CLINICAL-ANAMNESTIC AND MOLECULAR-GENETIC FACTORS IN DIFFERENT FORMS OF HYPERTENSION AND ITS RELATIONSHIP TO COURSE AND PREGNANCY OUTCOMES

Aim: to assess of the relationship of clinical and molecular genetic factors in the course and outcome of pregnancy in different forms of hypertension in pregnant women. Patients and methods: a total of 125 pregnant women who were divided into the following groups: with chronic hypertension (n =45), with gestational hypertension (n =20), with pre-eclampsia (n =10), superimposed preeclampsia upon chronic hypertension (n =15) and 35 women without hypertension in control group. Results: in pregnant women with chronic hypertension and superimposed preeclampsia upon chronic hypertension were observed higher incidence of overweight and obesity, smoking before pregnancy and family history of hypertension and thrombosis, the course and outcomes of pregnancy characterized by higher frequency of obstetric complications, higher frequency of polymorphisms of genes identified the renin-angiotensin system, folate cycle and endothelial function. Conclusions: Molecular-genetic factors, combined with the factors of cardiovascular risk may make some contribution to the phenotypic realization of pregnancy complications and adverse pregnancy outcomes in pregnant women with different forms of hypertension.

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COVID-19 Quarantine is a Risk Factor for Poor Pregnancy Outcomes in GDM Patients: A Retrospective Study

10.21203/rs.3.rs-836921/v1 ◽

2021 ◽

Author(s):

Qin-Yu Cai ◽

Yin Yang ◽

Ling-Ling Ruan ◽

Dang-Dang Wang ◽

Han-Lin Cui ◽

...

Keyword(s):

Pregnant Women ◽

Electronic Medical Records ◽

Pregnancy Outcomes ◽

Medical Records ◽

Control Group ◽

Second Trimester ◽

Public Health Emergencies ◽

Nuchal Cord ◽

Adverse Pregnancy ◽

Glucose Management

Abstract Aims: This study was to evaluate the effects of the home quarantine on pregnancy outcomes of gestational diabetes mellitus (GDM) patients during the COVID-19 outbreak.Methods: Thecomplete electronic medical records of GDM patients with home quarantine history were collected and classified into the home quarantine group from 24 February 2020 to 24 November 2020. The same period of GDM patients without home quarantine historywas included in the control group from 2018 and 2019.Results: A total of 1358 GDM patients were included in the analysis, including 484 in 2018, 468 in 2019, and 406 in 2020. GDM patients with home quarantine in 2020 had higher glycemic levels and worse pregnancy outcomes than 2018 and 2019, including higher cesarean section rate,lower Apgar scores, and higher incidence of macrosomia and nuchal cord. More importantly, the second trimester of home quarantine had brought a broader impactto pregnant women and fetuses.Conclusion: Home quarantine has aggravated the condition of GDM pregnant women and brought more adverse pregnancy outcomes during the COVID-19 outbreak. Therefore, we suggested that governments and hospitals should strengthen lifestyle guidance, glucose management, and antenatal care for GDM patients with home quarantine during public health emergencies.

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Maternal Pre-Pregnancy Obesity Combined With Abnormal Glucose Metabolism Further Increases Adverse Pregnancy Outcomes in Chinese Pregnant Women

Frontiers in Endocrinology ◽

10.3389/fendo.2021.754406 ◽

2022 ◽

Vol 12 ◽

Author(s):

Mei-Fang Li ◽

Jiang-Feng Ke ◽

Li Ma ◽

Jun-Wei Wang ◽

Zhi-Hui Zhang ◽

...

Keyword(s):

Glucose Metabolism ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Perinatal Outcomes ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Abnormal Glucose Metabolism ◽

