Biochemical Indicators as Predictive Markers by Combining Clinical Signs in Pre-eclampsia

AIM: To determine whether previously identified risk factors are associated with the development of a severe form of pre-eclampsia in a heterogeneous cohort of women, and the predictive values of these risk factors when combined with certain biochemical indicators. MATERIALS AND METHODS: Systematic review of data collected for a doctoral case-control study plus an examination of the indicators of pre-eclampsia and maternal IL10 levels. This examination was conducted in 100 women with pregnancies complicated by varying degrees of pre-eclampsia and in 80 normotensive patients hospitalized at the University Clinic of Gynecology and Obstetrics, Skopje, Republic of Macedonia. Patients with pre-eclampsia were categorized into moderate (m PE) and severe (s PE) pre-eclampsia group according to the degree of pre-eclampsia. The severity of pre-eclampsia was determined according to the definition of the World Health Organization, Handbook for guideline development from 2010. RESULTS: The regression analysis applied in this study showed that elevated systolic blood pressure of 160 mmHg or higher, diastolic blood pressure of 100 mmHg or higher, pregnancy at an older age, nulliparity, persistent proteinuria in pregnancy, the serum lactate dehydrogenase concentration of 450 U/L or higher, and reduced serum concentrations of IL10 as significant predictors of severe pre-eclampsia in pregnant women. While other variables predicted a higher likelihood for the development of severe pre-eclampsia, IL10 decreased such likelihood. IL10 was also found to be negatively correlated with proteinuria and positively correlated with blood platelets. Significantly higher concentration of IL10 was confirmed in patients with a higher number of platelets in the blood and vice versa. On the other hand, the serum concentration of IL10 was significantly lower in patients with a higher amount of proteins in the urine and vice versa. CONCLUSIONS: Examination of clinical risk factors combined with biochemical markers can improve the predictive success of pre-eclampsia and has important clinical values in improving the prognosis of pregnant women and fetuses.

Download Full-text

HIPEREMESIS GRAVIDARUM PADA IBU HAMIL DI KLINIK BIDAN SUPRIYATI SRIBIT BERBAH SLEMAN

Surya Medika: Jurnal Ilmiah Ilmu Keperawatan dan Ilmu Kesehatan Masyarakat ◽

10.32504/sm.v14i1.108 ◽

2019 ◽

Vol 14 (1) ◽

pp. 51

Author(s):

Pramukti Dian Setianingrum ◽

Farah Irmania Tsani

Keyword(s):

Blood Pressure ◽

Pregnant Women ◽

Hyperemesis Gravidarum ◽

Unwanted Pregnancy ◽

The Body ◽

Nausea And Vomiting ◽

Daily Activities ◽

World Health ◽

The World

Backgroud: The World Health Organization (WHO) explained that the number of Hyperemesis Gravidarum cases reached 12.5% of the total number of pregnancies in the world and the results of the Demographic Survey conducted in 2007, stated that 26% of women with live births experienced complications. The results of the observations conducted at the Midwife Supriyati Clinic found that pregnant women with hyperemesis gravidarum, with a comparison of 10 pregnant women who examined their contents there were about 4 pregnant women who complained of excessive nausea and vomiting. Objective: to determine the hyperemesis Gravidarum of pregnant mother in clinic. Methods: This study used Qualitative research methods by using a case study approach (Case Study.) Result: The description of excessive nausea of vomiting in women with Hipermemsis Gravidarum is continuous nausea and vomiting more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the body weight decreases and interferes with daily activities days The factors that influence the occurrence of Hyperemesis Gravidarum are Hormonal, Diet, Unwanted Pregnancy, and psychology, primigravida does not affect the occurrence of Hyperemesis Gravidarum. Conclusion: Mothers who experience Hyperemesis Gravidarum feel nausea vomiting continuously more than 10 times in one day, no appetite or vomiting when fed, the body feels weak, blood pressure decreases until the weight decreases and interferes with daily activities, it is because there are several factors, namely, hormonal actors, diet, unwanted pregnancy, and psychology.

Download Full-text

Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity

Viruses ◽

10.3390/v13050866 ◽

2021 ◽

Vol 13 (5) ◽

pp. 866

Author(s):

Masatoki Kaneko ◽

Junsuke Muraoka ◽

Kazumi Kusumoto ◽

Toshio Minematsu

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Vertical Transmission ◽

Human Cytomegalovirus ◽

Multiple Logistic Regression Analysis ◽

Clinical Signs ◽

Immunoglobulin M ◽

Igg Antibody ◽

Neurological Sequelae ◽

Previous Pregnancy

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

Download Full-text

Comparative Analysis of Clinical History, Sociodemographic, Behavioural Factors and Cardiovascular Risk Factors among Hypertensive in Awka, Nigeria

