scholarly journals Hypertensive Disorders of Pregnancy and Medication Use in the 2015 Pelotas (Brazil) Birth Cohort Study

2020 ◽  
Vol 17 (22) ◽  
pp. 8541
Author(s):  
Lisiane Freitas Leal ◽  
Sonia Marzia Grandi ◽  
Vanessa Iribarrem Avena Miranda ◽  
Tatiane da Silva Dal Pizzol ◽  
Robert William Platt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Gestational Hypertension ◽  
Anatomical Therapeutic Chemical ◽  
Adverse Outcomes ◽  
Birth Cohort Study ◽  
Chronic Hypertension ◽  
Omega 3 ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Hypertensive disorders of pregnancy account for approximately 22% of all maternal deaths in Latin America and the Caribbean. Pharmacotherapies play an important role in preventing and reducing the occurrence of adverse outcomes. However, the patterns of medications used for treating women with hypertensive disorders of pregnancy (HDP) living in this country is unclear. A population-based birth cohort study including 4262 women was conducted to describe the pattern of use of cardiovascular agents and acetylsalicylic acid between women with and without HDP in the 2015 Pelotas (Brazil) Birth Cohort. The prevalence of maternal and perinatal outcomes in this population was also assessed. HDP were classified according to Ministry of Health recommendations. Medications were defined using the Anatomical Therapeutic Chemical Classification System and the substance name. In this cohort, 1336 (31.3%) of women had HDP. Gestational hypertension was present in 636 (47.6%) women, 409 (30.6%) had chronic hypertension, 191 (14.3%) pre-eclampsia, and 89 (6.7%) pre-eclampsia superimposed on chronic hypertension. Approximately 70% of women with HDP reported not using any cardiovascular medications. Methyldopa in monotherapy was the most frequent treatment (16%), regardless of the type of HDP. Omega-3 was the medication most frequently reported by women without HDP. Preterm delivery, caesarean section, low birth weight, and neonatal intensive care admissions were more prevalent in women with HDP. Patterns of use of methyldopa were in-line with the Brazilian guidelines as the first-line therapy for HDP. However, the large number of women with HDP not using medications to manage HDP requires further investigation.

scholarly journals Hypertensive Disorders of Pregnancy and Recurrent Wheezing: 12 Month Follow-up of a Birth Cohort Study

2019 ◽  
Vol 143 (2) ◽  
pp. AB76
Author(s):  
Mariana Abduch Rahal ◽  
Luiza Ribeiro Magalhães ◽  
Juliana Rinaldis Silva ◽  
Fernanda Taniguchi Falleiros ◽  
Etienne Larissa Duim ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Birth Cohort Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Recurrent Wheezing ◽  
Hypertensive Disorders

scholarly journals Hypertensive Disorders of Pregnancy and Recurrent Wheezing: 18 Month Follow-up Of A Birth Cohort Study

2020 ◽  
Vol 145 (2) ◽  
pp. AB207
Author(s):  
Beatriz Yazbek ◽  
Mariana Rahal ◽  
Júlia Mello ◽  
Luiza Magalhaes ◽  
Fernanda Falleiros ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Birth Cohort Study ◽  
Hypertensive Disorders Of Pregnancy ◽  
Recurrent Wheezing ◽  
Hypertensive Disorders

Basal Plate Myometrial Fibers and Hypertensive Disorders of Pregnancy: A Case–Control Study

2017 ◽  
Vol 21 (3) ◽  
pp. 296-299 ◽  
Author(s):  
Ann A Wang ◽  
Linda M Ernst ◽  
Emily S Miller
Keyword(s):  
Case Control Study ◽  
Gestational Hypertension ◽  
Case Control ◽  
Basal Plate ◽  
Common Finding ◽  
Pathological Examination ◽  
Chronic Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Control Study

Introduction Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling. Methods This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses. Results Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders. Conclusions Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.

scholarly journals Associations of maternal hypertensive disorders during pregnancy with offspring risks of ischemic heart disease and stroke: a Nordic cohort study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
F Yang ◽  
H Chen ◽  
D Wei ◽  
I Janszky ◽  
N Roos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Heart Disease ◽  
Preterm Birth ◽  
Ischemic Heart Disease ◽  
Gestational Hypertension ◽  
Ischemic Heart ◽  
Chronic Hypertension ◽  
Medical Birth Register ◽  
Hypertensive Disorders

