Abstract 16375: The Association Between Pregestational Hypertension and Cardiovascular Events in Pregnant Females, a Population-based Study

Introduction: Pregestational hypertension is associated with poor fetal and maternal outcomes, however, the impact on maternal cardiovascular outcomes is not well defined. In this study, we aim to study the impact of pregestational hypertension on maternal cardiovascular outcomes. Methods: Pregnant women hospitalized from January 2016 to December 2017 were identified in the Nationwide Inpatient Sample. Pregnant females with pregestational hypertension were identified using AHRQ comorbidity measures. Outcomes of interest were mortality, myocardial infarction (MI), and stroke. Multivariate regression analysis adjusting for differences in baseline comorbidities was used for odds ratio (OR) and 95% confidence interval (CI). Results: Among 8,141,277 pregnant women, 224,295 (2.76%) had pregestational hypertension. Pregnant females with pregestational hypertension were significantly older (mean age of 31.52 +/- 6.03 vs. 28.65 +/- 5.84, p-value<0.001), and had a higher burden of comorbidities includingpregestational diabetes mellitus (10.4% vs. 1.1%, p-value<0.001), gestational diabetes (26.3% vs. 8.1%, p-value<0.001), obesity (27.6% vs. 7.7%, p-value<0.001), smoking (16.4% vs. 9.8%,p-value<0.001), hyperlipidemia (2.1% vs. 0.2%, p-value<0.001), and depression; 6.6% vs. 3.0%, p-value<0.001. Females with pregestational hypertension had more cesarean section; 46.6% vs. 29.2%, p-value<0.001, intra-uterine death; 1.3% vs. 0.4%, p-value<0.001, and spontaneous abortion; 0.6% vs. 0.3%, p-value<0.001. Pregetational hypertension had higher mortality rate (55.7 vs. 10.1 per 100,000 hospitalizations, p-value<0.001), MI rate (207.3 vs. 9.3 per 100,000 hospitalizations, p-value<0.001), and stroke rate (288.4 vs. 22.6 per 100,000 hospitalizations, p-value<0.001). Pregestational hypertension was associated with significantly worse outcomes including in-hospital mortality (aOR 3.01, 95% CI 2.48-3.67), MI (aOR 8.27, 95% CI 7.30-9.35), and stroke (aOR 9.31, 95% CI 8.47-10.24). Conclusions: Pregestational hypertension is associated with poor maternal cardiovascular outcomes in pregnancy. Further efforts should be directed to identifying high-risk females and better approaches to management are warranted.

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TSH levels associated with slimming pill use in a population-based study of brazilian women

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302007000900006 ◽

2007 ◽

Vol 51 (9) ◽

pp. 1448-1451 ◽

Cited By ~ 6

Author(s):

Rosely Sichieri ◽

Roseli Andrade ◽

Jader Baima ◽

Jodelia Henriques ◽

Mario Vaisman

Keyword(s):

Body Mass Index ◽

Multivariate Regression ◽

Population Based ◽

P Value ◽

Socioeconomic Level ◽

Obese Women ◽

Regression Analyses ◽

Population Based Study ◽

Frequency Of Use ◽

Tsh Levels

OBJECTIVE: To determine the consumption of slimming pills (SP) and its association with TSH levels. RESEARCH METHODS AND PROCEDURES: A survey was carried out in Rio de Janeiro (about 5 million inhabitants), Brazil, from June 2004 to April 2005. Households (1,500) were selected using three-stage probability sampling. Women were asked about use of SP, and blood sample was collected. Women were classified as users of SP any time in life, but not in previous two months (n = 293), current users (n = 150), and never users (n = 853). Weighted multivariate regression analyses compared TSH levels among these groups of users. RESULTS: The frequency of use of SP any time in life was 34% and the use in the previous two months was 11%. Both frequencies were greater among younger and obese women, and among those of high socioeconomic level (p-value < 0.001). TSH level was statistically lower among current users of SP (1.96 mUI/ml; 95%CI = 1.93-1.98) compared to previous users 2.83 mUI/ml (95%CI = 2.13-3.02) and never users 2.59 mUI/ml (95%CI = 2.20-3.21). These differences were still statistically significant after adjusting for age and body mass index. CONCLUSIONS: Use of SP decreased TSH levels among Brazilian women.

