scholarly journals Prevalence and Determinants of Chronic Kidney Disease in Women With Hypertensive Disorders in Pregnancy in Nigeria: A Cohort Study

2021 ◽  
Author(s):  
Salisu Ishaku ◽  
Timothy Olanrewaju ◽  
Joyce Browne ◽  
Kerstin Klipstein-Grobusch ◽  
Kayode Gbenga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Gestational Hypertension ◽  
Monitoring Program ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
One Year ◽  
In Pregnancy

Abstract BackgroundWorldwide, hypertensive disorders in pregnancy (HDPs) complicate between 5–10% of pregnancies. Sub-Saharan Africa 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.MethodsWomen with HDPs (n=410) and normotensive women (n=78) were recruited at delivery and prospectively followed-up for one year. Serum creatinine was measured and the estimated glomerular filtration rates(eGFR) using CKD-Epidemiology equation determined. CKD was defined as decreased eGFR<60mL/min/1.73m2 lasting for ≥ three months. Prevalence of CKD at six months and one year after delivery was estimated. Logistic regression analyses were conducted to evaluate predictors of CKD at six months and one year postpartum. ResultsWithin 24 hours of delivery, nine weeks and six 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 six months and one 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 independently predicted occurrence of decreased eGFR at six months postpartum (aOR= 1.18/year; 95%CI 1.04-1.34).ConclusionPrior 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.

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

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.

scholarly journals Kasus Hipertensi pada Kehamilan di Indonesia

2018 ◽  
Vol 32 (9) ◽  
pp. 295
Author(s):  
Novi Kartika Sari ◽  
Theodola Baning Rahayujati ◽  
Mohammad Hakimi
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Sampling Technique ◽  
Chronic Hypertension ◽  
Chi Square ◽  
Cross Sectional ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Cross Sectional Design ◽  
In Pregnancy

Determinants of pregnancy hypertensive disorders in Indonesia PurposeThis study aimed to assess the determinant factors of gestational hypertension (HDP) in Indonesia.MethodsThis research was an observational analytic study using a cross-sectional design. Sampling was calculated using consecutive sampling technique. The subjects were all pregnant women aged 15-54 years old in 33 provinces in Indonesia and 9024 women were selected as subjects. Chi-square and binomial regression tests were used to analyze the determinants of HDP to see the value of the Ratio Prevalence (RP). ResultsThe prevalence of hypertension among pregnant women was 6.18% (558 people) after being adjusted with external variables which were potentially confounders. The highest of hypertension was found in West Java with 59 pregnant women (10.57%). Overweight and chronic hypertension were related to hypertensive disorders in pregnancy with RP: 2.13 (95% CI: 1.80-2.51); and in overweight with RP: 4.36 (95% CI: 3.6-5.26) in hypertension assessments. The use of contraceptives was not a risk factor for hypertensive disorders in Indonesia with RP 0.92 (95% CI: 0.76-1.10). ConclusionOverweight and chronic hypertension are risk factors for the incidence of hypertensive disorders in pregnancy in Indonesia.

scholarly journals Hypertensive Disorders in Pregnancy

2018 ◽  
Vol 03 (02/03) ◽  
pp. 068-078
Author(s):  
Lalita Nemani
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Stress Test ◽  
Later Life ◽  
Chronic Hypertension ◽  
Prevention Measures ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Abstract Hypertension in pregnancy is defined as systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg or both on two different occasions at least 6 hours apart. Severe hypertension is SBP ≥ 160 mm Hg or DBP ≥ 110 mm Hg. Hypertension is the most common medical problem in pregnancy and one of the major causes of maternal and perinatal mortality and morbidity. Hypertensive disorders in pregnancy (HDP) are classified as (1) chronic hypertension, (2) chronic hypertension with superimposed preeclampsia, (3) preeclampsia-eclampsia, and (4) gestational hypertension. HDP contributes to increased risk of hypertension, stroke, and maternal cardiovascular disease (CVD) in later life. HDP can be considered as a failed cardiovascular stress test identifying women susceptible to CVD in later life. Further research is required to identify the mechanisms in HDP that contribute to CVD in later life so as to initiate appropriate prevention measures.

scholarly journals Occupational Risk Factors and Hypertensive Disorders in Pregnancy: A Systematic Review

