnancy (HDP) are classified as (1) chronic hypertension, (2) chronic hypertension with superimposed preeclampsia, (3) preeclampsia-eclampsia, and (4) gestational hypertension. HDP contributes to increased risk of hypertension, stroke, and maternal cardiovascular disease (CVD) in later life. HDP can be considered as a failed cardiovascular stress test identifying women susceptible to CVD in later life. Further research is required to identify the mechanisms in HDP that contribute to CVD in later life so as to initiate appropriate prevention measures.

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Hypertensive Disorders in Pregnancy and Gestational Diabetes

Obstetrics and Gynecology ◽

10.1097/01.aog.0000533455.45890.87 ◽

2018 ◽

Vol 131 ◽

pp. 105S

Author(s):

Christina C. Reed ◽

Monica Longo ◽

Giuseppe Chiossi ◽

Rachel Landgren ◽

Suneet Chauhan ◽

...

Keyword(s):

Gestational Diabetes ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

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Pregnancy outcome in elderly primigravidae at a Nigerian Tertiary Hospital: a five-year review

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180154 ◽

2018 ◽

Vol 7 (2) ◽

pp. 391

Author(s):

R. O. Opadiran ◽

A. D. Isah ◽

N. Adewole ◽

K. I. Omonua

Keyword(s):

Pregnancy Outcome ◽

Maternal Age ◽

Caesarean Delivery ◽

Neonatal Outcome ◽

Statistical Significance ◽

The Elderly ◽

Hypertensive Disorders ◽

Increased Risk ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

Background: Pregnancy though a physiologic process also comes with its complications. This has been found to be related to factors associated with the mother and fetus. Maternal age at first pregnancy is a determining factor which could affect pregnancy outcome. Objective of present study was to determine the effect of maternal age on obstetric outcome.Methods: A five-year retrospective case control study involving primigravid women aged 35years and above (elderly primigravidae) and the younger primigravidae aged below 35 years who delivered at the University of Abuja Teaching hospital (UATH) between 2012 and 2016. Data were collected from their case notes, antenatal and delivery registers. For comparative purposes, obstetric and perinatal parameters including antenatal, labour, delivery, postpartum factors were collected for both the elderly primigravidae and younger primigravidae. A total of 6,052 deliveries, of which 2,456 were primigravidae and 42 of them were ≥35years of age. Out of 42 cases, only 30 folders were found and analyzed. The matched controls were selected consecutively after each elderly primigravidae in the register without prior knowledge of their pregnancy outcome. The data was analyzed using SPSS version 20. Chi square test X2 and student T test were used for comparison of the two groups. Statistical significance was set at P values of ≤ 0.05 at 95% confidence interval.Results: The incidence of elderly primigravidae was found to be 1.2% in this study. There was increased risk of hypertensive disorders in pregnancy, caesarean delivery and low APGAR scores in the elderly primigravidae group but these were not statistically significant. No other differences in obstetrics and neonatal outcome were found between the two groups.Conclusions: Elderly primigravidae are at increased risk of hypertensive disorders in pregnancy and caesarean delivery than in younger primigravidae. On the other hand, neonatal outcome of the two groups were comparable.

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Clinical and haematological features of newborns of mothers with hypertensive disorders in pregnancy in Lagos, Nigeria

Nigerian Journal of Paediatrics ◽

10.4314/njp.v47i3.10 ◽

2020 ◽

Vol 47 (3) ◽

pp. 252-257

Author(s):

O.S. Omoniyi ◽

I.B. Fajolu ◽

A. Adediran ◽

E.O. Temiye ◽

J.I. Ladele

Keyword(s):

Birth Weight ◽

Cross Sectional Study ◽

Cross Sectional ◽

Pregnancy Hypertension ◽

Hypertensive Disorders ◽

Increased Risk ◽

Hypertensive Disorders In Pregnancy ◽

Key Words Newborn ◽

Haematological Indices ◽

In Pregnancy

Background: Newborns of mothers with hypertensive disorders in pregnancy have an increased risk of preterm delivery, low birth weight, perinatalasphyxia and haematological derangements such as polycythaemia, thrombocytopenia and neutropenia. These morbidities are associated with uteroplacental insufficiency. The haematological derangements however have not been studied in detail in African neonates. Objective: To determine the clinical and haematological features of newborns of hypertensive mothers Methods: Cross-sectional study involving 250 newborns; 125 newborns each of hypertensive mothers (cases), and normotensive mothers (controls). The babies were examined following delivery, their clinical data were recorded, and umbilical cord blood samples were analysed for haematological indices. Results: Preterm deliveries were significantly higher amongst infants of hypertensive mothers (31.2%)compared with controls (12.0%);p = 0.000. Similarly, the birth weight, length and head circumference of the cases were significantly lower than the controls; p = 0.008, 0.003 and 0.004 respectively. Low fifth minute APGAR scores occurred more frequently in cases (8.0%) than controls (0.8%), p=0.010; whilst the mean haematocrit was also significantly higher in cases than the controls, p = 0.013. The median absolute neutrophil count and platelet count were significantly lower in cases than controls; p=0.023 and 0.047 respectively. Thrombocytopenia was identified in 40.0% of the cases compared to 27.2% of the controls, p = 0.041 Conclusion: The present study has shown that newborns of hypertensive mothers have an increased risk of neonatal morbidities such as preterm birth, LBW and thrombocytopenia compared to the newborns of mothers with normal blood pressure in pregnancy, hence close attention needs to be paid to them with emphasis on their haematological system. Key words: newborn, pregnancy, hypertension, hypertensive disorders, haematological, clinical

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Alpha-Methyldopa May Attenuate Insulin Demand in Women with Gestational Diabetes Treated with Betamethasone

Healthcare ◽

10.3390/healthcare10010135 ◽

2022 ◽

Vol 10 (1) ◽

pp. 135

Author(s):

Ioannis Kakoulidis ◽

Costas Thomopoulos ◽

Ioannis Ilias ◽

Stefanos Stergiotis ◽

Stefanos Togias ◽

...

