Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection

Objective.The effects of rheumatoid arthritis (RA) and spondyloarthritis (SpA) on maternal and neonatal outcomes at a population level have not previously been well compared.Methods.A contemporary pregnancy cohort of 312,081 women and corresponding birth events was assembled for the province of Alberta from the random selection of 1 live birth event per woman. We identified 3 groups: (1) no inflammatory arthritis (no IA, n = 308,989), (2) RA (n = 631), and (3) SpA (n = 2461). We compared maternal and neonatal outcomes, comorbid conditions, and medication use among the 3 groups. Multivariable logistic regression models evaluated the independent association between RA and SpA, relative to no IA, and the outcomes of small for gestation age (SGA) and hypertensive disorders during pregnancy.Results.Pregnant women with RA were significantly more likely to have preterm delivery (13.5%), cesarean delivery (33.9%), hypertensive disorders in pregnancy (10.5%), and SGA babies (15.6%), compared to pregnant women with either SpA or no IA. Nonsteroidal antiinflammatory drugs and corticosteroid use were significantly higher in pregnant women with RA compared to the other groups. Women with RA were significantly more likely to have an SGA baby (OR 1.51, 95% CI 1.21–1.88; p < 0.01), and hypertensive disorder in pregnancy (OR 1.51, 95% CI 1.16–1.97; p < 0.01), compared to women with no IA, while no difference was found between women with SpA and those with no IA.Conclusion.Women with RA have a higher risk of worse maternal and neonatal outcomes, whereas the risk of these events is similar between women with and without SpA.

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Neonatal Outcomes from Mothers with Hypertension Disorders of Pregnancy: A Retrospective Study at a Referral Hospital in Rwanda

Rwanda Journal of Medicine and Health Sciences ◽

10.4314/rjmhs.v3i2.9 ◽

2020 ◽

Vol 3 (2) ◽

pp. 193-203

Author(s):

Phoibe Uwizeyimana ◽

Emerthe Musabyemariya ◽

Olive Tengera ◽

Anita Collins

Keyword(s):

Retrospective Study ◽

Neonatal Morbidity ◽

Neonatal Outcomes ◽

Morbidity And Mortality ◽

University Teaching ◽

Delivery Mode ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

Maternal Hypertension ◽

In Pregnancy

Background Globally, maternal hypertensive disorders in pregnancy significantly increase both maternal and perinatal morbidity and mortality. Maternal hypertension affects 14 percent of pregnancies. Eearly detection and management are critical for improving the health outcomes of both mother and neonate. Objective To assess the association between maternal hypertension disorders in pregnancy and immediate neonatal outcomes at a University Teaching Hospital in Rwanda. Methods A retrospective study of maternal files with hypertension disorders was conducted from January 1, 2016, to March 31, 2019. A census sample of 114 records and pretested checklist was used to collect data. Descriptive statistics were used to analyze associations between maternal factors and immediate neonatal outcomes. Results Neonatal outcomes included low birth weight (75.4%), prematurity (59.6%), admission to neonatal intensive care unit (50.4%), intrauterine growth restriction (32.4%), and neonatal death (22.8%). Nearly two-thirds (62%) of mothers had preeclampsia. Significant associations with immediate neonatal outcomes included gestational age, medical history, delivery mode, maternal referral status, preterm birth, prematurity, and abortion. Conclusion Maternal hypertensive disorders were significantly associated with adverse neonatal outcomes in our study population in Rwanda. Improving early detection, health education, and management of hypertensive disorders in pregnancy is critical to reduce maternal and neonatal morbidity and mortality. Rwanda J Med Health Sci 2020;3(2):193-203

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VP36.19: Maternal, fetal and neonatal outcomes in patients with hypertensive disorders in pregnancy and fetal growth restriction

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.22890 ◽

2020 ◽

Vol 56 (S1) ◽

pp. 213-213

Author(s):

M.M. Ancheta Gonzalez ◽

M.N. Campo Campo ◽

D.P. Cuesta Castro ◽

R. Garcia‐Posada ◽

J.H. Gutierrez‐Marin ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Neonatal Outcomes ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

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Prevalence and Risk Factors of Hypertensive Disorders in Pregnancy: Case of Mezam Division, NWR Cameroon

Journal of Women's Health and Development ◽

10.26502/fjwhd.2644-28840035 ◽

2020 ◽

Vol 03 (03) ◽

Author(s):