Abstract Background A substantial body of evidence suggests that children exposed to maternal hypertensive disorders during pregnancy (HDP) have increased risks of preterm birth, fetal growth restriction and several cardiovascular risk factors (e.g., hypertension, obesity, diabetes) later in life. However, the direct evidence on the link between maternal HDP and the risk of severe cardiovascular diseases such as ischemic heart disease (IHD) and stroke in the offspring is very limited. Objective To investigate the associations between maternal HDP and the risk of IHD and stroke in the offspring. Methods We conducted a population-based cohort study by linking several national registers in Sweden and Finland. Live singleton births from the Swedish Medical Birth Register (1973–2014) and the Finnish Medical Birth Register (1987- 2014) were followed for IHD and stroke until 2014 by the national patient and cause of death registers. We performed Cox regression models to examine the association between maternal HDP and its subtypes, i.e., pre-existing chronic hypertension, gestational hypertension, and preeclampsia, and the risk of IHD, and stroke in the offspring while adjusting for relevant maternal and pregnancy-related confounders. We conducted sibling analyses to control for unmeasured shared familial (genetic and/or environmental) risk factors. Results Among the 5,807,122 singletons included in the study, 218,322 (3.76%) children were born to mothers with HDP. During the up to 41 years of follow-up, 2,340 (0.04%) offspring were diagnosed with IHD and 5,360 (0.09%) were diagnosed with stroke. Offspring exposed to maternal HDP had an increased risk of IHD (adjusted hazard ratio (aHR), 1.29; 95% confidence interval (CI), 1.01–1.63), and stroke (aHR,1.33; 95% CI, 1.14–1.56). Significantly increased rates of stroke were also observed in children exposed to the subtypes of maternal HDP: pre-existing chronic hypertension (aHR, 1.64; 95% CI, 1.03–2.60), gestational hypertension (HR, 1.38; 95% CI, 1.08–1.77), and preeclampsia (HR, 1.26; 95% CI, 1.02–1.55). The associations between maternal HDP and offspring's IHD and stroke were independent of preterm birth and small for gestational age at birth. Maternal HDP remained associated with stroke in the offspring (aHR, 1.94; 95% CI, 1.16–3.22), but not with IHD (aHR, 0.89; 95% CI, 0.47–1.67) in the sibling analyses. Conclusion Children to mothers with HDP have increased rates of IHD and stroke from childhood to young adulthood. While the link between maternal HDP and IHD in the offspring seemed to be attributed to confounding by familial factors, the relation between maternal HDP and stroke persisted even when considering such confounding. Persons born to mothers with HDP may benefit from early screening and prevention efforts to reduce the risk of IHD and stroke later in life. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Swedish Heart and Lung Foundation

Hypertensive disorders in pregnancy and intellectual abilities in the offspring in young adulthood: The Helsinki Birth Cohort Study

2011 ◽  
Vol 44 (4) ◽  
pp. 394-403 ◽  
Author(s):  
Soile Tuovinen ◽  
Katri Räikkönen ◽  
Eero Kajantie ◽  
Jukka T. Leskinen ◽  
Markus Henriksson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Young Adulthood ◽  
Birth Cohort Study ◽  
Hypertensive Disorders ◽  
Intellectual Abilities ◽  
Hypertensive Disorders In Pregnancy ◽  
In Pregnancy

scholarly journals Earlier onset of proteinuria or hypertension is a predictor of progression from gestational hypertension or gestational proteinuria to preeclampsia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mamoru Morikawa ◽  
Michinori Mayama ◽  
Kiwamu Noshiro ◽  
Yoshihiro Saito ◽  
Kinuko Nakagawa-Akabane ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Regression Models ◽  
Gestational Hypertension ◽  
P Value ◽  
Hypertensive Disorders Of Pregnancy ◽  
Multivariate Logistic Regression ◽  
Logistic Regression Models ◽  
Hypertensive Disorders ◽  
New Onset

AbstractAlthough gestational hypertension (GH) is a well-known disorder, gestational proteinuria (GP) has been far less emphasized. According to international criteria, hypertensive disorders of pregnancy include GH but not GP. Previous studies have not revealed the predictors of progression from GP to preeclampsia or those of progression from GH to preeclampsia. We aimed to determine both sets of predictors. A retrospective cohort study was conducted with singleton pregnant women who delivered at 22 gestational weeks or later. Preeclampsia was divided into three types: new onset of hypertension/proteinuria at 20 gestational weeks or later and additional new onset of other symptoms at < 7 days or at ≥ 7 days later. Of 94 women with preeclampsia, 20 exhibited proteinuria before preeclampsia, 14 experienced hypertension before preeclampsia, and 60 exhibited simultaneous new onset of both hypertension and proteinuria before preeclampsia; the outcomes of all types were similar. Of 34 women with presumptive GP, 58.8% developed preeclampsia; this proportion was significantly higher than that of 89 women with presumptive GH who developed preeclampsia (15.7%). According to multivariate logistic regression models, earlier onset of hypertension/proteinuria (before or at 34.7/33.9 gestational weeks) was a predicator for progression from presumptive GH/GP to preeclampsia (odds ratios: 1.21/1.21, P value: 0.0044/0.0477, respectively).

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