Immunoglobulin E Levels and Hypertensive Disorders of Pregnancy: Japan Environment and Children’s Study

Abstract High serum immunoglobulin E (IgE) levels are associated with cardiovascular events. We aimed to evaluate the association between total IgE levels during the first trimester of pregnancy and hypertensive disorders of pregnancy (HDP) development in a large Japanese cohort. We analysed data pertaining to singleton primipara pregnancies recorded in the Japan Environment and Children’s Study involving births in 2011–2014. First trimester’s serum IgE levels were determined using the immunonephelometric technique. High serum IgE was defined as IgE levels ≥170 IU/ml. A multiple logistic regression model was used to estimate the risk of high serum IgE levels on HDP, comprising early-onset and late-onset hypertension. A total of 32,518 participants were enrolled. The prevalence of total, early-onset, and late-onset HDP was 3.2%, 0.6%, and 2.3%, respectively. Patients with high serum IgE levels had an increased risk of late-onset hypertension (adjusted odds ratio [aOR]: 1.19, 95% confidence interval: 1.01–1.40). No correlation was found with either HDP (total) or early-onset hypertension (aOR: 1.15 and 0.85, 95% confidence interval: 0.99–1.32 and 0.60–1.21, respectively). High serum IgE levels during the first trimester are associated with late-onset hypertension. Our results could influence and shape further research regarding the pathogenesis of late-onset hypertension.

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Immunoglobulin E levels and pregnancy-induced hypertension: Japan Environment and Children’s Study

Scientific Reports ◽

10.1038/s41598-021-88227-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hyo Kyozuka ◽

◽

Tsuyoshi Murata ◽

Toma Fukuda ◽

Yuta Endo ◽

...

Keyword(s):

Immunoglobulin E ◽

Late Onset ◽

First Trimester ◽

High Serum ◽

Pregnancy Induced Hypertension ◽

Serum Ige ◽

Japanese Cohort ◽

Increased Risk ◽

Induced Hypertension ◽

Hypertensive Disorders In Pregnancy

AbstractHigh serum immunoglobulin E (IgE) levels are associated with cardiovascular events. We aimed to evaluate the association between total IgE levels during the first trimester of pregnancy and pregnancy-induced hypertension (PIH) development in a large Japanese cohort. We analysed data pertaining to singleton primipara pregnancies recorded in the Japan Environment and Children’s Study involving births from 2011 to 2014. Serum IgE levels were determined using the immunonephelometric technique. High serum IgE was defined as level ≥ 170 IU/ml. Hypertensive disorders in pregnancy (HDP) were categorized into early onset (Eo) PIH (developed < 34 weeks) or late onset (Lo) PIH (developed ≧ 34 weeks). A multiple logistic regression model was used to estimate the risk of high serum IgE levels on PIH, Eo-PIH, and Lo-PIH. Overall, 32,518 participants were enrolled. The prevalence of total, Eo-, and Lo-PIH was 3.2%, 0.6%, and 2.3%, respectively. Patients with high serum IgE levels had an increased risk of Lo-HDP (adjusted odds ratio [aOR]:1.19, 95% confidence interval 1.01–1.40). No correlation was found with either PIH (total) or Eo-PIH. High serum IgE levels during the first trimester were associated with the risk of Lo-PIH. Our results could influence and shape further research regarding the pathogenesis of Lo hypertension.

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Stroke in Pregnancy and Puerperium: Validated Incidence Trends With Risk Factor Analysis in Finland 1987–2016

Neurology ◽

10.1212/wnl.0000000000011990 ◽

2021 ◽

pp. 10.1212/WNL.0000000000011990

Author(s):

Liisa Karjalainen ◽

Minna Tikkanen ◽

Kirsi Rantanen ◽

Karoliina Aarnio ◽

Aino Korhonen ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Postpartum Period ◽