2021 ◽  
Vol 18 (16) ◽  
pp. 8277
Author(s):  
Emanuela Spadarella ◽  
Veruscka Leso ◽  
Luca Fontana ◽  
Angela Giordano ◽  
Ivo Iavicoli
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Job Strain ◽  
Gestational Hypertension ◽  
Occupational Risk Factors ◽  
Occupational Risks ◽  
Hypertensive Disorders ◽  
Evidence Quality ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Hypertensive disorders in pregnancy (HDP), including gestational hypertension (GH) and preeclampsia (PE), characterize a major cause of maternal and prenatal morbidity and mortality. In this systematic review, we tested the hypothesis that occupational factors would impact the risk for HDP in pregnant workers. MEDLINE, Scopus, and Web of Knowledge databases were searched for studies published between database inception and 1 April 2021. All observational studies enrolling > 10 pregnant workers and published in English were included. Un-experimental, non-occupational human studies were excluded. Evidence was synthesized according to the risk for HDP development in employed women, eventually exposed to chemical, physical, biological and organizational risk factors. The evidence quality was assessed through the Newcastle–Ottawa scale. Out of 745 records identified, 27 were eligible. No definite conclusions could be extrapolated for the majority of the examined risk factors, while more homogenous data supported positive associations between job-strain and HDP risk. Limitations due to the lack of suitable characterizations of workplace exposure (i.e., doses, length, co-exposures) and possible interplay with personal issues should be deeply addressed. This may be helpful to better assess occupational risks for pregnant women and plan adequate measures of control to protect their health and that of their children.

Chronic Kidney Disease as a Long-term Consequence of Preeclampsia and Hypertensive Disorders in Pregnancy

2016 ◽  
Vol 70 (3) ◽  
pp. 148-152
Author(s):  
Biljana Gerasimovska Kitanovska ◽  
Vesna Gerasimovska
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Literature Search ◽  
Later Life ◽  
Potential Association ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Abstract Introduction. Preeclampsia is a condition characterized by hypertension, proteinuria after 20th week of gestation, dysfunction of other maternal organs or uteroplacentary dysfunction and is associated with short-term renal damage. Recent studies report on potential association of preeclampsia with chronic kidney disease in later life. The aim of this study was to determine this potential association by literature review and our results. Methods. A Pubmed (Medline) literature search on the association of preeclampsia and subsequent chronic kidney disease was carried out. Our study was conducted at the Department of Nephrology of the University Clinical Centre Skopje in 2010 and included women who consulted the Clinic due to hypertension or impaired renal function and who had either preeclampsia or hypertensive disorders in pregnancy. Thirty patients with decreased glomerular filtration that occurred 1-28 years after pregnancy with hypertensive disorder were included in the study. Results. Literature search yielded 227 abstracts, of which 19 papers were selected, and they referred only to chronic kidney disease in the period after delivery in patients with preeclampsia. Various risks for emergence of chronic kidney disease in later life were reported in recent literature, varying from 1.2 to 14 for preeclampsia and in patients with superimposed preeclampsia, the risk was 45 times higher. In our study, risk of reduction in glomerular filtration rate was highest in the first 5 years (OR 3.6, 95% CI 1.06-22.5). Delivery before 27 weeks of gestation insignificantly increased the risk of reduced glomerular filtration in the later period (OR 1.33 95% CI 0.2-8.5). Preeclampsia is not a direct risk factor for chronic kidney disease, however, proteinuria over 0.3 g/24h in the group of patients with hypertension or preeclampsia in pregnancy, increased the risk of reduced glomerular filtration rate by 28 times (OR 28.5, 95% CI 2.7-30.9). Conclusions. Patients with preeclampsia need careful monitoring in postpartal and long-term period, not only for cardiovascular but for chronic kidney disease.

scholarly journals Maternal and perinatal outcome in women with hypertensive disorders in pregnancy

