Low Gestational Age Associated with Abnormal Retinal Vascularization and Increased Blood Pressure in Adult Women

AbstractObjectivesTo evaluate the serum levels of the serine proteinase inhibitor kallistatin in women with preeclampsia (PE).MethodsThe clinical and laboratory parameters of 55 consecutive women with early-onset PE (EOPE) and 55 consecutive women with late-onset PE (LOPE) were compared with 110 consecutive gestational age (GA)-matched (±1 week) pregnant women with an uncomplicated pregnancy and an appropriate for gestational age fetus.ResultsMean serum kallistatin was significantly lower in women with PE compared to the GA-matched-controls (27.74±8.29 ng/mL vs. 37.86±20.64 ng/mL, p<0.001); in women with EOPE compared to that of women in the control group GA-matched for EOPE (24.85±6.65 ng/mL vs. 33.37±17.46 ng/mL, p=0.002); and in women with LOPE compared to that of women in the control group GA-matched for LOPE (30.87±8.81 ng/mL vs. 42.25±22.67 ng/mL, p=0.002). Mean serum kallistatin was significantly lower in women with EOPE compared to LOPE (24.85±6.65 ng/mL vs. 30.87±8.81 ng/mL, p<0.001). Serum kallistatin had negative correlations with systolic and diastolic blood pressure, creatinine, and positive correlation with GA at sampling and GA at birth.ConclusionsSerum kallistatin levels are decreased in preeclamptic pregnancies compared to the GA-matched-controls. This decrease was also significant in women with EOPE compared to LOPE. Serum kallistatin had negative correlation with systolic and diastolic blood pressure, creatinine and positive correlation with GA at sampling and GA at birth.

Download Full-text

Blood Pressure Trajectories Across Pregnancy and Associations with Gestational Age at Birth: A Functional Data Analytic Approach

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2020.12.017 ◽

2021 ◽

Vol 37 (2) ◽

pp. e24

Author(s):

K. Horsley ◽

J. Ramsay ◽

B. Ditto ◽

D. Da Costa

Keyword(s):

Blood Pressure ◽

Gestational Age ◽

Functional Data ◽

Analytic Approach ◽

Gestational Age At Birth ◽

Data Analytic ◽

Age At Birth

Download Full-text

The effect of VDR gene polymorphisms and vitamin D level on blood pressure, risk of preeclampsia, gestational age, and body mass index

Journal of Cellular Biochemistry ◽

10.1002/jcb.27934 ◽

2018 ◽

Vol 120 (4) ◽

pp. 6441-6448 ◽

Cited By ~ 7

Author(s):

Negin Rezavand ◽

Saba Tabarok ◽

Ziba Rahimi ◽

Asad Vaisi‐Raygani ◽

Ehsan Mohammadi ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Vitamin D ◽

Body Mass ◽

Gestational Age ◽

Gene Polymorphisms ◽

Vdr Gene ◽

Vdr Gene Polymorphisms ◽

Risk Of Preeclampsia

Download Full-text

Increased systolic daily ambulatory blood pressure in adult women born preterm

Pediatric Nephrology ◽

10.1007/s00467-004-1717-4 ◽

2004 ◽

Vol 20 (2) ◽

pp. 232-233 ◽

Cited By ~ 36

Author(s):

Anna Kistner ◽

Gianni Celsi ◽

Mireille Vanp�e ◽

Stefan H. Jacobson

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Adult Women

Download Full-text

Bloodletting has no effect on the blood pressure abnormalities of hyperandrogenic women taking oral contraceptives in a randomized clinical trial

Scientific Reports ◽

10.1038/s41598-021-01606-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Manuel Luque-Ramírez ◽

Andrés E. Ortiz-Flores ◽

Lía Nattero-Chávez ◽

M.Ángeles Martínez-García ◽

María Insenser ◽

...

Keyword(s):