First Trimester ◽

Class Iii ◽

Hypertensive Disorders Of Pregnancy ◽

Risk Factor Management ◽

Incidence Trends ◽

Hypertensive Disorders ◽

Increased Risk

Objective:To investigate whether previously reported increasing incidence of pregnancy-associated stroke (PAS) is observed in chart-validated register data in Finland. In an exploratory analysis, we studied risk factors for PAS.Methods:We performed a retrospective population-based cohort study and nested case-control study in Finland 1987-2016. The Medical Birth Register (MBR) was linked with the Hospital Discharge Register to identify women with incident stroke (ischemic stroke, cerebral venous thrombosis, intracerebral or subarachnoid hemorrhage) during pregnancy or puerperium. Cases were verified from patient records. Incidence of PAS over the study period, in 5-year age groups and pregnancy/postpartum period were calculated per number of deliveries. Three matched controls were selected for each case from MBR to compare risk factors.Results:After chart review, 29.6% (257/868) of cases were PAS. The incidence of PAS was 14.5 (95%CI: 12.8-16.3) per 100,000 deliveries. Incidence increased from 11.1 to 25.2 per 100,000 deliveries from 1987-1991 to 2012-2016 (p<0.0001). Incidence increased by age from 9.8 to 29.9 per 100,000 deliveries from ages 20-24 to ages >40 (p<0.0001). During early postpartum period, incidence was 5-fold greater compared to the first trimester. Maternal mortality was 6.6%. In the multivariable adjusted model, smoking beyond 12 gestational weeks (odds ratio [OR] 1.8, 95%CI: 1.2-2.7), migraine (OR 16.3, 95%CI: 5.3-49.8), and hypertensive disorders of pregnancy (OR 4.0, 95%CI: 2.5-6.3) were the most important risk factors for PAS.Conclusion:PAS incidence is increasing stressing the importance of careful pregnancy surveillance and risk factor management, particularly in older expectant mothers and extending to puerperium.Classification of Evidence:This study provides Class III evidence that smoking beyond 12 gestational weeks, migraine and hypertensive disorders of pregnancy are associated with an increased risk of PAS.

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High Fetal Fraction on First Trimester Cell-Free DNA Aneuploidy Screening and Adverse Pregnancy Outcomes

American Journal of Perinatology ◽

10.1055/s-0039-1694005 ◽

2019 ◽

Vol 37 (01) ◽

pp. 008-013 ◽

Cited By ~ 4

Author(s):

Lydia L. Shook ◽

Mark A. Clapp ◽

Penelope S. Roberts ◽

Sarah N. Bernstein ◽

Ilona T. Goldfarb

Keyword(s):

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

First Trimester ◽

Hypertensive Disorders Of Pregnancy ◽

Aneuploidy Screening ◽

Hypertensive Disorders ◽

Increased Risk ◽

Adverse Pregnancy ◽

Fetal Fraction

Abstract Objective To test the hypothesis that high fetal fraction (FF) on first trimester cell-free deoxyribonucleic acid (cfDNA) aneuploidy screening is associated with adverse perinatal outcomes. Study Design This is a single-institution retrospective cohort study of women who underwent cfDNA screening at <14 weeks' gestation and delivered a singleton infant between July 2016 and June 2018. Women with abnormal results were excluded. Women with high FF (≥95th percentile) were compared with women with normal FF (5th–95th percentiles). Outcomes investigated were preterm birth, small for gestational age, and hypertensive disorders of pregnancy. Results A total of 2,033 women met inclusion criteria. The mean FF was 10.0%, and FF >16.5% was considered high (n = 102). Women with high FF had a greater chance of delivering a small for gestational age infant <fifth percentile, with an adjusted odds ratio of 2.4 (95% confidence interval: 1.1–4.8, p = 0.039). There was no significant association between high FF and either preterm birth or hypertensive disorders of pregnancy. Conclusion Women with a high FF in the first trimester are at increased risk of delivering a small for gestational age infant <fifth percentile. Further investigation into the clinical implications of a high FF is warranted.

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Association between maternal hypertensive disorders of pregnancy and child neurodevelopment at 3 years of age: a retrospective cohort study

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174420000586 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Masahiro Noda ◽

Satomi Yoshida ◽

Hiroki Mishina ◽

Keisuke Matsubayashi ◽

Koji Kawakami

Keyword(s):

Confidence Interval ◽

Gestational Hypertension ◽

Exposed Group ◽

Control Group ◽

Developmental Abnormality ◽

Hypertensive Disorders Of Pregnancy ◽

Developmental Abnormalities ◽

Hypertensive Disorders ◽

Increased Risk ◽

Child Neurodevelopment

Abstract Hypertensive disorders of pregnancy (HDP) affect up to 10% of women during pregnancy and influence child neurodevelopment, including mental and motor function. We assessed whether HDP, including gestational hypertension, preeclampsia, superimposed preeclampsia, and eclampsia, correlate with motor and mental developmental abnormalities in 3-year-old children, using data obtained between April 2004 and March 2013 through a mandatory population-based health checkup of mothers and children in Kobe city, Japan. The primary outcome was motor and mental developmental abnormalities at 3 years of age; parental-reported questionnaires and physician’s medical examinations were evaluated. The association between maternal HDP and child neurodevelopmental abnormality was evaluated using a logistic regression model. Of the 43,854 participating children, 1120 were born to women with HDP and 42,734 were born to women without HDP. The prevalence of motor developmental abnormality was 1.7% in the exposed group and 0.95% in the control group; the prevalence of mental developmental abnormality was 2.41% in the exposed group and 1.22% in the control group. Children born to mothers with HDP did not have an increased risk of motor developmental abnormality at the age of 3 years [adjusted odds ratio (OR) 1.17, 95% confidence interval 0.72–1.91], but had an increased risk of mental developmental abnormality (adjusted OR 1.80, 95% confidence interval 1.21–2.69). Maternal HDP were associated with mental development abnormality in 3-year-old children. These findings may be clinically relevant; mental abnormality in children born to women with HDP could be detected during early stages, which would facilitate early intervention.

