Relationship between body mass index and mean arterial pressure in normotensive and chronic hypertensive pregnant women: a prospective, longitudinal study

Background Whether or not norepinephrine infusions for support of hemodynamic status in patients with septic shock should be weight based is unknown. This situation is particularly pertinent in patients who are extremely overweight or obese. Objective To compare dosing requirements and effect of norepinephrine on blood pressure in obese and nonobese patients with septic shock. Methods In a retrospective cohort study, data on adult patients with septic shock who received norepinephrine infusion for support of hemodynamic status in a tertiary care, academic medical center were analyzed. Patients were categorized as obese (body mass index ≥ 30) or nonobese (body mass index < 30). The primary outcome was dosing requirements of norepinephrine at 60 minutes after the start of the infusion. The secondary outcome was the log-transformed ratio of mean arterial pressure to norepinephrine. Results The final cohort consisted of 100 obese and 100 nonobese patients. Mean norepinephrine infusion rate at 60 minutes was 0.09 (SD, 0.08) μg/kg per minute in the obese group and 0.13 (SD, 0.14) μg/kg per minute in the nonobese group (P = .006). The non–weight-based dose at 60 minutes was 9 μg/min in obese patients and 8 μg/min in nonobese patients (P = .72). The log transformed mean arterial pressure to norepinephrine ratio at 60 minutes was 2.5 (SD, 0.9) in obese patients and 2.5 (SD, 0.8) in nonobese patients (P = .54) Conclusions Compared with nonobese patients, obese patients with septic shock require lower weight-based doses of norepinephrine and similar total norepinephrine doses.

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A longitudinal study of thyroid function in pregnancy.

Clinical Chemistry ◽

10.1093/clinchem/35.2.275 ◽

1989 ◽

Vol 35 (2) ◽

pp. 275-278 ◽

Cited By ~ 13

Author(s):

A Price ◽

H Griffiths ◽

B W Morris

Keyword(s):

Longitudinal Study ◽

Pregnant Women ◽

Thyroid Function ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal ◽

In Pregnancy

Abstract We undertook a prospective longitudinal study of thyroid function in 36 pregnant women. There were significant increases in thyroxin-binding globulin, thyrotropin, and triiodothyronine. Albumin, free thyroxin (measured by an analog and a nonanalog method), and the free thyroxin index were significantly decreased. Results for the free thyroxin methods were correlated with each other in each trimester. We could find no evidence for artifacts related to albumin or thyroxin-binding globulin with either method for free thyroxin.

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Bone density changes in pregnant women treated with heparin: a prospective, longitudinal study

Human Reproduction ◽

10.1093/humrep/14.11.2876 ◽

1999 ◽

Vol 14 (11) ◽

pp. 2876-2880 ◽

Cited By ~ 50

Author(s):

M. Backos ◽

R. Rai ◽

E. Thomas ◽

M. Murphy ◽

C. Doré ◽

...

Keyword(s):

Longitudinal Study ◽

Bone Density ◽

Pregnant Women ◽

Prospective Longitudinal Study ◽

Prospective Longitudinal

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Efforts to Improve Immunization Coverage during Pregnancy among Ob-Gyns

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/2016/6120701 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 13

Author(s):

Katherine M. Jones ◽

Sarah Carroll ◽

Debra Hawks ◽

Cora-Ann McElwain ◽

Jay Schulkin

Keyword(s):

Longitudinal Study ◽

Health Outcomes ◽

Pregnant Women ◽

Random Sample ◽

Immunization Coverage ◽

Neonatal Health ◽

Prospective Longitudinal Study ◽

Maternal And Neonatal Health ◽

Influenza Vaccinations ◽

Prospective Longitudinal

Background.Influenza and Tdap vaccines are vital factors for improving maternal and neonatal health outcomes.Methods.A prospective, longitudinal study was conducted to determine whether the American College of Obstetricians and Gynecologists’ (ACOG’s) efforts to increase ob-gyn use of their immunization toolkits and vaccination administration were successful. Pre- and postintervention questionnaires were mailed to a random sample of 1,500 ACOG members between August 2012 and July 2015.Results.Significantly more postintervention survey ob-gyns reported that they received the immunization toolkits than preintervention survey ob-gyns (84.5% versus 67.0%,p<.001). The large majority of ob-gyns from both surveys (76.9% versus 78.9%) reported that they offered or planned to offer influenza vaccinations to their patients for the 2012-2013 and 2014-2015 flu seasons. Postintervention survey respondents were significantly more likely than preintervention survey participants to report that they routinely offer Tdap vaccinations to all patients during pregnancy (76.8% versus 59.3%,p<.001).Conclusion.ACOG’s efforts to improve ob-gyn use of immunization toolkits and vaccine administration appear to have been successful in several ways. ACOG’s toolkits are an example of an effective intervention to overcome barriers to offering vaccines and help improve influenza and Tdap immunization coverage for pregnant women.

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