Blood Pressure ◽

Clinical Trial ◽

Iron Overload ◽

Oral Contraceptives ◽

Polycystic Ovary ◽

Experimental Period ◽

Adult Women ◽

Open Label ◽

Iron Depletion ◽

Functional Hyperandrogenism

AbstractNormoferritinemic women with functional hyperandrogenism show a mild iron overload. Iron excess, hyperandrogenism, and cardioautonomic dysfunction contribute to blood pressure (BP) abnormalities in these patients. Furthermore, combined oral contraceptives (COC) prescribed for hyperandrogenic symptoms may worse BP recordings. Iron depletion by phlebotomy appears to lower BP in other acquired iron overload conditions. We aimed to determine the effect of iron depletion on the office BP, ambulatory BP monitoring, and frequency of hypertension in patients with functional hyperandrogenism submitted to standard therapy with COC. We conducted a phase 2 randomized, controlled, parallel, open-label clinical trial (NCT02460445) in adult women with functional hyperandrogenism including hyperandrogenic polycystic ovary syndrome and idiopathic hyperandrogenism. After a 3-month run-in period of treatment with 35 µg ethinylestradiol plus 2 mg cyproterone acetate, participants were randomized (1:1) to three scheduled bloodlettings or observation for another 9 months. Main outcome measures were the changes in office BP, 24-h-ambulatory BP, and frequency of hypertension in both study arms. From June 2015 to June 2019, 33 women were included in the intention-to-treat analyses. We observed an increase in mean office systolic BP [mean of the differences (MD): 2.5 (0.3–4.8) mmHg] and night-time ambulatory systolic BP [MD 4.1 (1.4–6.8) mmHg] after 3 months on COC. The percentage of nocturnal BP non-dippers also increased, from 28.1 to 92.3% (P < 0.001). Office and ambulatory BP did not change throughout the experimental period of the trial, both when considering all women as a whole or as a function of the study arm. The frequency of the non-dipping pattern in BP decreased during the experimental period [OR 0.694 (0.577–0.835), P < 0.001], regardless of the study arm. Decreasing iron stores by scheduled bloodletting does not override the BP abnormalities caused by COC in women with functional hyperandrogenism.

Download Full-text

Arterial health during early childhood following abnormal fetal growth

BMC Pediatrics ◽

10.1186/s12887-021-02951-2 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Rasmus F.W. Olander ◽

Johnny K.M. Sundholm ◽

Sanna Suonsyrjä ◽

Taisto Sarkola

Keyword(s):

Blood Pressure ◽

Early Childhood ◽

Cardiovascular Risk ◽

Lean Body Mass ◽

Body Mass ◽

Fetal Growth ◽

Gestational Age ◽

Fetal Programming ◽

Independent Effect ◽

Appropriate For Gestational Age

Abstract Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed. Conclusions Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood.

Download Full-text

BIOMARKER TERKINI DALAM USAHA MEMPREDIKSI PREEKLAMPSIA

Berkala Kedokteran ◽

10.20527/jbk.v13i1.3448 ◽

2017 ◽

Vol 13 (1) ◽

pp. 119 ◽

Cited By ~ 1

Author(s):

Yosef Dwi Cahyadi Salan

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Gestational Age ◽

Growth Pattern ◽

Abnormal Placentation ◽

Immunological Markers ◽

Life Threatening ◽

Early Biomarker ◽

Main Factors ◽

Angiogenic Markers

Abstract: Preeclampsia is a life-threatening disease and can occur in all pregnant women. Preeclampsia was defined as a disease in pregnant women that is characterized by an increase in blood pressure exceeds 140 mmHg for systolic and 90 mmHg for diastolic that occured in pregnant women with gestational age above 20 weeks. In recent decades the incidence of preeclampsia continues to rise and is caused by various factors. Factors to be considered as the most influential is the process of the growth of the placenta which is abnormal, but the main factors that trigger the growth of the placenta become abnormal is not yet certainly known, some studies tryingto find out the various factors that can trigger the growth of abnormal placentation of preeclampsia, especially the associationof the growth pattern blood vessels in the placenta are thought to have a major role in the occurrence of preeclampsia in pregnant women. From these studies are found several biomarkers that are believed to be an early marker in an attempt to prevent the occurrence of preeclampsia in pregnant women, such as angiogenic markers, immunological markers, markers of Metabolic and Endocrine marker. Keywords: Preeclampsia, Abnormal Placentation, and Early Biomarker. Abstrak: Preeklampsia merupakan salah satu penyakit yang mengancam jiwa dan dapat terjadi pada semua ibu hamil. Preeklampsia didefinisikan sebagai suatu penyakit pada ibu hamil yang ditandai dengan adanya peningkatan tekanan darah melebihi 140 mmHg untuk sistolik dan 90 mmHg untuk diastolik yang terjadi pada ibu hamil dengan usia kehamilan diatas 20 minggu. Dalam beberapa dekade terakhir angka kejadian preeklampsia terus meningkat dan disebabkan oleh berbagai macam faktor. Faktor yang dianggap paling berpengaruh yaitu adanya proses pertumbuhan plasenta yang tidak normal, akan tetapi faktor utama yang mencetuskan terjadinya pertumbuhan plasenta secara abnormal tersebut belum diketahui dengan pasti, beberapa penelitian mencoba mencari tau berbagai faktor yang dapat memicu terjadinya pertumbuhan plasenta abnormal pada preeklampsia, terutama yang berhubungan dengan pola pertumbuhan pembuluh darah pada plasenta yang diduga memiliki peranan besar dalam terjadinya preeklampsia pada ibu hamil. Dari penelitian-penelitian tersebut didapatkan beberapa biomarker yang dipercaya dapat menjadi penanda dini dalam usaha untuk mencegah terjadinya preeklampsia pada ibu hamil, seperti marker Angiogenik, marker Immunologis, marker Metabolik, dan marker Endokrin. Kata-kata Kunci: Preeklampsia, Pertumbuhan Plasenta Abnormal, dan Biomarker Penanda Dini.