Keyword(s):

Gestational Diabetes ◽

Pregnant Women ◽

Insulin Treatment ◽

Insulin Dose ◽

Exogenous Insulin ◽

Third Trimester ◽

The Third ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

Gestational diabetes mellitus (GDM) is associated with hypertensive disorders in pregnancy. Alpha-methyl-DOPA (αMD) is a commonly used medication for hypertension in pregnant women. This medication may be associated with alteration in insulin resistance and glucose homeostasis. The aim of the present study was to investigate in 152 pregnant women whether the demands of exogenous insulin in glucocorticoid-treated women during pregnancy are different between those with GDM and hypertension treated with αMD and those without hypertension. In the group of women with GDM under insulin treatment, who received αMD for hypertension, the increase in insulin needs was relatively lower by at least 30% of the pre-admission insulin dose compared to all of the remaining women not receiving αMD in the same group (9 women vs. 50 women, p = 0.035). Our work raises the hypothesis that αMD can favorably modulate insulin sensitivity in the third trimester of pregnancy in previously insulin-treated women with gestational diabetes who receive glucocorticoids.

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Association between maternal triglycerides and disturbed glucose metabolism in pregnancy

Acta Diabetologica ◽

10.1007/s00592-020-01644-z ◽

2021 ◽

Author(s):

Daniel Eppel ◽

Michael Feichtinger ◽

Tina Lindner ◽

Grammata Kotzaeridi ◽

Ingo Rosicky ◽

...

Keyword(s):

Insulin Resistance ◽

Glucose Metabolism ◽

Gestational Diabetes ◽

Pregnant Women ◽

Early Pregnancy ◽

Early Gestation ◽

Glucose Levels ◽

Increased Risk ◽

Mean Glucose ◽

In Pregnancy

Abstract Aims Dyslipidemia in pregnancy is associated with adverse pregnancy outcomes as elevated triglycerides might be considered as a risk factor for hyperglycemia and gestational diabetes. As only a few studies have addressed the association between maternal triglycerides and glucose metabolism, we aimed to explore the pathophysiologic associations of moderate hypertriglyceridemia and maternal glucose metabolism in pregnancy. Methods Sixty-seven pregnant women received a detailed metabolic characterization at 12+0–22+6 weeks of gestation by an extended 2h-75g OGTT (oral glucose tolerance test); with measurements of glucose, insulin and C-peptide at fasting and every 30 min after ingestion and assessment of triglycerides at fasting state. All examinations were repeated at 24+0–27+6 weeks of gestation. Results Elevated triglycerides in early gestation were associated with insulin resistance and β-cell dysfunction. Mean glucose concentrations during the OGTT in early pregnancy were already higher in women with hypertriglyceridemia as compared to women with triglycerides in the normal range. A higher degree of insulin resistance and increased OGTT glucose levels were also observed when metabolic assessments were repeated between 24 and 28 weeks of gestation. Of note, elevated triglycerides at early gestation were associated with development of gestational diabetes by logistic regression (odds ratio: 1.16, 95%CI: 1.03–1.34, p=0.022 for an increase of 10 mg/dl). Conclusions Hypertriglyceridemia at the start of pregnancy is closely related to impaired insulin action and β-cell function. Women with hypertriglyceridemia have higher mean glucose levels in early- and mid-gestation. Pregnant women with elevated triglycerides in early pregnancy are at increased risk of developing gestational diabetes.

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Feto-maternal outcome in COVID-19 positive patients with hypertensive disorders in pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211499 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1846

Author(s):

Niranjan N. Chavan ◽

Hera S. Mirza ◽

Priyanka Sonawane ◽

Umme Ammara Iqbal

Keyword(s):

Pregnant Women ◽

Neonatal Intensive Care ◽

Severe Infection ◽

Risk Groups ◽

Current Data ◽

Nasopharyngeal Swab ◽

Hypertensive Disorders ◽

Increased Risk ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

Background: Since the first confirmed case in December 2019, the data pertaining to the COVID-19 pandemic has been rapidly evolving. In current study, the relation of COVID-19 and its effect on pregnant women with hypertensive disorders in pregnancy, including symptoms and foetomaternal outcome were studied.Methods: Women with hypertensive disorders in pregnancy consecutively admitted for delivery and tested via nasopharyngeal swab for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR) from 1 April 2020 to 30 September 2020 were included in the study.Results: In our study, 56 women having hypertensive disorders in pregnancy with COVID-19 infections delivering 60 babies (4 twins), 46.43% were in the age group of <25 years, 51.78 % were <37 weeks gestation. Delivery was by caesarean section in 76.78%. Out of these, 33.92% patients required ICU admission. 40% babies delivered had birth weight of <2.5 kg out of which 13.33% had IUGR and 26.66% were preterm. There was 13.33% stillbirth and 6.66% neonatal deaths. 4 maternal death has been reported.Conclusions: With the current data available it does not appear that pregnant women are at increased risk of severe infection than the general population, but clinicians should be aware of high-risk groups. Women will need to be monitored in their booking maternity units and should be transferred to centres with appropriate neonatal intensive care facilities for delivery. In pregnant women with COVID-19 infection, if maternal illness is not severe, the considerations should be based more on obstetric indications for delivery.

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