scholarly journals The Association of Familial Hypertension and Risk of Gestational Hypertension and Preeclampsia

2021 ◽  
Vol 18 (13) ◽  
pp. 7045
Author(s):  
Małgorzata Lewandowska
Keyword(s):  
Risk Factor ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Gestational Hypertension ◽  
First Trimester ◽  
Chronic Hypertension ◽  
Modifiable Factors ◽  
The Family ◽  
Maternal Hypertension

It has not been established how history of hypertension in the father or mother of pregnant women, combined with obesity or smoking, affects the risk of main forms of pregnancy-induced hypertension. A cohort of 912 pregnant women, recruited in the first trimester, was assessed; 113 (12.4%) women developed gestational hypertension (GH), 24 (2.6%) developed preeclampsia (PE) and 775 women remained normotensive (a control group). Multiple logistic regression was used to calculate adjusted odds ratios (AOR) (and 95% confidence intervals) of GH and PE for chronic hypertension in the father or mother of pregnant women. Some differences were discovered. (1) Paternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for GH (AOR-a = 1.98 (1.2–3.28), p = 0.008). This odds ratio increased in pregnant women who smoked in the first trimester (AOR-a = 4.71 (1.01–21.96); p = 0.048) or smoked before pregnancy (AOR-a = 3.15 (1.16–8.54); p = 0.024), or had pre-pregnancy overweight (AOR-a = 2.67 (1.02–7.02); p = 0.046). (2) Maternal hypertension (vs. absence of hypertension in the family) was an independent risk factor for preeclampsia (PE) (AOR-a = 3.26 (1.3–8.16); p = 0.012). This odds ratio increased in the obese women (AOR-a = 6.51 (1.05–40.25); p = 0.044) and (paradoxically) in women who had never smoked (AOR-a = 5.31 (1.91–14.8); p = 0.001). Conclusions: Chronic hypertension in the father or mother affected the risk of preeclampsia and gestational hypertension in different ways. Modifiable factors (overweight/obesity and smoking) may exacerbate the relationships in question, however, paradoxically, beneficial effects of smoking for preeclampsia risk are also possible. Importantly, paternal and maternal hypertension were not independent risk factors for GH/PE in a subgroup of women with normal body mass index (BMI).

scholarly journals Incidence and Predictors of Acute Kidney Injury Among Women With Severe Pre-eclampsia at Mbarara Regional Referral Hospital

2021 ◽  
Author(s):  
Mariam Hassan ◽  
Roland Mayanja ◽  
Wasswa G.M Ssalongo ◽  
Natumanya Robert ◽  
Lugobe Henry Mark ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Serum Creatinine ◽  
Independent Risk Factor ◽  
Statistical Significance ◽  
Kidney Injury ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Baseline Serum ◽  
Regional Referral Hospital

Abstract BackgroundThe presence of acute kidney injury (AKI) in pre-eclampsia complicates treatment including; increasing length of hospital stay and a need to access services like dialysis which are largely expensive in resource-limited settings. We aimed to determine incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital in southwestern Uganda. MethodsWe carried out a hospital-based prospective cohort study from 16 November 2018 to 18 April 2019, among pregnant women with severe preeclampsia followed up in the hospital. We enrolled 70 mothers with severe pre-eclampsia and eclampsia; we excluded patients with a history of chronic renal disease, chronic hypertension, and gestational hypertension.Data on socio-demographics, laboratory parameters, health system, obstetric and medical factors were collected. Baseline serum creatinine, complete blood count, and CD4 T-cell count were all done at admission (0-hour). Second serum creatinine was done at 48-hours to determine the presence of AKI. AKI was defined as a rise in serum creatinine of 0.3mg/dl or more from the baseline. The proportion of women diagnosed with acute kidney injury among the total number of women with severe pre-eclampsia was reported as incidence proportion. Univariate and multivariate logistic regression was used to establish the association of acute kidney injury and severe pre-eclampsia.ResultsIncidence of acute kidney injury was high (41.4%) among women with severe pre-eclampsia. Antenatal care attendance was protective 0.36 (0.16, 0.80), p<0.013 at bivariate analysis but had no statistical significance at multivariate analysis. Eclampsia was an independent risk factor for acute kidney injury. (aRR 2.74 (1.06, 7.08), P<0. 037.ConclusionThe incidence of acute kidney injury in patients with preeclampsia is high. Eclampsia is an independent risk factor of acute kidney injury.

