scholarly journals Management of hypertensive disorders in pregnancy in Black women: a systematic review

2021 ◽  
Author(s):  
Jeeva John ◽  
Gwenetta Curry
Keyword(s):  
Systematic Review ◽  
Black Women ◽  
Randomised Control Trial ◽  
Free Text ◽  
Hypertensive Disorders ◽  
Black Patients ◽  
Study Results ◽  
Hypertensive Disorders In Pregnancy ◽  
Randomised Control Trials ◽  
In Pregnancy

Abstract Background: Black women are four times more likely to die than White women due to complications during pregnancy or childbirth in the U.K. This cohort are also more prone to Hypertensive Disorders in Pregnancy (HDP). Outside of pregnancy, there are race based differences in the management of hypertension as Calcium-Channel Blockers (CCB) 9 are more effective in reducing blood pressure in Black patients. It is unclear whether these differences in anti-hypertensive management extend to the management of hypertension in pregnancy. The primary objective was to address this gap in evidence by undertaking a systematic review of all randomised control trials investigating pharmacological management of HDP to assess whether CCBs are the most effective anti-hypertensive agent in Black pregnant women. Methods: The following electronic databases were searched: PubMed, MEDLINE and Embase. We used MeSH and free text terms in conjunction to increase sensitivity to potentially relevant studies. Inclusion criteria included: (1) study involved treatment of HDP; (2) study was of a randomised control trial design; (3) one of the treatment arms involved CCBs and (4) English full-text. Information regarding baseline participant data, type of anti-hypertensive, and clinical outcomes was extracted from each study. Results: This review highlighted four randomised control trials, which published race or ethnicity demographics, with only one trial that stratified HDP outcomes by ethnicity. Conclusions: There is a lack of evidence to draw definite conclusions as to whether CCBs are the most effective anti-hypertensive agent for Black patients with HDP, highlighting the need for further research in this area. However, this review demonstrates some evidence to support the hypothesis that CCBs could be more effective in the management of HDP in Black patients and that Labetalol, which is the current first-line management of HDP, may not represent the gold standard of treatment in this cohort.

scholarly journals Are Calcium-Channel Blockers the Most Effective Anti-hypertensive Agent in Black Women With Hypertensive Disorders of Pregnancy? A Systematic Review

2021 ◽  
Author(s):  
Jeeva Reeba John ◽  
Gwenetta Curry
Keyword(s):  
Systematic Review ◽  
Black Women ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Randomised Control Trial ◽  
Channel Blockers ◽  
Hypertensive Disorders ◽  
Black Patients ◽  
Randomised Control Trials ◽  
In Pregnancy

Abstract BackgroundBlack women are four times more likely to die than White women due to complications during pregnancy or childbirth in the U.K. This cohort are also more prone to Hypertensive Disorders in Pregnancy (HDP). Outside of pregnancy, there are race based differences in the management of hypertension as Calcium-Channel Blockers (CCB) are more effective in reducing blood pressure in Black patients. It is unclear whether these differences in anti-hypertensive management extend to the management of hypertension in pregnancy. The primary objective was to address this gap in evidence by undertaking a systematic review of randomised control trials, where one treatment arm comprised of CCBs, investigating pharmacological management of HDP to assess whether CCBs are the most effective anti-hypertensive agent in Black pregnant women.MethodsThe following electronic databases were searched: MEDLINE and Embase. We used MeSH and free text terms in conjunction to increase sensitivity to potentially relevant studies. Inclusion criteria included: (1) study involved drug treatment of HDP; (2) study was of randomised control trial design; (3) one of the treatment arms involved CCBs (4) English full-text and (5) outcome data was stratified by race, and included Black women. Information regarding baseline participant data, type of anti-hypertensive, and clinical outcomes was extracted from each study.ResultsThis review highlighted four randomised control trials, which published race or ethnicity demographics, with only one trial that stratified HDP outcomes by ethnicity. ConclusionsThere is a lack of evidence to draw definite conclusions as to whether CCBs are the most effective anti-hypertensive agent for Black patients with HDP, highlighting the need for further research in this area. However, this review demonstrates some evidence to support the hypothesis that CCBs could be more effective in the management of HDP in Black patients and that Labetalol, which is the current first-line management of HDP, may not represent the gold standard of treatment in this cohort.

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.

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.

Maternal Recall of Hypertensive Disorders in Pregnancy: A Systematic Review

2013 ◽  
Vol 22 (1) ◽  
pp. 37-47 ◽  
Author(s):  
Jennifer J. Stuart ◽  
C. Noel Bairey Merz ◽  
Sarah L. Berga ◽  
Virginia M. Miller ◽  
Pamela Ouyang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hypertensive Disorders ◽  
Maternal Recall ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

scholarly journals Urinary placental growth factor as a predictor of complications in hypertensive disorders in pregnancy: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046005
Author(s):  
Camille Francoeur ◽  
Julie Moreau ◽  
Samuel Lemaire-Paquette ◽  
Marie-Claude Battista ◽  
Marie-Eve Roy-Lacroix ◽  
...  
Keyword(s):  
Systematic Review ◽  
Growth Factor ◽  
Pregnant Women ◽  
Meta Analysis ◽  
Placental Growth Factor ◽  
Study Quality ◽  
Hypertensive Disorders ◽  
Hypertensive Disorders In Pregnancy ◽  
Study Quality Assessment ◽  
In Pregnancy

IntroductionPreeclampsia is an important cause of maternal and fetal morbidity and mortality. Although the diagnostic and prognostic values of circulating placental growth factor (PlGF) have been extensively studied, urinary PlGF represents an excellent alternative to facilitate sample collection in the follow-up of pregnant women. The aim of this study is to determine whether urinary PlGF levels throughout pregnancy can predict severe maternal, fetal/placental and neonatal complications in women with hypertensive disorders in pregnancy.Methods and analysisStudies that evaluated pregnant women with hypertensive disorders and at least one measurement of urinary PlGF will be included. Studies that measure urinary PlGF after the occurrence of the complications will be excluded. The main outcome will consist of severe maternal complications in women with hypertensive disorders in pregnancy. Secondary outcomes will consist of severe fetal/placental and neonatal complications as defined by the International Collaboration to Harmonize Outcomes for Pre-eclampsia. Prospective cohort studies and case–controls studies reporting original data will be included. Studies will be identified by searching MEDLINE and SCOPUS databases. The first literature search was conducted on 2 March 2020, and another search will be performed before analyses. All eligible studies will be assessed for risk of bias with a standardised 10-items study quality assessment tool adapted from the Study Quality Assessment tools developed by the National Institutes of Health (NIH). Summary of ORs and 95% CIs will be reported to evaluate the association between urinary PlGF levels and hypertensive disorders in pregnancy and its complications. A random-effect meta-analysis will also be performed.Ethics and disseminationReview by an ethics committee will not be required for this systematic review. This study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will be submitted for publication in a peer-reviewed journal as well as for presentation at conferences targeting different stakeholders, including researchers, physicians and patients.PROSPERO registration numberCRD42020186313.

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