Induced Hypertension ◽

Adverse Perinatal Outcomes ◽

Adverse Pregnancy

AimsOur aim was to evaluate the separate and combined effects of maternal pre-pregnancy obesity and gestational abnormal glucose metabolism (GAGM) on adverse perinatal outcomes.MethodsA total of 2,796 Chinese pregnant women with singleton delivery were studied, including 257 women with pre-pregnancy obesity alone, 604 with GAGM alone, 190 with both two conditions, and 1,745 with neither pre-pregnancy obesity nor GAGM as control group. The prevalence and risks of adverse pregnancy outcomes were compared among the four groups.ResultsCompared with the normal group, pregnant women with maternal pre-pregnancy obesity alone, GAGM alone, and both two conditions faced significantly increased risks of pregnancy-induced hypertension (PIH) (odds ratio (OR) 4.045, [95% confidence interval (CI) 2.286–7.156]; 1.993 [1.171–3.393]; 8.495 [4.982–14.485]), preeclampsia (2.649 [1.224–5.735]; 2.129 [1.128–4.017]; 4.643 [2.217–9.727]), cesarean delivery (1.589 [1.212–2.083]; 1.328 [1.095–1.611]; 2.627 [1.908–3.617]), preterm delivery (1.899 [1.205–2.993]; 1.358 [0.937–1.968]; 2.301 [1.423–3.720]), macrosomia (2.449 [1.517–3.954]; 1.966 [1.356–2.851]; 4.576 [2.895–7.233]), and total adverse maternal outcomes (1.762 [1.331–2.332]; 1.365 [1.122–1.659]; 3.228 [2.272–4.587]) and neonatal outcomes (1.951 [1.361–2.798]; 1.547 [1.170–2.046]; 3.557 [2.471–5.122]). Most importantly, there were no obvious risk differences in adverse pregnancy outcomes between maternal pre-pregnancy obesity and GAGM group except PIH, but pregnant women with both obesity and GAGM exhibited dramatically higher risks of adverse pregnancy outcomes than those with each condition alone.ConclusionsMaternal pre-pregnancy obesity and GAGM were independently associated with increased risks of adverse pregnancy outcomes. The combination of pre-pregnancy obesity and GAGM further worsens adverse pregnancy outcomes compared with each condition alone.

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The Different Outcomes in Pregnant Women with Severe Features of Preeclampsia between New Onset Hypertension Group and Pre-Existing Hypertension Group

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.06.12379 ◽

2021 ◽

Vol 104 (6) ◽

pp. 951-958

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Apgar Score ◽

Chronic Hypertension ◽

Exclusion Criteria ◽

Impaired Liver Function ◽

Impaired Liver ◽

Significant Difference ◽

Adverse Pregnancy ◽

New Onset

Background: There are extensive evidence that preeclampsia is the reason for many maternal and perinatal morbidities. However, there are no previous study on the different outcomes in severe preeclamptic women between new onset hypertension and chronic hypertension. Objective: To compare the rate of low Apgar score at 5 minutes and other adverse pregnancy outcomes of preeclamptic women with severe features between those who had new onset hypertension in pregnancy and those with chronic hypertension before pregnancy. Materials and Methods: A retrospective cohort study was conducted. The medical records of pregnant women diagnosed with preeclampsia with severe features and delivered at Chonburi Hospital between January 2017 and June 2020 were reviewed. The authors categorized these pregnant women into two groups, new onset hypertension and chronic hypertension. Descriptive statistics were used for the data analyses. Results: Of the 526 women diagnosed with preeclampsia with severe features, 290 met the inclusion and exclusion criteria. Eighty-nine had superimposed preeclampsia on chronic hypertension and 201 patients had new onset hypertension. The rate of low Apgar score at 5 minutes was not statistically different between the two groups (p=0.258). The incidence of impaired liver function and HELLP syndrome were increased in the new onset hypertension group at 18.9% versus 6.7% (p=0.008) and 9.5% versus 1.1% (p=0.010), respectively. Conclusion: There was no significant difference in the rate of low Apgar score between the two groups. Regarding the severity of maternal outcomes, new onset preeclampsia with severe features seems to be more severe than superimposed preeclampsia on chronic hypertension. Keywords: Low Apgar score; Preeclampsia with severe features; Chronic hypertension; Superimposed preeclampsia; Pregnancy outcomes

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Pregnancy outcome after exposure to oral contraceptives during the periconceptional period

Human & Experimental Toxicology ◽

10.1177/0960327108092290 ◽

2008 ◽

Vol 27 (4) ◽

pp. 307-313 ◽

Cited By ~ 11

Author(s):

HK Ahn ◽

JS Choi ◽

JY Han ◽

MH Kim ◽

JH Chung ◽

...

Keyword(s):

Pregnant Women ◽

Oral Contraceptives ◽

Gestational Age ◽

Pregnancy Outcomes ◽

Adverse Pregnancy Outcomes ◽

Exposed Group ◽

Large For Gestational Age ◽

Control Group ◽

Periconceptional Period ◽

Adverse Pregnancy

To evaluate whether periconceptional exposure to oral contraceptives (OCs) increased adverse pregnancy outcomes, 136 pregnant women taking OCs within the periconceptional period were identified at the Korean Motherisk Program. Of them, 120 pregnant women accepted to participate in their study and were followed up until completion of the pregnancy. A control group of 240 age- and gravidity-matched pregnant women exposed to non-teratogen drugs for at least 1 month before pregnancy was also included. The median gestational age at delivery was 39.1 (27.0–41.0) weeks in the exposed group and 39.3 (27.4–42.0) weeks in the control group ( P = 0.19). In the exposed group, 7.1% of babies were born with low birth weight versus 2.6% in the control group ( P = 0.068). The number of preterm deliveries or babies born large for gestational age did not differ between the two groups. In the exposed group, the rate of birth defects was 3.2% ( n = 3/99) versus 3.6% ( n = 7/193) in the control group ( P = 1.0). There were 15 women who took high doses of progesterone (emergency contraception) and no adverse fetal outcomes were observed. In conclusion, periconceptional exposure to OCs does not appear to increase the risk for adverse pregnancy outcomes.