scholarly journals Differential Diagnosis of Preeclampsia Based on Urine Peptidome Features Revealed by High Resolution Mass Spectrometry

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1039
Author(s):  
Alexey S. Kononikhin ◽  
Natalia V. Zakharova ◽  
Viktoria A. Sergeeva ◽  
Maria I. Indeykina ◽  
Natalia L. Starodubtseva ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
High Resolution ◽  
High Resolution Mass Spectrometry ◽  
Gestational Hypertension ◽  
Characteristic Curve ◽  
First Trimester ◽  
Chronic Hypertension ◽  
High Resolution Mass ◽  
Diagnostic Potential ◽  
Resolution Mass

Preeclampsia (PE) is a severe pregnancy complication, which may be considered as a systemic response in the second half of pregnancy to physiological failures in the first trimester, and can lead to very serious consequences for the health of the mother and fetus. Since PE is often associated with proteinuria, urine proteomic assays may represent a powerful tool for timely diagnostics and appropriate management. High resolution mass spectrometry was applied for peptidome analysis of 127 urine samples of pregnant women with various hypertensive complications: normotensive controls (n = 17), chronic hypertension (n = 16), gestational hypertension (n = 15), mild PE (n = 25), severe PE (n = 25), and 29 patients with complicated diagnoses. Analysis revealed 3869 peptides, which mostly belong to 116 groups with overlapping sequences. A panel of 22 marker peptide groups reliably differentiating PE was created by multivariate statistics, and included 15 collagen groups (from COL1A1, COL3A1, COL2A1, COL4A4, COL5A1, and COL8A1), and single loci from alpha-1-antitrypsin, fibrinogen, membrane-associated progesterone receptor component 1, insulin, EMI domain-containing protein 1, lysine-specific demethylase 6B, and alpha-2-HS-glycoprotein each. ROC analysis of the created model resulted in 88% sensitivity, 96.8% specificity, and receiver operating characteristic curve (AUC) = 0.947. Obtained results confirm the high diagnostic potential of urinary peptidome profiling for pregnancy hypertensive disorders diagnostics.

Lorazepam Is an Independent Risk Factor for Transitioning to Delirium in Intensive Care Unit Patients

2006 ◽  
Vol 104 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Pratik Pandharipande ◽  
Ayumi Shintani ◽  
Josh Peterson ◽  
Brenda Truman Pun ◽  
Grant R. Wilkinson ◽  
...  
Keyword(s):  
Risk Factor ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
A Priori ◽  
Dose Administration ◽  
P Values ◽  
Mechanically Ventilated ◽  
Analgesic Dose ◽  
Ventilated Patients ◽  
Relevant Covariates

Background Delirium has recently been shown as a predictor of death, increased cost, and longer duration of stay in ventilated patients. Sedative and analgesic medications relieve anxiety and pain but may contribute to patients' transitioning into delirium. Methods In this cohort study, the authors designed a priori an investigation to determine whether sedative and analgesic medications independently increased the probability of daily transition to delirium. Markov regression modeling (adjusting for 11 covariates) was used in the evaluation of 198 mechanically ventilated patients to determine the probability of daily transition to delirium as a function of sedative and analgesic dose administration during the previous 24 h. Results Lorazepam was an independent risk factor for daily transition to delirium (odds ratio, 1.2 [95% confidence interval, 1.1-1.4]; P = 0.003), whereas fentanyl, morphine, and propofol were associated with higher but not statistically significant odds ratios. Increasing age and Acute Physiology and Chronic Health Evaluation II scores were also independent predictors of transitioning to delirium (multivariable P values &lt; 0.05). Conclusions Lorazepam administration is an important and potentially modifiable risk factor for transitioning into delirium even after adjusting for relevant covariates.

scholarly journals 464: Fetal tachycardia is an independent risk factor for chromosomal anomalies during first trimester genetic screening

2018 ◽  
Vol 218 (1) ◽  
pp. S279
Author(s):  
Andres Espinoza ◽  
Wesley Lee ◽  
Alireza A. Shamshirsaz ◽  
Michael A. Belfort ◽  
Jimmy Espinoza
Keyword(s):  
Risk Factor ◽  
Genetic Screening ◽  
Independent Risk Factor ◽  
First Trimester ◽  
Chromosomal Anomalies ◽  
Fetal Tachycardia