2021 ◽  
Vol 10 (2) ◽  
pp. 46-49
Author(s):  
Lakshmi A ◽  
Akshatha DS ◽  
Pooja P ◽  
Prashanth FG ◽  
Veena MV ◽  
...  
Keyword(s):  
Gestational Hypertension ◽  
Adverse Outcomes ◽  
Fetal Mortality ◽  
Chronic Hypertension ◽  
Hypertensive Disorder ◽  
Mortality And Morbidity ◽  
Hypertensive Disorders ◽  
Study Results ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Aims and objectives To determine the effect of hypertension in pregnancy To determine the maternal and fetal outcome in patients with hypertensive disorders of pregnancy. Materials and methods This is a retrospective study conducted in ESIC MC and PGIMSR, Bangalore from January 2020 to December 2020. All pregnant women who presented with Hypertensive disorder in pregnancy were included in the study. Results A total of 1503 patients who delivered during the study period were included in the study of which 172 patients had hypertensive disorder (11.44 %). Gestational hypertension occurred in 113 cases, preeclampsia in 45 cases, chronic hypertension in 8 cases, chronic hypertension with superimposed preeclampsia in 2 cases and eclampsia in 4 cases. Of these 85(49.41%) cases were primigravida and 87(50.58%) were multigravida. 38 deliveries occurred preterm and 134 were term. 4 patients had intrauterine fetal demise. Gestational diabetes occurred in 30(17.44%) cases, hypothyroidism in 45 cases(26.16%), IUGR in 11 cases(6.39%), oligohydramnios in 10 cases(5.81%). Discussion Hypertensive disorders in pregnancy is a spectrum of disease. It is one of the non communicable diseases occurring in pregnancy. It is the third most common cause of maternal mortality. By timely detection and proper management, it is possible to decrease the complications and adverse outcomes associated with this condition. Conclusion Hypertensive disorders in pregnancy is an important cause for maternal and fetal mortality and morbidity. Hence it is important to identify the risk factors and prevent it for better outcome.

scholarly journals P.076 Hypertensive disorders in pregnancy are strongly associated with future stroke and hypertension: A systematic review and meta-analysis

2021 ◽  
Vol 48 (s3) ◽  
pp. S40-S41
Author(s):  
AR Switzer ◽  
EE Smith ◽  
A Ganesh
Keyword(s):  
Gestational Hypertension ◽  
Meta Analysis ◽  
Stroke Mortality ◽  
Case Control Studies ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Hypertensive Disorders ◽  
Hazard Ratios ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

Background: We aimed to evaluate the association between hypertensive disorders in pregnancy (HDP) and future risk of stroke, stroke death, and hypertension. Methods: Systematic searches were performed in MEDLINE and EMBASE up to April 27th, 2020. Exposure of interest included the different types of HDP. Outcomes of interest included hypertension incidence, stroke incidence, stroke subtype, and stroke mortality. Results: Eighteen cohort and 1 case-control studies involving >10 million women were included in the meta-analysis. Pooled hazard ratios with 95% confidence interval generally adjusted for age at delivery, ethnicity, and vascular risk factors are listed in table 1. Conclusions: Increasing severities of HDP carry higher hazards of hypertension and stroke years later. HDP, including gestational hypertension alone, are also associated with future stroke mortality.

scholarly journals Hypertension in pregnancy

2007 ◽  
Vol 1 (1) ◽  
pp. 13-20
Author(s):  
Andrea Ungar ◽  
Elena Lotti ◽  
Lorella Lambertucci
Keyword(s):  
Blood Pressure ◽  
Gestational Hypertension ◽  
Medical Problem ◽  
Chronic Hypertension ◽  
Intrauterine Growth ◽  
Relative Paucity ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Prompt Diagnosis ◽  
In Pregnancy

Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

scholarly journals Electrocardiographic profile of patients with hypertensive disorders in pregnancy

2017 ◽  
Vol 6 (6) ◽  
pp. 2569
Author(s):  
Devika Desai ◽  
Madhva Prasad S.
Keyword(s):  
Sinus Tachycardia ◽  
Gestational Hypertension ◽  
Age Distribution ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Simple Tool ◽  
Hypertensive Disorders In Pregnancy ◽  
Ecg Abnormalities ◽  
Electrocardiographic Abnormalities ◽  
In Pregnancy

Background: Preeclampsia in pregnancy is a frequently encountered entity. Recent evidence suggests that preeclampsia can be considered as a screening test for future cardiovascular problems and abnormalities in pregnancy may help in counselling patients regarding future risk of cardiovascular problems. Electrocardiography (ECG) is a simple tool for detecting cardiovascular problems. While physiological changes in the ECG in pregnancy have been documented, the pattern of ECG in hypertensive disorders of pregnancy is not adequately studied in India. This formed the basis of the study.Methods: 140 patients who have been diagnosed as gestational hypertension and pre-eclampsia during the pregnancy were studied in the antenatal period. An ECG (non-portable, standard, 12 lead) available in the hospital was done, and the ECG was reported by the physician on-call.Results: The average age distribution of the patients was 28.26 years. Majority of the patients in the study were primigravidae. 35% of the patients were more than 37 weeks of gestation. 20 patients showed electrocardiographic abnormalities. The most common abnormality was sinus tachycardia and left axis deviation.Conclusions: ECG abnormalities are seen in 14.2% of preeclamptic women. ECG abnormalities in preeclamptic women studied had no relation to the maternal age, gestational age; parity and use of antihypertensives.

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