Ophthalmic artery peak systolic velocity ratio distinguishes preeclampsia from chronic and gestational hypertension: A prospective cohort study

Author(s):  
Katherine GY Lau ◽  
Allan Wright ◽  
Emmanouil Kountouris ◽  
Kypros H Nicolaides ◽  
Nikos A Kametas
BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032280
Author(s):  
Gabriela Amstad Bencaiova ◽  
Deborah Ruth Vogt ◽  
Irene Hoesli

IntroductionHepcidin production is normally upregulated by iron stores, and in obesity has been shown to be overexpressed and correlated with low iron status. The increased hepcidin may restrain the iron release from the cells by affecting the expression of ferroportin, which probably associates with the development of diabetes complication. First, we investigate the difference of serum hepcidin and iron parameters between obese and non-obese pregnant women; second, we examine the correlation between serum hepcidin and adverse maternal and neonatal outcomes in pregnant women.Methods and analysisThis is a mono-centre, prospective cohort study with a study (obese) and a control group (non-obese women). In the first trimester, 188 singleton pregnancies will be recruited. Thereof, we expect 75 with a body mass index (BMI) ≥30 kg/m2and 113 with a BMI 18.5–30 kg/m2. Serum hepcidin, iron and haematological parameters will be measured at 11–14, 24–28, 32–36 weeks of gestation and at time of delivery. Blood pressure, weight, BMI and smoking status will be examined at all visits. We will assess the composite endpoints adverse maternal outcomes (including pre-eclampsia, gestational hypertension, gestational diabetes mellitus, haemorrhage, placenta abruption) and adverse neonatal outcomes (preterm birth, intrauterine growth restriction, preterm premature rupture of membranes, Apgar score <7 at 5 min, stillbirth, neonatal death).Recruitment has started in April 2019.Ethics and disseminationThis study received ethical approval from the ethics committee in Basel. The results of the study will be published in a peer-reviewed journal, and presented at national scientific conferences.Trial registration numberNCT03792464.


BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025970 ◽  
Author(s):  
Meijin Cai ◽  
Kok Hian Tan ◽  
Seng Bin Ang

IntroductionPhysical activity (PA) during first 20 weeks of pregnancy may lower risks of gestational diabetes mellitus (GDM) and gestational hypertension (GH), though evidence of association remains inconclusive. Current studies rely heavily on subjective assessment of PA levels. Wearable activity trackers provide a convenient and objective surrogate index for PA validated by evidence-based steps/day categorisation along a physical inactivity/activity continuum. I-ACT primarily aims to examine objectively measured PA levels and patterns in first and second trimesters of pregnancy and the association with GDM and/or GH in Singapore, a multiethnic Asian population. Secondary aims include investigating the bio-socio-demographic factors associated with sedentary behaviour, and association of early pregnancy PA level with maternal weight at 6 weeks postdelivery. Results may facilitate identification of high-risk mothers-to-be and formulation of interventional strategies.Methods and analysisProspective cohort study that will recruit 408 women at first antenatal visit at <12 weeks’ gestation. Baseline bio-socio-demographic factors and PA levels assessed by participant characteristics form and the International Physical Activity Questionnaire (IPAQ), respectively. An activity tracker (Fitbit) will be provided to be worn daily from date of recruitment to end of 20 weeks’ gestation. Tracker-recorded data will be synchronised with an application on participant’s smartphone. Compliance will be reinforced with fortnightly reminders. After 20 weeks, a second IPAQ and a feedback form will be administered. GDM screened at 24–28 weeks’ gestation. GH diagnosed after 20-weeks gestation. Maternal weight assessed at 6 weeks postdelivery. Appropriate statistical tests will be used to compare continuous and categorical PA measurements between first and second trimesters. Logistic regression will be used to analyse associations.Ethics and disseminationEthical approval obtained from the Centralised Institutional Review Board of SingHealth (reference 2017/2836). Dissemination of results will be via peer-reviewed research publications both online and in print, conference presentations, posters and medical forums.


2012 ◽  
Vol 207 (6) ◽  
pp. 487.e1-487.e9 ◽  
Author(s):  
Louise M. O'Brien ◽  
Alexandra S. Bullough ◽  
Jocelynn T. Owusu ◽  
Kimberley A. Tremblay ◽  
Cynthia A. Brincat ◽  
...  

2019 ◽  
Vol 18 ◽  
pp. 35-41
Author(s):  
Alfred O. Osoti ◽  
Stephanie T. Page ◽  
Barbra A. Richardson ◽  
Brandon L. Guthrie ◽  
John Kinuthia ◽  
...  

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiayou Luo ◽  
Chunli Fan ◽  
Miyang Luo ◽  
Junqun Fang ◽  
Shujin Zhou ◽  
...  

Abstract Background This study aimed to evaluate the incidence rates and risks of pregnancy complications among nulliparous and multiparous women with advanced maternal age (AMA, ≥35 years) in China. Methods We performed a community-based prospective cohort study of 10,171 pregnant women in selected two sub-districts and 11 towns of Liuyang from 2013 to 2015. All subjects were followed up from the first prenatal care (at ≤12 weeks) to delivery, and risks of pregnancy complications were compared by parity and maternal age groups. Results Among nulliparas, women with AMA showed significantly increased risks for gestational hypertension (OR 8.44, 95%CI 1.68–2.88), preeclampsia/eclampsia (OR 9.92, 95%CI 4.87–18.78), premature rupture of membrane (OR 6.84, 95%CI 2.00–17.69), as compared to women in the 20–29-year age group. Among multiparas with AMA, increased risks were found for gestational diabetes mellitus (OR 3.29, 95%CI 1.76–5.94), anemia (OR 1.85, 95%CI 1.25–2.69), polyhydramnios (OR 3.29, 95%CI 1.56–6.64), premature rupture of membrane (OR 5.14, 95%CI 2.12–12.29), and preterm labor (OR 1.89, 95CI 1.42–2.50). Conclusions Women with AMA were associated with increased risks of pregnancy complications, and complications with increased risks differed in nulliparas and multiparas. Women with AMA should be identified as a high-risk group in clinical practice.


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