Download Full-text

Apelin 13 and Blood Pressure, Is there any Association in Pre-eclampsia? - A Case-control Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46243.14403 ◽

2021 ◽

Author(s):

Rajeev Gandham ◽

CD Dayanand ◽

SR Sheela

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Gestational Age ◽

Case Control Study ◽

Case Control ◽

Maternal Serum ◽

Research Centre ◽

Categorical Variables ◽

Enzyme Linked Immunosorbent Assay ◽

Control Study

Introduction: Pre-eclampsia is a pregnancy specific disorder, characterised by the onset of hypertension and proteinuria. Pre-eclampsia is the leading cause of maternal, perinatal morbidity and mortality. The exact cause of pre-eclampsia is not known clearly and needs to be explored. Aim: To evaluate the maternal serum apelin 13 levels among pre-eclampsia and healthy pregnant women and also, to find the association between apelin 13 and blood pressure. Materials and Methods: A case-control study was conducted between Department of Biochemistry and Department of Obstetrics and Gynaecology, RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India. After approval from the Institutional Ethics Committee and written informed consent from study subjects, a total of 270 pregnant women were recruited for this study. Among them, 135 pre-eclamptic women were considered as cases and 135 normotensive healthy pregnant women served as controls. According to the pre-eclampsia severity, cases were grouped into mild (n=47) and severe pre-eclampsia (n=88). Blood samples were collected from all the study subjects and was analysed for apelin 13 by Enzyme Linked Immunosorbent Assay (ELISA) method. Maternal and foetal adverse outcomes were recorded. Results were expressed as mean±Standard Deviation (SD). Categorical variables were expressed in percentages. Spearman’s correlation was applied and p<0.05 was considered significant. Results: The mean gestational age was 36.66±3.69 weeks which was, significantly low in pre-eclamptic women compared with healthy pregnant women. BMI (26.94±3.81 kg/m2), systolic (157.82±15.14 mmHg), diastolic (101.68±11.02 mmHg) and Mean Arterial Pressure (MAP) (120.20±11.12 mmHg), pulse rate (88.14±5.82 bpm), Aspartate Transaminase (AST) (25.25±12.49 IU/L) and Alanine Transaminase (ALT) (19.01±10.95 IU/L) were significantly increased in pre-eclamptic women when compared with control group. Mean maternal serum apelin 13 (341.44±218.63 pg/mL) concentrations were significantly lower in pre-eclampsia compared with healthy pregnant women. Maternal serum apelin 13 concentrations were negatively correlated with Systolic Blood Pressure (SBP) (r = -0.196), Diastolic Blood Pressure (DBP) (r = -0.172) and MAP (r =-0.204). Adverse maternal outcomes such as epigastric pain 75 (55.55%), oedema 62 (45.92%) and persistent headache 35 (25.92%) were higher in pre-eclamptic group. Additionally, adverse foetal outcomes were more in pre-eclamptic cases including significantly decreased birth weight (2.40±0.65), babies requiring Neonatal Intensive Care Unit (NICU) admission were 54 (40%), preterm birth (≤37 wks) in 50 (37.03%), Respiratory Distress Syndrome (RDS) 31 (22.96%), Small for Gestational Age (SGA) in 4 (2.96%) and Intra Uterine Death (IUD) in 11 (8.14%) babies. Conclusion: It was concluded from the present study that there was low maternal serum apelin 13 concentrations in pre-eclampsia and had negative correlation with blood pressure, suggesting its potential role in the pathophysiology of pre-eclampsia.

Download Full-text

Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival

Einstein (São Paulo) ◽

10.1590/s1679-45082016ao3721 ◽

2016 ◽

Vol 14 (3) ◽

pp. 311-316

Author(s):

Flavia Westphal ◽

Suzete Maria Fustinoni ◽

Vânia Lopes Pinto ◽

Patrícia de Souza Melo ◽

Anelise Riedel Abrahão

Keyword(s):

Gestational Age ◽

Medical Records ◽

Family Income ◽

Proper Time ◽

Pregnancy Termination ◽

University Hospital ◽

Alcoholic Beverages ◽

Lower Percentage ◽

Adult Women ◽

Fetal Medicine

ABSTRACT Objective: To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. Methods: This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival. The sample comprised 94 medical records. The Statistical Package for the Social Sciences (SPSS), version 19, was used for the data statistical analysis. Results: The population of the study included young adult women, who had complete or incomplete high school education, employed, with family income of one to three minimum wages, single, nonsmokers, who did not drink alcoholic beverages or used illicit drugs. Women with more advanced gestational age upon fetal diagnosis (p=0.0066) and/or upon admission to the specialized unit (p=0.0018) presented a lower percentage of termination of pregnancy. Conclusion: Due to characteristics different from those classically considered as of high gestational risk, these women might not be easily identified during the classification of gestational risk, what may contribute to a late diagnosis of fetal diseases. Early diagnosis enables access to specialized multiprofessional care in the proper time for couple's counseling on the possibility of requesting legal authorization for pregnancy termination.

Download Full-text