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Hypertensive Disorders of Pregnancy Appear Not to Be Associated with Alzheimer's Disease Later in Life

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000439043 ◽

2015 ◽

Vol 5 (3) ◽

pp. 375-385 ◽

Cited By ~ 10

Author(s):

Carolien N.H. Abheiden ◽

Rebecca van Doornik ◽

Annet M. Aukes ◽

Wiesje M. van der Flier ◽

Philip Scheltens ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Late Onset ◽

Medical Center ◽

White Matter Lesions ◽

Hypertensive Disorders Of Pregnancy ◽

Telephone Surveys ◽

Hypertensive Disorders ◽

Increased Risk ◽

History Of

Background: After hypertensive disorders of pregnancy, more subjective cognitive complaints and white matter lesions are reported compared to women after normal pregnancies. Both have a causal relationship with Alzheimer's disease (AD). Aim: To investigate if women whose pregnancy was complicated by hypertensive disorders have an increased risk of AD. Methods: A case-control study in women with AD from the Alzheimer Center of the VU University Medical Center Amsterdam and women without AD. Paper and telephone surveys were performed. Results: The response rate was 85.2%. No relation between women with (n = 104) and without AD (n = 129) reporting pregnancies complicated by hypertensive disorders (p = 0.11) was found. Women with early-onset AD reported hypertensive disorders of pregnancy more often (p = 0.02) compared to women with late-onset AD. Conclusion: A reported history of hypertensive disorders of pregnancy appears not to be associated with AD later in life.

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P-059. Prevalence and risk analysis of early-onset and late-onset of hypertensive disorders of pregnancy

Pregnancy Hypertension ◽

10.1016/j.preghy.2021.07.094 ◽

2021 ◽

Vol 25 ◽

pp. e48

Author(s):

Koh Nagata ◽

Sara Kusumoto ◽

Chiaki Satoh ◽

Masaki Nishi ◽

Masashi Noguchi ◽

...

Keyword(s):

Risk Analysis ◽

Early Onset ◽

Late Onset ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Association of Fetal Fraction of Cell-Free DNA and Hypertensive Disorders of Pregnancy

American Journal of Perinatology ◽

10.1055/s-0038-1667374 ◽

2018 ◽

Vol 36 (03) ◽

pp. 311-316 ◽

Cited By ~ 5

Author(s):

Nathanael Koelper ◽

Mary Sammel ◽

Lorraine Dugoff ◽

Whitney Bender

Keyword(s):

Multinomial Logistic Regression ◽

First Trimester ◽

Chronic Hypertension ◽

Hypertensive Disorders Of Pregnancy ◽

Cell Free Dna ◽

Free Dna ◽

Hypertensive Disorders ◽

Increased Risk ◽

The Relationship ◽

Fetal Fraction

Objective The objective of this study is to examine the relationship between fetal fraction and hypertensive disorders of pregnancy. Study Design This is a retrospective cohort study of women with singleton pregnancies who had cell-free DNA (cfDNA) screening at 10 to 20 weeks of gestation. The primary outcome was the development of gestational hypertension (gHTN), preeclampsia (PEC), and PEC with severe features. Multinomial logistic regression was performed to assess the relationship between fetal fraction and pregnancy outcomes of interest while controlling for potential confounders. Results Among 2,701 women meeting inclusion criteria, 387 (14.3%) were diagnosed with hypertensive disorders of pregnancy. First-trimester fetal fraction was significantly lower in women diagnosed with hypertensive disorders of pregnancy (10.9 vs. 12.4, p < 0.0001). An increased risk of gHTN and PEC, PEC with severe features with delivery > 34 weeks, and PEC with severe features with delivery ≤ 34 weeks was seen with lower first-trimester fetal fractions (odds ratio [OR]: 0.55, 95% confidence interval [CI] [0.36–0.83], p = 0.005; OR: 0.59, 95% CI [0.35–0.99], p = 0.048; and OR: 0.27, 95% CI [0.08–0.96], p = 0.044). The relationship between fetal fraction and hypertensive disorders of pregnancy was not statistically significant after adjusting for maternal age, race, body mass index, and chronic hypertension. Conclusion Fetal fraction of cfDNA at 10 to 20 weeks of gestation was not associated with the development of hypertensive disorders of pregnancy.

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