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Clinical evolution of COVID-19 during pregnancy at different altitudes: a population-based study

10.1101/2020.09.14.20193177 ◽

2020 ◽

Author(s):

Juan Alonso Leon-Abarca ◽

Maria Teresa Pena-Gallardo ◽

Jorge Soliz ◽

Roberto Alfonso Accinelli

Keyword(s):

Pregnant Women ◽

Case Fatality ◽

Population Based ◽

Reproductive Age ◽

Rt Pcr ◽

Population Based Study ◽

Icu Admission ◽

The Impact ◽

Prevalence Ratios ◽

Binomial Models

Background: The impact of influenza and various types of coronaviruses (SARS-CoV and MERS-CoV) on pregnancy has been reported. However, the current pandemic caused by SARS-CoV-2 continues to reveal important data for understanding its behavior in pregnant women. Methods: We analyzed the records of 326,586 non-pregnant women of reproductive age and 7,444 pregnant women with no other risk factor who also had a SARS-CoV-2 RT-PCR result to estimate adjusted prevalence (aP) and adjusted prevalence ratios (aPR) of COVID-19 and its requirement of hospitalization, intubation, ICU admission and case-fatality rates. Adjustment was done through Poisson regressions for age and altitude of residence and birth. Generalized binomial models were used to generate probability plots to display how each outcome varied across ages and altitudes. Results: Pregnancy was independently associated with a 15% higher probability of COVID-19 (aPR: 1.15), a 116% higher probability of its following admission (aPR: 2.169) and a 127% higher probability of ICU admission (aPR: 2.275). Also, pregnancy was associated with 84.2% higher probability of developing pneumonia (aPR: 1.842) and a 163% higher probability of its following admission (aPR: 2.639). There were no significant differences in COVID-19 case-fatality rates between pregnant and non pregnant women (1.178, 95% CI: 0.68-1.67). Conclusion: Pregnancy was associated with a higher probability of COVID-19, developing of pneumonia, hospitalization, and ICU admission. Our results also suggest that the risk of COVID-19 and its related outcomes, except for intubation, decrease with altitude. Keywords: COVID-19, SARS-CoV-2, pregnancy, reproductive age, altitude

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Population-Based Study of Disability and Institutionalization After Transient Ischemic Attack and Stroke

Stroke ◽

10.1161/strokeaha.113.001584 ◽

2013 ◽

Vol 44 (10) ◽

pp. 2854-2861 ◽

Cited By ~ 103

Author(s):

Ramon Luengo-Fernandez ◽

Nicola L.M. Paul ◽

Alastair M. Gray ◽

Sarah T. Pendlebury ◽

Linda M. Bull ◽

...

Keyword(s):

Transient Ischemic Attack ◽

Care Home ◽

Multivariate Regression Analysis ◽

Population Based ◽

Modified Rankin Scale ◽

Term Outcome ◽

Population Based Study ◽

Long Term Outcome ◽

Ischemic Attack ◽

The Impact

Background and Purpose— Long-term outcome information after transient ischemic attack (TIA) and stroke is required to help plan and allocate care services. We evaluated the impact of TIA and stroke on disability and institutionalization over 5 years using data from a population-based study. Methods— Patients from a UK population-based cohort study (Oxford Vascular Study) were recruited from 2002 to 2007 and followed up to 2012. Patients were followed up at 1, 6, 12, 24, and 60 months postevent and assessed using the modified Rankin scale. A multivariate regression analysis was performed to assess the predictors of disability postevent. Results— A total of 748 index stroke and 440 TIA cases were studied. For patients with TIA, disability levels increased from 14% (63 of 440) premorbidly to 23% (60 of 256) at 5 years ( P =0.002), with occurrence of subsequent stroke being a major predictor of disability. For stroke survivors, the proportion disabled (modified Rankin scale >2) increased from 21% (154 of 748) premorbidly to 43% (273 of 634) at 1 month ( P <0.001), with 39% (132 of 339) of survivors disabled 5 years after stroke. Five years postevent, 70% (483 of 690) of patients with stroke and 48% (179 of 375) of patients with TIA were either dead or disabled. The 5-year risk of care home institutionalization was 11% after TIA and 19% after stroke. The average 5-year cost per institutionalized patient was $99 831 (SD, 67 020) for TIA and $125 359 (SD, 91 121) for stroke. Conclusions— Our results show that 70% of patients with stroke are either dead or disabled 5 years after the event. Thus, there remains considerable scope for improvements in acute treatment and secondary prevention to reduce postevent disability and institutionalization.

