scholarly journals Clustering Longitudinal Blood Pressure Trajectories to Examine Heterogeneity in Outcomes Among Preeclampsia Cases and Controls

Hypertension ◽  
2021 ◽  
Author(s):  
Kyle R. Roell ◽  
Quaker E. Harmon ◽  
Kari Klungsøyr ◽  
Anna E. Bauer ◽  
Per Magnus ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Clinical Importance ◽  
Organ Damage ◽  
Reference Cluster ◽  
Nested Case Control ◽  
Control Study ◽  
New Onset

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.

scholarly journals The Joint Role of Thyroid Function and Iodine Status on Risk of Preterm Birth and Small for Gestational Age: A Population-Based Nested Case-Control Study of Finnish Women

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2573 ◽  
Author(s):  
Alexandra C. Purdue-Smithe ◽  
Tuija Männistö ◽  
Griffith A. Bell ◽  
Sunni L. Mumford ◽  
Aiyi Liu ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Case Control Study ◽  
Population Based ◽  
Case Control ◽  
Iodine Status ◽  
Unit Increase ◽  
Nested Case Control ◽  
Control Study

Normal maternal thyroid function during pregnancy is essential for fetal development and depends upon an adequate supply of iodine. Little is known about how iodine status is associated with preterm birth and small for gestational age (SGA) in mildly iodine insufficient populations. Our objective was to evaluate associations of early pregnancy serum iodine, thyroglobulin (Tg), and thyroid-stimulating hormone (TSH) with odds of preterm birth and SGA in a prospective, population-based, nested case-control study from all births in Finland (2012–2013). Cases of preterm birth (n = 208) and SGA (n = 209) were randomly chosen from among all singleton births. Controls were randomly chosen from among singleton births that were not preterm (n = 242) or SGA (n = 241) infants during the same time period. Women provided blood samples at 10–14 weeks’ gestation for serum iodide, Tg and TSH measurement. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for preterm birth and SGA. Each log-unit increase in serum iodide was associated with higher odds of preterm birth (adjusted OR = 1.19, 95% CI = 1.02–1.40), but was not associated with SGA (adjusted OR = 1.01, 95% CI = 0.86–1.18). Tg was not associated with preterm birth (OR per 1 log-unit increase = 0.87, 95% CI = 0.73–1.05), but was inversely associated with SGA (OR per log-unit increase = 0.78, 95% CI = 0.65–0.94). Neither high nor low TSH (versus normal) were associated with either outcome. These findings suggest that among Finnish women, iodine status is not related to SGA, but higher serum iodide may be positively associated with preterm birth.

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

2011 ◽  
Vol 29 ◽  
pp. e423-e424
Author(s):  
M. Laganović ◽  
D. Kuzmanić ◽  
I. Vuković Lela ◽  
M. Vrkić Kirhmajer ◽  
Lj. Banfić ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Premature Birth ◽  
Young Men ◽  
Organ Damage

Adverse Outcomes with Maternal Blood Pressure Less than 140/90 in Pregnancy Complicated by Hypertension

2019 ◽  
Vol 36 (13) ◽  
pp. 1394-1400 ◽  
Author(s):  
Courtney J. Mitchell ◽  
Alan Tita ◽  
Sarah B. Anderson ◽  
Daniel N. Pasko ◽  
Lorie M. Harper
Keyword(s):  
Blood Pressure ◽  
Preterm Birth ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Maternal Blood ◽  
Adverse Outcomes ◽  
Chronic Hypertension ◽  
Increased Risk

Objective We assessed the risk of small for gestational age and other outcomes in pregnancies complicated by chronic hypertension with blood pressure <140/90 mm Hg. Study Design Retrospective cohort of singletons with hypertension at a single institution from 2000 to 2014. Mean systolic blood pressure and mean diastolic blood pressure were analyzed as continuous and dichotomous variables (<120/80 and 120–139/80–89 mm Hg). The primary outcome was small for gestational age. Secondary outcomes included birth weight, preeclampsia, preterm birth <35 weeks, and a composite of adverse neonatal outcomes. Results Small for gestational age was not increased with a mean systolic blood pressure <120 mm Hg compared with a mean systolic blood pressure 120 to 129 mm Hg (adjusted odds ratio [AOR] 1.6; 95% confidence interval [CI] 0.92–2.79). Mean diastolic blood pressure <80 mm Hg was associated with a decrease in the risk preeclampsia (AOR 0.57; 95% CI 0.35–0.94), preterm birth <35 weeks (AOR 0.35; 95% CI 0.20–0.62), and the composite neonatal outcome (AOR 0.42; 95% CI 0.22–0.81). Conclusion Mean systolic blood pressure <120 mm Hg and mean diastolic blood pressure <80 mm Hg were not associated with increased risk of small for gestational age when compared with higher, normal mean systolic and diastolic blood pressures.

Antenatal Blood Pressure for Prediction of Preeclampsia, Preterm Birth, and Small for Gestational Age Babies

2016 ◽  
Vol 36 (3) ◽  
pp. 150
Author(s):  
C. Macdonald-Wallis ◽  
R.J. Silverwood ◽  
B.L. de Stavola ◽  
H. Inskip ◽  
C. Cooper ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age

scholarly journals Deep clinical and biological phenotyping of the preterm birth and small for gestational age syndromes: The INTERBIO-21st Newborn Case-Control Study protocol

2019 ◽  
Vol 2 ◽  
pp. 49 ◽  
Author(s):  
Stephen H. Kennedy ◽  
Cesar G. Victora ◽  
Rachel Craik ◽  
Stephen Ash ◽  
Fernando C. Barros ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Phase Ii ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Case Control Study ◽  
Human Growth ◽  
Case Control ◽  
International Standards ◽  
Population Characteristics ◽  
Control Study

Background: INTERBIO-21st is Phase II of the INTERGROWTH-21st Project, the population-based, research initiative involving nearly 70,000 mothers and babies worldwide coordinated by Oxford University and performed by a multidisciplinary network of more than 400 healthcare professionals and scientists from 35 institutions in 21 countries worldwide. Phase I, conducted 2008-2015, consisted of nine complementary studies designed to describe optimal human growth and neurodevelopment, based conceptually on the WHO prescriptive approach. The studies generated a set of international standards for monitoring growth and neurodevelopment, which complement the existing WHO Child Growth Standards. Phase II aims to improve the functional classification of the highly heterogenous preterm birth and fetal growth restriction syndromes through a better understanding of how environmental exposures, clinical conditions and nutrition influence patterns of human growth from conception to childhood, as well as specific neurodevelopmental domains and associated behaviors at 2 years of age. Methods: In the INTERBIO-21st Newborn Case-Control Study, a major component of Phase II, our objective is to investigate the mechanisms potentially responsible for preterm birth and small for gestational age and their interactions, using deep phenotyping of clinical, growth and epidemiological data and associated nutritional, biochemical, omic and histological profiles. Here we describe the study sites, population characteristics, study design, methodology and standardization procedures for the collection of longitudinal clinical data and biological samples (maternal blood, umbilical cord blood, placental tissue, maternal feces and infant buccal swabs) for the study that was conducted between 2012 and 2018 in Brazil, Kenya, Pakistan, South Africa, Thailand and the UK. Discussion: Our study provides a unique resource for the planned analyses given the range of potentially disadvantageous exposures (including poor nutrition, pregnancy complications and infections) in geographically diverse populations worldwide. The study should enhance current medical knowledge and provide new insights into environmental influences on human growth and neurodevelopment.

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