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Maternal and Neonatal Outcomes in Pregnant Women with Psoriasis and Psoriatic Arthritis: A Systematic Review and Meta-Analysis

Rheumatology ◽

10.1093/rheumatology/keab357 ◽

2021 ◽

Author(s):

Wenhui Xie ◽

Hong Huang ◽

Lanlan Ji ◽

Zhuoli Zhang

Keyword(s):

Psoriatic Arthritis ◽

General Population ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Meta Analysis ◽

Clinical Status ◽

Maternal Outcomes ◽

Close Monitoring ◽

Adverse Pregnancy

Abstract Objective Psoriasis and psoriatic arthritis (PsA) are inflammatory diseases that affect women in their reproductive years. We aimed to investigate whether maternal psoriasis and PsA are associated with adverse pregnancy outcomes. Methods We searched multiple electronic databases from inception to 3 August 2020, and reference lists of selected articles. Observational studies reporting at least one pregnancy outcomes in women with psoriasis or PsA with a comparator of general population or healthy subjects were included. Data were pooled by random-effects models and expressed as odds ratio (OR) and 95% confidence interval (CI). Results Overall, 16 studies were included in the meta-analysis. The pooled analyses showed pregnant women with psoriatic diseases have significantly higher risk of adverse maternal outcomes compared with general population (caesarean delivery: 1.33 (1.17-1.52); preterm birth: 1.32 (1.15-1.52); (pre)eclampsia: 1.28 (1.14-1.43); gestational diabetes: 1.19 (1.10-1.30); gestational hypertension: 1.30 (1.18-1.44). However, no statistically increased risks of fetal complications were observed in women with psoriatic diseases (small for gestational age: 1.02 (0.93-1.11); low birth weight: 1.15 (0.93-1.42); congenital malformations: 1.03 (0.93-1.14); Apgar score <7: 1.07 (0.81-1.39); neonatal mortality: 1.13 (0.90-1.43); stillbirth: 1.19 (0.95-1.50)). Subgroup analysis found similar results in women with either psoriasis or PsA regarding maternal outcomes and the magnitude of risk estimates seems to be greater in PsA though without statistical difference. Conclusions Pregnant women with psoriasis and PsA have excess risk of adverse maternal events, but not adverse neonatal events. Close monitoring of the mothers’ clinical status before and during pregnancy is decidedly required in daily practice.

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Oral Anaerobic Microflora and Pregnancy Complication

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7601 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1681-1685

Author(s):

Irena Andonova ◽

Vasil Iliev

Keyword(s):

Bacterial Vaginosis ◽

Pregnant Women ◽

Pregnancy Outcomes ◽

Preterm Labor ◽

Bacterial Flora ◽

Anaerobic Bacteria ◽

Adverse Pregnancy Outcomes ◽

Obstetric Outcomes ◽

Control Group ◽

Adverse Pregnancy

Bacterial vaginosis and periodontal diseases share very similar pathogenesis. Each of these diseases occurs when healthy microbiome changes to predominately anaerobic bacterial flora. Bacterial vaginosis is proven factor for adverse pregnancy outcomes. In recent years it has been hypothesized that infection from distant sites of the fetoplacental unit may also elicit an inflammatory response in utero. Aim: The study is designed to determine whether the presence of specific oral anaerobic bacteria in subgingival sulcus of mother increase the risk of adverse obstetric outcomes. Material and Methods: Case-control study. Control group: 50 patients who gave birth to neonate whit normal birth weight at term. Group cases: I group - 40 pregnant women who were hospitalized with signs of preterm labor. II - 20 pregnant women, who have an ultrasound diagnosis of fetal growth retardation. Sub-gingival microbiological paper-point swab was taken in all patients. Results: The total number of isolated oral anaerobic bacteria was statistically significantly higher in the cases group compared to control group p <0.01. In our study, pregnant women who tested positive for Porphyrmonas gingivalis for 6.65 times were more likely to have preterm labor compare with pregnant women with negative oral swabs (95.0% CI: 1.38-32.11 / p <0.05), and for 2,79 times more likely to have fetus with intrauterine growth restriction (95.0% CI: 1.10-7.91 / p <0.05 Conclusions: The study confirmed the hypothesis of a statistically significant association between oral anaerobic infection and adverse pregnancy outcomes. In the future, more studies are needed to investigate the role of the microbial load, maternal immune response, pathophysiological pathway that leads to negative pregnancy outcome.