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 JAK2V617F-positive clonal hematopoiesis of indeterminate potential in pregnant women

2019 ◽  
Vol 13 (3) ◽  
pp. 204-210
Author(s):  
I. A. Olkhovskiy ◽  
J. G. Garber ◽  
A. S. Gorbenko ◽  
M. A. Stolyar ◽  
O. M. Miller ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Hypertension ◽  
Lymphoblastic Leukemia ◽  
Venous Blood ◽  
First Trimester ◽  
Polymerase Chain Reaction Test ◽  
Routine Laboratory ◽  
Jak2 Mutation ◽  
Blood Samples ◽  
Increased Risk

Aim: to assess the prevalence of V617F somatic mutation of the JAK2 gene in pregnant women.Materials and methods. This non-interventional study was performed in the framework of routine clinical practice and included 1532 samples of venous blood from pregnant women who applied for medical assistance at Krasnoyarsk Regional Clinical Center for Maternal and Child Welfare. We used blood samples left after all routine laboratory tests had been done. These leftovers were pooled in the way that ensured an equal ratio of nucleated cells. Each pool contained 7 separate blood samples. The unused samples that remained after the pooling were frozen and stored at –20°C until the end of entire testing procedure. The V617F JAK2 mutation was detected by the real-time allele-specific polymerase chain reaction test.Results. Among the examined pregnant women, 6 (0.4 %) were identified as carriers of V617F JAK2 mutation. Three women with this mutation suffered from infertility for 4, 5, and 10 years; two of them had repeated miscarriages in the first trimester of pregnancy. The 6 women – carriers of this mutations had no concomitant genetic polymorphisms typical of thrombophilia (factors FII, FV), and no abnormal coagulation characteristics. Analysis of their medical records showed that in the past, two of these women had gestational hypertension, one developed a clinical picture of preeclampsia, and another one (with the maximum presence of the mutant allele) had a history of acute lymphoblastic leukemia followed by stable remission.Conclusion. The routine laboratory detection of the V617F JAK2 mutation can facilitate timely identification of the increased risk of pregnancy pathology, as well as timely diagnosis of hematological cancer.

scholarly journals Correlation Between Divided Doses of Chronic Antihypertensive Drugs and Pregnancy Outcomes

2017 ◽  
Vol 8 (3) ◽  
pp. 328-332
Author(s):  
Safura Hatamipour Dehno ◽  
Simin Taghavi ◽  
Nayyereh Ayati
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Antihypertensive Drugs ◽  
Gestational Hypertension ◽  
Blood Pressure Monitoring ◽  
Perinatal Outcomes ◽  
Chronic Hypertension ◽  
Pressure Monitoring ◽  
Fetal Complications

Objectives: Hypertension, as a common problem during pregnancy, is a major cause of maternal and fetal morbidity and mortality. Anti-hypertensive drugs are used to prolong the pregnancy or modify perinatal outcomes in pregnant women with hypertensive disorders. Severe monitoring of blood pressure is subsequently essential in these mothers. The aim of this study was to evaluate the correlation between divided doses of chronic hypertensive drugs and the end of pregnancy in mothers with gestational hypertension. Materials and Methods: In this prospective research, 99 pregnant women with chronic hypertension, who were treated with antihypertensive medicines, were studied during pregnancy. During routine follow-up of these mothers, the number of the drug and the divided doses were recorded. The incidence of maternal and fetal outcomes were evaluated according to the number of less or more than 5 divided doses. Results: Maternal and fetal-baby complications were observed in 5.50 and 5.53% cases, respectively. The incidence of maternal and fetal complications were significantly enhanced by increasing the number of up-taken anti-hypertensive drugs. The maternal and fetal-baby complications were higher in mothers who received more than five divided doses compared to those who received less than five doses. Conclusion: Based on our results, chronic hypertension was associated with maternal and fetal-baby complications in half of the cases. It is clarified that precise blood pressure monitoring and regularly taking of anti-hypertensive medicine may decrease the hypertension side effects. The awareness about this field in the pre-pregnancy consulting is considered as the patients’ rights and should be respected.

scholarly journals Hypertension in pregnancy in general practice

2019 ◽  
Vol 23 (2) ◽  
pp. 15-20
Author(s):  
Irina Е. Moiseeva
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Gestational Hypertension ◽  
Chronic Hypertension ◽  
Proper Treatment ◽  
Social Significance ◽  
Knowledge And Skills ◽  
Hypertension In Pregnancy ◽  
Treatment And Prevention ◽  
In Pregnancy

