Risk of Stillbirth in Women with Gestational Diabetes and High Blood Pressure

2020 ◽  
Author(s):  
Hamid Reza TABATABAEE ◽  
Atefeh ZAHEDI ◽  
Koorosh ETEMAD ◽  
Tannaz VALADBEIG ◽  
Sepideh MAHDAVI ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Gestational Diabetes ◽  
High Blood Pressure ◽  
Maternal Age ◽  
Maternal Education ◽  
Healthcare Services ◽  
Population Based ◽  
Significance Level ◽  
Quality Healthcare ◽  
Increased Risk

Background: Both Gestational diabetes and hypertension almost affect 10.5% of the pregnancies. This study was conducted to investigate and compare the pregnancy outcomes in women with gestational diabetes or high blood pressure with outcomes belonging to healthy mothers. Methods: This population-based case-control study was conducted in 8 provinces and two cities of Iran on women referred to the public health centers during 2015 to 2018. Descriptive statistics for variables presented by percentages and frequencies and logistic regression analysis was used to analyze data at a significance level of less than 0.05. Results: Some variables such as ethnicity, maternal education and age, gestational diabetes, high blood pressure and previous pregnancy outcome were significantly associated with stillbirth. Maternal age greater than 35 yr (OR=1.78, CI: 1.29-2.48), maternal illiteracy (OR=3.67, CI: 2.25-5.98), a previous stillbirth (OR=9.92, CI: 4.98-19.78), gestational diabetes among women who had never had a screening test (OR =3.91, CI: 2.96-5.18) and high blood pressure (OR =1.95, CI: 1.38-2.77) were important factors associated with stillbirth. Maternal and paternal occupation, paternal education and age, place of residence, smoking and maternal BMI were significantly associated with stillbirth. Conclusion: Gestational diabetes, hypertension, a previous miscarriage, stillbirth, first pregnancy, low education level, advanced maternal age and ethnicity were associated with an increased risk of stillbirth. It is necessary to provide high-quality healthcare services before and during pregnancy particularly for those at heightened risk and improve knowledge of mothers on the side effects of each of the mentioned risk factors in order to control these factors more effectively and thus reducing the risk of stillbirth.

scholarly journals Rates of Chronic Medical Conditions in 1991 Gulf War Veterans Compared to the General Population

2019 ◽  
Vol 16 (6) ◽  
pp. 949 ◽  
Author(s):  
Clara Zundel ◽  
Maxine Krengel ◽  
Timothy Heeren ◽  
Megan Yee ◽  
Claudia Grasso ◽  
...  
Keyword(s):  
Blood Pressure ◽  
General Population ◽  
High Blood Pressure ◽  
Population Based ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Gulf War Veterans ◽  
Increased Risk ◽  
Prevalence Estimates ◽  
The Difference

Prevalence of nine chronic medical conditions in the population-based Ft. Devens Cohort (FDC) of GW veterans were compared with the population-based 2013–2014 National Health and Nutrition Examination Survey (NHANES) cohort. Excess prevalence was calculated as the difference in prevalence estimates from the Ft. Devens and NHANES cohorts; and confidence intervals and p-values are based on the standard errors for the two prevalence estimates. FDC males were at increased risk for reporting seven chronic medical conditions compared with NHANES males. FDC females were at decreased risk for high blood pressure and increased risk for diabetes when compared with NHANES females. FDC veterans reporting war-related chemical weapons exposure showed higher risk of high blood pressure; diabetes; arthritis and chronic bronchitis while those reporting taking anti-nerve gas pills had increased risk of heart attack and diabetes. GW veterans are at higher risk of chronic conditions than the general population and these risks are associated with self-reported toxicant exposures.

scholarly journals Prevalence and risk factors of intrahepatic cholestasis of pregnancy in a Chinese population

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xing-Xing Gao ◽  
Meng-Ying Ye ◽  
Yan Liu ◽  
Jin-Yan Li ◽  
Li Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intrahepatic Cholestasis ◽  
Chinese Population ◽  
Maternal Age ◽  
Maternal Education ◽  
Population Based ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Multiple Pregnancies ◽  
Increased Risk ◽  
Cholestasis Of Pregnancy

Abstract Studies on the risk factors for intrahepatic cholestasis of pregnancy (ICP) in a population-based cohort are lacking. We assess the prevalence and risk factors of ICP in a Chinese population. In this study, a cohort study was conducted that included 12,200 eligible pregnant women. The overall incidence of ICP in this cohort was 6.06%. With increasing maternal age, the incidence of ICP decreased in women younger than 30 years of age but increased in those older than 30. With increasing pre-pregnancy BMI, the incidence of ICP decreased if the pre-pregnancy BMI was less than 23 kg/m2 but increased if it was 23 kg/m2 or higher. Further analysis showed that the risk of ICP increased when maternal age was < 25 years (Adjusted RR  2.01; 95% CI 1.64–2.47) or ≥ 35 years (Adjusted RR  1.34; 95% CI 1.02–1.76). Furthermore, an increased risk of ICP was associated with pre-pregnancy underweight (adjusted RR  1.27; 95% CI 1.04–1.56), inadequate gestational weight gain (GWG) (adjusted RR  1.58; 95% CI 1.28–1.96), lower maternal education (adjusted RR  2.96; 95% CI 2.35–3.74), multiparity (adjusted RR  1.54; 95% CI 1.23–1.93), and twin/multiple pregnancies (adjusted RR  2.12; 95% CI 1.25–3.58). Maternal age (< 25 or ≥ 35 years), underweight, inadequate GWG, lower maternal education, multiparity, and twin/multiple pregnancies were identified as risk factors of ICP.