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Pregnancy outcomes among women with systemic lupus erythematosus: a retrospective cohort study from Thailand

Lupus ◽

10.1177/0961203317721353 ◽

2017 ◽

Vol 27 (1) ◽

pp. 158-164 ◽

Cited By ~ 16

Author(s):

S Phansenee ◽

R Sekararithi ◽

P Jatavan ◽

T Tongsong

Keyword(s):

Lupus Erythematosus ◽

Pregnancy Outcomes ◽

Medical Records ◽

Retrospective Cohort ◽

Control Group ◽

Chronic Hypertension ◽

Study Group ◽

Systemic Lupus ◽

Adverse Pregnancy ◽

Active Disease

Objective The objective of this paper is to compare adverse pregnancy outcomes between normal pregnancies and pregnancies with systemic lupus erythematosus (SLE), particularly focusing on uncomplicated SLE with remission. Methods A retrospective cohort study was conducted by accessing the Maternal-Fetal Medicine (MFM) Unit database and the full medical records of the women. The records of singleton pregnancies with SLE and no underlying disease were assigned as the study group and their medical records were reviewed. The low-risk pregnancies were randomly selected as the controls. The adverse pregnancy outcomes were compared between the control group vs women with SLE, control group vs uncomplicated SLE, and between the subgroups within the study group. Results Of 28,003 births during the study period, 1400 controls and 140 pregnancies with SLE were compared. The rates of fetal loss, preterm birth, small-for-date, low birth weight and preeclampsia were significantly higher in the study groups with a relative risk of 5.6 (95% CI: 2.9–10.9), 3.2 (95% CI: 2.5–4.1), 3.5 (95% CI: 2.4–4.9), 4.2 (95% CI: 3.4–5.3) and 2.9 (95% CI: 1.9–4.4), respectively. The increased rates of most adverse outcomes were still noted even in the cases of uncomplicated SLE. Among women with SLE, lupus nephritis, chronic hypertension, antiphospholipid syndrome, active disease at the onset of pregnancies, and proteinuria were significantly associated with such outcomes. Conclusions Pregnancies with SLE, even in uncomplicated cases with remission, increase the risk of poor pregnancy outcomes. The presence of lupus nephritis, chronic hypertension, antiphospholipid syndrome, active disease at the onset of pregnancies, and proteinuria were significantly associated with such outcomes.

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Adverse pregnancy outcomes and inherited thrombophilia

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0059 ◽

2018 ◽

Vol 46 (4) ◽

pp. 411-417 ◽

Cited By ~ 5

Author(s):

Dominik Dłuski ◽

Radzisław Mierzyński ◽

Elżbieta Poniedziałek-Czajkowska ◽

Bożena Leszczyńska-Gorzelak

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Protein C ◽

Antithrombin Iii ◽

Activated Protein C ◽

Protein S ◽

Adverse Pregnancy Outcomes ◽

Control Group ◽

Inherited Thrombophilia ◽

Adverse Pregnancy

Abstract Aim: (1) To evaluate the prevalence of inherited thrombophilia in pregnant women with adverse pregnancy outcomes: intrauterine growth retardation (IUGR), preeclampsia (PE) and placental abruption. (2) To assess the impact of inherited thrombophilia on the nature of obstetric complications. (3) To assess levels of protein S, protein C, antithrombin III and homocysteine in pregnant women with adverse pregnancy outcomes. Subjects and methods: The study comprised 162 pregnant women. The patients were divided into three test groups and one control group. In all 162 patients the following tests were completed: activated protein C resistance (APC-R), the level of free protein S, activity of protein C, antithrombin III and the level of homocysteine. The data were statistically analyzed via χ2 of independence or homogeneity test. Results: In 32 of 162 patients participating in clinical research thrombophilia was diagnosed (10 patients with APC-R, 21 patients with protein S deficiency, one patient with hyperhomocysteinemia): seven patients belonged to the control group and 25 patients had diagnosed adverse pregnancy outcomes (P=0.04). In 32 patients with diagnosed thrombophilia, level of protein S was decreased (P=0.04). Protein S deficiency was diagnosed, when level of protein S was lower than 30% in the second trimester and lower than 24% in the third trimester. The incidence of activated protein C resistance caused by the mutation of factor V Leiden was in six patients (5.9%) with adverse pregnancy outcomes, and in four patients (6.6%) from the control group. Results were not statistically significant. No protein C deficiency was diagnosed (diagnosis: level<60%), but in 50% of patients with thrombophilia level of protein C was over the norm (P=0.02). The level of antithrombin III was often decreased in patients with preeclampsia – (32.4%), then in the other patients – (17.2%) (P=0.04), but no patient was diagnosed with antithrombin III deficiency (diagnosis: level<60%). Conclusions: Tests for thrombophilia should be carried out in women with adverse pregnancy outcomes in their history, who are planning pregnancy, to start anticoagulant prophylaxis. Our study supports the thesis that tests for thrombophilia should be carried out in women with a history of adverse pregnancy outcomes and who are planning a pregnancy to start anticoagulant prophylaxis.

