scholarly journals The alarming rise in risk factors for hypertensive disorders of pregnancy

2022 ◽  
Author(s):  
Miriam F. Oostwaard
Keyword(s):  
Risk Factors ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals Prevention of Hypertensive Disorders of Pregnancy—Is There a Place for Metformin?

2021 ◽  
Vol 10 (13) ◽  
pp. 2805
Author(s):  
Elżbieta Poniedziałek-Czajkowska ◽  
Radzisław Mierzyński ◽  
Dominik Dłuski ◽  
Bożena Leszczyńska-Gorzelak
Keyword(s):  
Risk Factors ◽  
Risk Groups ◽  
Trophoblast Invasion ◽  
Pregnancy Induced Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Induced Hypertension ◽  
Endothelium Function ◽  
Hypoglycemic Drug ◽  
The Ideal

The possibility of prophylaxis of hypertensive disorders of pregnancy (HDPs) such as preeclampsia (PE) and pregnancy-induced hypertension is of interest due to the unpredictable course of these diseases and the risks they carry for both mother and fetus. It has been proven that their development is associated with the presence of the placenta, and the processes that initiate it begin at the time of the abnormal invasion of the trophoblast in early pregnancy. The ideal HDP prophylaxis should alleviate the influence of risk factors and, at the same time, promote physiological trophoblast invasion and maintain the physiologic endothelium function without any harm to both mother and fetus. So far, aspirin is the only effective and recommended pharmacological agent for the prevention of HDPs in high-risk groups. Metformin is a hypoglycemic drug with a proven protective effect on the cardiovascular system. Respecting the anti-inflammatory properties of metformin and its favorable impact on the endothelium, it seems to be an interesting option for HDP prophylaxis. The results of previous studies on such use of metformin are ambiguous, although they indicate that in a certain group of pregnant women, it might be effective in preventing hypertensive complications. The aim of this study is to present the possibility of metformin in the prevention of hypertensive disorders of pregnancy with respect to its impact on the pathogenic elements of development

Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011990
Author(s):  
Liisa Karjalainen ◽  
Minna Tikkanen ◽  
Kirsi Rantanen ◽  
Karoliina Aarnio ◽  
Aino Korhonen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Postpartum Period ◽  
First Trimester ◽  
Class Iii ◽  
Hypertensive Disorders Of Pregnancy ◽  
Risk Factor Management ◽  
Incidence Trends ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

scholarly journals Incidence and Risk Factors of Hypertensive Disorders of Pregnancy — 8 Provinces, China, 2014–2018

2021 ◽  
Vol 3 (22) ◽  
pp. 476-482
Author(s):  
Wei Zhao ◽  
◽  
Jiangli Di ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals Maternal hypertensive disorders in pregnancy and early childhood cardiometabolic risk factors: The Generation R Study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261351
Author(s):  
Dionne V. Gootjes ◽  
Anke G. Posthumus ◽  
Vincent W. V. Jaddoe ◽  
Bas B. van Rijn ◽  
Eric A. P. Steegers
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Body Mass Index ◽  
Early Childhood ◽  
Body Mass ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Childhood Body Mass Index

The objective of this study was to determine the associations between hypertensive disorders of pregnancy and early childhood cardiometabolic risk factors in the offspring. Therefore, 7794 women from the Generation Rotterdam Study were included, an ongoing population-based prospective birth cohort. Women with a hypertensive disorder of pregnancy were classified as such when they were affected by pregnancy induced hypertension, pre-eclampsia or the haemolysis, elevated liver enzymes and low platelet count (HELLP) syndrome during pregnancy. Early childhood cardiometabolic risk factors were defined as the body mass index at the age of 2, 6, 12, 36 months and 6 years. Additionally, it included systolic blood pressure, diastolic blood pressure, total fat mass, cholesterol, triglycerides, insulin and clustering of cardiometabolic risk factors at 6 years of age. Sex-specific differences in the associations between hypertensive disorders and early childhood cardiometabolic risk factors were investigated. Maternal hypertensive disorders of pregnancy were inversely associated with childhood body mass index at 12 months (confounder model: -0.15 SD, 95% CI -0.27; -0.03) and childhood triglyceride at 6 years of age (confounder model: -0.28 SD, 95% CI -0.45; -0.10). For the association with triglycerides, this was only present in girls. Maternal hypertensive disorders of pregnancy were not associated with childhood body mass index at 2, 6 and 36 months. No associations were observed between maternal hypertensive disorders of pregnancy and systolic blood pressure, diastolic blood pressure, body mass index, fat mass index and cholesterol levels at 6 years of age. Our findings do not support an independent and consistent association between maternal hypertensive disorders of pregnancy and early childhood cardiometabolic risk factors in their offspring. However, this does not rule out possible longer term effects of maternal hypertensive disorders of pregnancy on offspring cardiometabolic health.

scholarly journals Risk factors for hypertensive disorders of pregnancy in Abuja, Nigeria: A prospective case-control study

2020 ◽  
Vol 37 (1) ◽  
pp. 46
Author(s):  
MalachyEmeka Ayogu ◽  
GodwinOtuodichinma Akaba ◽  
RichardA Offiong ◽  
NathanielD Adewole ◽  
BissalahAhmed Ekele
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Control Study ◽  
Prospective Case Control Study

scholarly journals Risk factors for hypertensive disorders of pregnancy in Southern Brazil

2011 ◽  
Vol 57 (6) ◽  
pp. 678-682 ◽  
Author(s):  
Caroline Abrão Dalmáz ◽  
Kátia Gonçalves dos Santos ◽  
Mariana Rodrigues Botton ◽  
Israel Roisenberg
Keyword(s):  
Risk Factors ◽  
Southern Brazil ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Disparate Rates of Cesarean Delivery in Term Nulliparous Women with Hypertensive Disorders of Pregnancy

2019 ◽  
Vol 36 (10) ◽  
pp. 997-1001 ◽  
Author(s):  
Christina A. Penfield ◽  
Michael P. Nageotte ◽  
Deborah A. Wing
Keyword(s):  
Risk Factors ◽  
Cesarean Delivery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Target Population ◽  
Vital Statistics ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Important Target ◽  
Nulliparous Women

Objective To evaluate the prevalence of cesarean delivery in women with hypertensive disorders of pregnancy (HDP), and explore whether maternal, sociodemographic, or obstetric comorbidities contribute to cesarean delivery rates. Study Design This is a retrospective cohort study of nulliparous, term, singleton, vertex women using the 2013 U.S. National Vital Statistics Report. We compared prevalence of risk factors for cesarean delivery between women with and without HDP, and then calculated probabilities of cesarean delivery after controlling for these risk factors. Results In this cohort of 1,439,977 women, the unadjusted probability of cesarean delivery in women with HDP was 39.5 versus 26.8% in those without the diagnosis (p < 0.01). Hypertensive women had more risk factors for cesarean delivery, most notably morbid obesity (9.0 vs. 3.1%, p < 0.01), diabetes (9.9 vs. 4.4%, p < 0.01), and induction of labor (59.2 vs. 26.9%, p < 0.01). Despite this, after controlling for these risk factors, hypertensive women remained significantly more likely to undergo cesarean delivery (35.1 vs. 26.4%, p < 0.01). Conclusion Even after controlling for multiple comorbidities, hypertension remained a significant risk factor for cesarean delivery in nulliparous women at term. Hypertensive women may therefore represent an important target population in efforts aimed at reduction of cesarean rates.

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