The Need for Personalized Risk-Stratified Approaches to Treatment for Gestational Diabetes: A Narrative Review

2021 ◽  
Author(s):  
Shamil D. Cooray ◽  
Jacqueline A. Boyle ◽  
Georgia Soldatos ◽  
Shakila Thangaratinam ◽  
Helena J. Teede
Keyword(s):  
Gestational Diabetes ◽  
Pregnancy Outcomes ◽  
Population Based ◽  
Adverse Pregnancy Outcomes ◽  
Therapeutic Interventions ◽  
Clinical Prediction Model ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Individual ◽  
Personalized Risk

AbstractGestational diabetes mellitus (GDM) is common and is associated with an increased risk of adverse pregnancy outcomes. However, the prevailing one-size-fits-all approach that treats all women with GDM as having equivalent risk needs revision, given the clinical heterogeneity of GDM, the limitations of a population-based approach to risk, and the need to move beyond a glucocentric focus to address other intersecting risk factors. To address these challenges, we propose using a clinical prediction model for adverse pregnancy outcomes to guide risk-stratified approaches to treatment tailored to the individual needs of women with GDM. This will allow preventative and therapeutic interventions to be delivered to those who will maximally benefit, sparing expense, and harm for those at a lower risk.

Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Kim ◽  
H Jung ◽  
P.S Yang ◽  
H.T Yu ◽  
T.H Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Pressure ◽  
Middle Age ◽  
Population Based ◽  
Entire Cohort ◽  
Incident Dementia ◽  
Increased Risk ◽  
Diagnosis Of Dementia ◽  
History Of ◽  
The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p&lt;0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p&lt;0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

scholarly journals 607: Adolescent maternal age is associated with increased risk of perinatal complications in gravidas with gestational diabetes

2016 ◽  
Vol 214 (1) ◽  
pp. S324-S325
Author(s):  
Christina A. Penfield ◽  
Rachel A. Pilliod ◽  
Tania F. Esakoff ◽  
Amy M. Valent ◽  
Aaron B. Caughey
Keyword(s):  
Gestational Diabetes ◽  
Maternal Age ◽  
Perinatal Complications ◽  
Increased Risk

In a population-based prospective study, no association between high blood pressure and mortality after age 85 years

2006 ◽  
Vol 24 (2) ◽  
pp. 287-292 ◽  
Author(s):  
Thomas van Bemmel ◽  
Jacobijn Gussekloo ◽  
Rudi GJ Westendorp ◽  
Gerard J Blauw
Keyword(s):  
Blood Pressure ◽  
Prospective Study ◽  
High Blood Pressure ◽  
Population Based

Abstract P058: Elevated Systolic Blood Pressure is Associated with Mortality in Faster, but Not Slower Walking Elderly Adults

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Michelle C Odden ◽  
Carmen A Peralta ◽  
Mary N Haan ◽  
Kenneth E Covinsky
Keyword(s):  
Blood Pressure ◽  
At Risk ◽  
High Blood Pressure ◽  
Walking Speed ◽  
Mortality Data ◽  
P Value ◽  
Elderly Adults ◽  
Risk Of Death ◽  
Risk Of Mortality ◽  
Increased Risk

Introduction: The association between high blood pressure (BP) and risk of death varies by age and appears to be attenuated in some elderly adults. Walking speed is an excellent measure of functional status and may identify which elders may be most at risk for the adverse consequences of hypertension. Hypothesis: We hypothesized that elevated BP would be associated with greater risk of mortality in faster walkers, but not in slower walkers. Methods: The study population included 2,340 persons ≥ 65 years, with measured BP, in the National Health and Nutrition Examination Survey (NHANES) waves 1999-2000 and 2001-2002. Mortality data was linked to death certificate data in the National Death Index. Walking speed was measured over a 20-foot walk; 243 (8%) did not complete the walk for various safety and logistical reasons. Participants with walking speed above the mean (2.7 ft/sec) were classified as faster walkers. Potential confouders included age, sex, race, survey year, lifestyle and physiologic factors, chronic health conditions, and antihypertensive use. Results: There were 589 deaths recorded through December 31 st , 2006. Among faster walkers, those with elevated systolic BP (≥140 mmHg) had a higher mortality rate compared to those with systolic BP <140 mmHg (236 vs. 161 per 100,000 person-years). Among slower walkers, mortality rates did not appear to differ by the presence of elevated systolic BP (586 vs. 563 per 100,000 person-years). This pattern remained after multivariable adjustment; there was an association between elevated systolic BP and mortality in faster, but not slower walkers (Table). Elevated diastolic BP was not independently associated with an increased risk of mortality. Conclusions: If confirmed in other studies, walking speed could be a simple measure to identify elderly adults who are most at risk for poor outcomes related to high blood pressure. Table Association of elevated blood pressure and mortality, stratified by walking speed Hazard Ratio (HR) of Death Faster Walking Speed >2.7 ft/sec (n = 1,279) Slower Walking Speed ≤ 2.7 ft/sec (n = 818) p-value for interaction HR (95% CI) p-value HR (95% CI) p-value Elevated Systolic BP (≥140 mmHg) 1.44 (1.04, 1.99) 0.03 1.08 (0.82, 1.42) 0.56 0.11 Elevated Diastolic BP (≥90 mmHg) 1.09 (0.52, 2.27) 0.82 0.65 (0.30, 1.45) 0.28 0.28 Funding (This research has received full or partial funding support from the American Heart Association, Western States Affiliate (California, Nevada&Utah))

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