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Sleep Disorders in Pregnancy

Seminars in Neurology ◽

10.1055/s-0037-1608843 ◽

2017 ◽

Vol 37 (06) ◽

pp. 661-668 ◽

Cited By ~ 8

Author(s):

Mihaela Bazalakova

Keyword(s):

Sleep Disorders ◽

Pregnancy Outcomes ◽

Gestational Hypertension ◽

Adverse Pregnancy Outcomes ◽

Chronic Hypertension ◽

Short Sleep Duration ◽

Risk Pregnancy ◽

Obstructive Sleep ◽

Adverse Pregnancy ◽

In Pregnancy

AbstractSleep and pregnancy are dynamic processes with unique and evolving physiological substrates. Given the “restorative hypothesis” of sleep as an anabolic process essential for cellular and tissue regeneration, the largely unexplored role of sleep in gestational physiology and pregnancy outcomes promises to be a fascinating topic. Emerging literature suggests that objectively measured or self-reported short sleep duration may be a risk for adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), gestational hypertension, and cesarean delivery. In this review, we discuss obstructive sleep apnea (OSA) and restless legs syndrome (RLS), two sleep disorders prevalent in pregnancy. OSA is especially likely in high-risk pregnancy where it is associated with comorbid cardiovascular and metabolic disturbances. We review new data strongly suggesting that OSA is an independent risk factor for GDM and gestational hypertension. It remains to be seen if sleep disruption, whether or not in the context of gestational RLS and gestational OSA, is a modifiable factor for adverse pregnancy outcomes. Clinicians are encouraged to query sleep symptoms in pregnant women and to have a low threshold to pursue investigations for OSA, including the subjective symptoms of snoring, witnessed apneas, and daytime sleepiness, and also medical comorbidities, such as chronic hypertension.

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Lipid Characteristics of Pregnant Women With Subclinical Hypothyroidism and Their Correlation to the Pregnancy Outcomes

10.21203/rs.3.rs-424258/v1 ◽

2021 ◽

Author(s):

Jingjing Li ◽

Yajuan Xu ◽

Zongzong Sun ◽

Yanjun Cai ◽

Biao Wang ◽

...

Keyword(s):

Pregnant Women ◽

Subclinical Hypothyroidism ◽

Pregnancy Outcomes ◽

Metabolic Pathways ◽

Enrichment Analysis ◽

Control Group ◽

Pathway Enrichment Analysis ◽

Adverse Pregnancy ◽

Factor Α ◽

In Pregnancy

Abstract Subclinical hypothyroidism (SCH) in pregnancy has become an important complication of pregnancy. We used nontargeted lipidomics to compare differential metabolites between women with SCH and healthy women. The metabolic pathways of the differential metabolites were analyzed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. We found: 1. Multivariate analysis revealed 143 lipid molecules with different levels between the SCH group and the control group. Based on fold change, 30 differential lipid metabolites were selected as potential biomarkers. 2. KEGG pathway enrichment analysis showed that the differential metabolites participate in such pathways as pathogenic Escherichia coli infection response, metabolic pathways, glycerophospholipid metabolism. 3. Correlation analysis showed that sphingomyelin (SM) and phosphatidylcholine (PC) were positively correlated with tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6), while phosphatidylglycerol (PG), and phosphatidylinositol (PI) were negatively correlated with them. And PG was positively correlated with birth weight. The lipid profile of pregnant women with SCH is significantly different from that of healthy pregnant women. Lipid molecules with differential metabolism, such as SM, PE, and PI, might be targets for further investigation of the pathogenesis of SCH in pregnancy and reduce the incidence of adverse pregnancy outcomes.

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