Nkem Ernest Njukang ◽

Tah Aldof Yoah ◽

Martin Sama ◽

Thomas Obinchemti EGBE ◽

Joseph Kamgno

Keyword(s):

Risk Factors ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

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Faculty Opinions recommendation of Hypertensive disorders in pregnancy: screening by uterine artery Doppler imaging and blood pressure at 11-13 weeks.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1279983.747087 ◽

2009 ◽

Author(s):

Amar Bhide ◽

Rohan D'Souza

Keyword(s):

Blood Pressure ◽

Uterine Artery ◽

Doppler Imaging ◽

Uterine Artery Doppler ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

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Hypertensive Disorders in Pregnancy Current Practice Review

Current Hypertension Reviews ◽

10.2174/1573402113666170529110024 ◽

2018 ◽

Vol 13 (2) ◽

Cited By ~ 1

Author(s):

Kim Turner ◽

Afshan B. Hameed

Keyword(s):

Current Practice ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

Practice Review ◽

In Pregnancy

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The association between mental illness, psychotropic medication use and hypertensive disorders in pregnancy: A multicentre study

Pregnancy Hypertension ◽

10.1016/j.preghy.2021.02.002 ◽

2021 ◽

Vol 24 ◽

pp. 22-26

Author(s):

Jacqueline Frayne ◽

Stuart Watson ◽

Martien Snellen ◽

Thinh Nguyen ◽

Megan Galbally

Keyword(s):

Mental Illness ◽

Multicentre Study ◽

Psychotropic Medication ◽

Medication Use ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

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Prevalence of hypertensive disorders in pregnancy in China: A systematic review and meta-analysis

Pregnancy Hypertension ◽

10.1016/j.preghy.2021.02.001 ◽

2021 ◽

Vol 24 ◽

pp. 13-21

Author(s):

Fang Li ◽

Jiabi Qin ◽

Senmao Zhang ◽

Lizhang Chen

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

In Pregnancy

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Prevalence and determinants of chronic kidney disease in women with hypertensive disorders in pregnancy in Nigeria: a cohort study

BMC Nephrology ◽

10.1186/s12882-021-02419-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Salisu M. Ishaku ◽

Timothy Olusegun Olanrewaju ◽

Joyce L. Browne ◽

Kerstin Klipstein-Grobusch ◽

Gbenga A. Kayode ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Gestational Hypertension ◽

Monitoring Program ◽

Sub Saharan Africa ◽

Future Research ◽

Hypertensive Disorders ◽

Hypertensive Disorders In Pregnancy ◽

Sub Saharan ◽

In Pregnancy

Abstract Background Worldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5 and 10% of pregnancies. Sub-Saharan Africa (SSA) is disproportionately affected by a high burden of HDPs and chronic kidney disease (CKD). Despite mounting evidence associating HDPs with the development of CKD, data from SSA are scarce. Methods Women with HDPs (n = 410) and normotensive women (n = 78) were recruited at delivery and prospectively followed-up at 9 weeks, 6 months and 1 year postpartum. Serum creatinine was measured at all time points and the estimated glomerular filtration rates (eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR< 60 mL/min/1.73m2 lasting for ≥ 3 months. Prevalence of CKD at 6 months and 1 year after delivery was estimated. Logistic regression analyses were conducted to evaluate risk factors for CKD at 6 months and 1 year postpartum. Results Within 24 h of delivery, 9 weeks, and 6 months postpartum, women with HDPs were more likely to have a decreased eGFR compared to normotensive women (12, 5.7, 4.3% versus 0, 2 and 2.4%, respectively). The prevalence of CKD in HDPs at 6 months and 1 year postpartum was 6.1 and 7.6%, respectively, as opposed to zero prevalence in the normotensive women for the corresponding periods. Proportions of decreased eGFR varied with HDP sub-types and intervening postpartum time since delivery, with pre-eclampsia/eclampsia showing higher prevalence than chronic and gestational hypertension. Only maternal age was independently shown to be a risk factor for decreased eGFR at 6 months postpartum (aOR = 1.18/year; 95%CI 1.04–1.34). Conclusion Prior HDP was associated with risk of future CKD, with prior HDPs being more likely to experience evidence of CKD over periods of postpartum follow-up. Routine screening of women following HDP-complicated pregnancies should be part of a postpartum monitoring program to identify women at higher risk. Future research should report on both the eGFR and total urinary albumin excretion to enable detection of women at risk of future deterioration of renal function.

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