Hypertension occurs in 5–30% of pregnant women. Its medical and social significance is associated with the risk of a negative impact on the course of pregnancy and on the condition of the fetus and newborn.This requires from the general practitioner to have enough knowledge and skills in this area.Clinical variants of hypertension in pregnancy include pre-existing hypertension (chronic hypertension), gestational hypertension, chronic hypertension complicated by preeclampsia, and preeclampsia/eclampsia.The main tasks of general practitioners — early diagnosis, proper treatment and prevention of complications of hypertension in pregnant women.

Incidence, Risk Factors, and Outcomes for Atrial Arrhythmias in Trauma Patients

2011 ◽  
Vol 77 (5) ◽  
pp. 634-639 ◽  
Author(s):  
Pantelis Hadjizacharia ◽  
Terence O'Keeffe ◽  
Carlos V.R. Brown ◽  
Kenji Inaba ◽  
Ali Salim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Beta Blockers ◽  
Head Injuries ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Trauma Patients ◽  
Academic Level ◽  
Incidence Risk

The purpose of this study is to determine the incidence, risk factors, and outcomes after the development of an atrial arrhythmia (AA) in trauma patients admitted to the Intensive Care Unit (ICU). We performed a retrospective study of more than 7 years of trauma patients admitted to the ICU at an urban, academic Level I trauma center. Patients with AA, defined as atrial fibrillation, atrial flutter, or paroxysmal supraventricular tachycardia, were compared with patients without AA. Groups were compared by univariate and multivariate analysis. Three thousand, four hundred and ninety-nine trauma patients were admitted to the ICU during the study period and 210 (6%) developed an AA. AA patients were more likely to sustain blunt trauma, were older, more often female, more severely injured, and sustained more head injuries. The only independent risk factor for developing an AA was age > 55 years (odds ratio = 4.6, P < 0.01). Mortality was higher in the AA group (33% vs 14%, P < 0.01) and AA was an independent risk factor for mortality (odds ratio = 1.7, P = 0.01). Twenty-eight per cent (n = 59) of AA patients received beta-blockers in the postinjury period, and these patients had lower mortality (22% vs 37%, P = 0.04). AA occurs in 6 per cent of trauma patients admitted to the ICU. Developing an AA is an independent risk factor for mortality after trauma. Beta-blocker therapy was associated with decreased mortality in trauma patients with AA.

scholarly journals Association of family history of schizophrenia and history of obstetric complications at birth: relationship with age at onset and psychopathology dimensions in a Nigerian cohort

2020 ◽  
Vol 20 (2) ◽  
pp. 697-708
Author(s):  
Justus Uchenna Onu ◽  
Jude Uzoma Ohaeri
Keyword(s):  
Risk Factor ◽  
Family History ◽  
Independent Risk Factor ◽  
Age At Onset ◽  
Obstetric Complications ◽  
Symptom Dimensions ◽  
Clinical Phenotypes ◽  
The Family ◽  
Psychopathological Symptom ◽  
History Of

Background: The nature of the association between obstetric complications (OCs) at birth and the genetic aetiology of schizo- phrenia remains unclear, as some authors suggest that it is an independent risk factor while others support either interactionism or an epiphenomenon perspective. Objective: To examine the association of family history of schizophrenia (FHS) with history of OCs, with a view to assessing whether this relationship moderates clinical phenotypes such as symptom dimensions and age at onset of illness. Methods: This study examined OCs among schizophrenia probands using the Obstetric Complications Scale. An inquiry into family history was performed using the Family history method. Psychopathological symptom dimensions were assessed using standard scales. Data were analyzed to examine the interaction of FHS and history of OCs with age at onset and symptom dimensions, using ANCOVA. Results: FHS was significantly associated with the disorganized symptoms dimension (p=0.03). History of OCs was significant- ly associated with earlier age at onset (p=0.007). However, in ANCOVA, the effect of the interaction between FHS and history of OCs was not significant for age at onset and symptom dimensions (P = 0.059). Conclusion: FHS was significantly associated with disorganization syndrome, and OCs was significantly associated with age at onset. Keywords: Family history; schizophrenia; obstetric complications; symptom dimensions; age at onset.

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