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THE IMPACT OF THE QTC INTERVAL ON MORTALITY AND CARDIOVASCULAR OUTCOMES: A POPULATION-BASED STUDY IN HEALTHY ASIANS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)31986-6 ◽

2016 ◽

Vol 67 (13) ◽

pp. 1985

Author(s):

Jonathan Yap ◽

Ai Zhen Jin ◽

Shwe Zin Nyunt ◽

Tze Pin Ng ◽

A. Mark Richards ◽

...

Keyword(s):

Population Based ◽

Cardiovascular Outcomes ◽

Qtc Interval ◽

Population Based Study ◽

The Impact

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Impact of SARS-CoV-2 Infection on Pregnancy Outcomes: A Population-Based Study

Clinical Infectious Diseases ◽

10.1093/cid/ciab104 ◽

2021 ◽

Author(s):

Francesca Crovetto ◽

Fàtima Crispi ◽

Elisa Llurba ◽

Rosalia Pascal ◽

Marta Larroya ◽

...

Keyword(s):

Pregnant Women ◽

Preterm Delivery ◽

Pregnancy Outcomes ◽

Pregnancy Complications ◽

Primary Outcome ◽

Fetal Distress ◽

Population Based ◽

Rt Pcr ◽

Population Based Study ◽

The Impact

Abstract Background A population-based study to describe the impact of SARS-CoV-2 infection on pregnancy outcomes. Methods Prospective, population-based study including pregnant women consecutively attended at first/second trimester or at delivery at three hospitals in Barcelona, Spain. SARS-CoV-2 antibodies (IgG and IgM/IgA) were measured in all participants and nasopharyngeal RT-PCR was performed at delivery. The primary outcome was a composite of pregnancy complications in SARS-CoV-2 positive versus negative women: miscarriage, preeclampsia, preterm delivery, perinatal death, small-for-gestational age, neonatal admission. Secondary outcomes were components of the primary outcome plus abnormal fetal growth, malformation, intrapartum fetal distress. Outcomes were also compared between positive symptomatic and positive asymptomatic SARS-CoV-2 women. Results Of 2,225 pregnant women, 317 (14.2%) were positive for SARS-CoV-2 antibodies (n=314, 99.1%) and/or RT-PCR (n=36, 11.4%). Among positive women, 217 (68.5%) were asymptomatic, 93 (29.3%) had mild COVID-19 and 7 (2.2%) pneumonia, of which 3 required intensive care unit admission. In women with and without SARS-CoV-2 infection, the primary outcome occurred in 43 (13.6%) and 268 (14%), respectively [risk difference -0.4%, (95% CI: -4.1% to 4.1)]. As compared with non-infected women, women with symptomatic COVID-19 had increased rates of preterm delivery (7.2% vs. 16.9%, p=0.003) and intrapartum fetal distress (9.1% vs. 19.2%, p=0.004), while asymptomatic women had similar rates to non-infected cases. Among 143 fetuses from infected mothers, none had anti-SARS-CoV-2 IgM/IgA in cord blood. Conclusions The overall rate of pregnancy complications in women with SARS-CoV-2 infection was similar to non-infected women. However, symptomatic COVID-19 was associated with modest increases in preterm delivery and intrapartum fetal distress.

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