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2019/v31i630303 ◽

2019 ◽

pp. 1-8

Author(s):

Chidinma Ifeyinwa Mmaju ◽

Peter Osezele Okonudo ◽

Gladys Ahaneku ◽

Ufoaroh Chinyelu Uchenna

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Marital Status ◽

Cardiovascular Risk Factors ◽

Occupational Status ◽

Clinical History ◽

Cross Sectional Study ◽

World Health ◽

Cross Sectional

Background: Hypertension is a major modifiable risk factor for cardiovascular diseases and research studies done in Nigeria observed prevalence rate of hypertension to range from 26.4% to 36.9%. Aim: This study aimed to evaluate the sociodemographic, clinical, behavioral and cardiovascular risk factors associated with hypertension in Awka, South East, Nigeria. Methods: Cross-sectional study was used.391 participants aged from 18 years above were recruited for this study. Structured questionnaires were constructed in line with World Health Organization Step approach was utilized for data collection. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and Diastolic blood pressure ≥ 90 mmHg. Chi-square and independent sample T test were used to test comparison between two groups. Results: The mean age of the subjects was 45.87±17. 49.33.7% of retired subjects has the highest prevalence was statistically associated with hypertension in occupational status of the subjects, marital status was statically significant with hypertension and prevalence of hypertension among the subjects were 81.1%, 8.5%, 8.6% for married, single and divorcee respectively, (P<0.001) and also no association was observed between hypertension and subjects that occasionally use high salt often(x2=0.341, P>0.001). Conclusion: The study showed that age, family history of hypertension, consistent increase in blood pressure, occupational and marital status are associated risk factors of hypertension in Awka, South East, Nigeria. There is need to create awareness on the risk factors and encourage changes in sedentary life style.

Download Full-text

Oxidative Stress, Neutrophil Elastase and Vascular Endothelial Growth Factor in Obese Pregnant Women with Preeclampsia

Biomedical & Pharmacology Journal ◽

10.13005/bpj/1819 ◽

2019 ◽

Vol 12 (04) ◽

pp. 1887-1891

Author(s):

Moushira Zakia ◽

Taghreed Shalabi ◽

Tamer Hussein ◽

Mohamed Hammam ◽

Eman Youness ◽

...

Keyword(s):

Oxidative Stress ◽

Risk Factors ◽

Blood Pressure ◽

Growth Factor ◽

Pregnant Women ◽

Neutrophil Elastase ◽

Inflammatory Marker ◽

Vascular Endothelial ◽

Obese Women ◽

Endothelial Growth Factor

Oxidative stress, inflammation, and vascular endothelial proliferation and obesity are risk factors associated with preeclampsia (PE). Thepresent study aimed to investigate the levels of malondialdehyde (MDA) as a putative circulatory marker of oxidative stress, neutrophil Elastase (NE) as inflammatory marker andvascular endothelial growth factor (VEGF) as marker for vascular permeability-enhancing activities inobese women withpreeclampsia PE and compare withnormal pregnancy women. The study was carried out on 50 pregnant obese women with PE and 50 normal pregnant women. The preeclampsia women were characterized with high blood pressure 160/110 mmHg and proteinuria. The gestational age ranged from ≥32 weeks to <37 weeks. Pre pregnancyweightwas recorded. Body mass index (BMI) was calculatedat delivery.SerumMDA, NEand VEGF were estimatedby ELISA. Significant higher levels of serum MAD,NE and VEGF were observed in obese PE patients as compared to normal controls. Our results suggested thatobesity;oxidative stress, NEandVEGFbiomarkers are risk factors for PE,emphasizing their role as feasible candidate risk markersfor cases withhigh blood pressure in early pregnancy.

Download Full-text

Characterisation of children hospitalised with pneumonia in central Vietnam: a prospective study

European Respiratory Journal ◽

10.1183/13993003.02256-2018 ◽

2019 ◽

Vol 54 (1) ◽

pp. 1802256 ◽

Cited By ~ 5

Author(s):

Phuong T.K. Nguyen ◽

Hoang T. Tran ◽

Dominic A. Fitzgerald ◽

Thach S. Tran ◽

Stephen M. Graham ◽

...

Keyword(s):

Risk Factors ◽

Hospital Admissions ◽

Adverse Outcome ◽

Tertiary Care ◽

Clinical Signs ◽

Severe Pneumonia ◽

Careful Consideration ◽

World Health ◽

Management Approach ◽

Who Criteria

Pneumonia is the most common reason for paediatric hospital admission in Vietnam. The potential value of using the World Health Organization (WHO) case management approach in Vietnam has not been documented.We performed a prospective descriptive study of all children (2–59 months) admitted with “pneumonia” (as assessed by the admitting clinician) to the Da Nang Hospital for Women and Children to characterise their disease profiles and assess risk factors for an adverse outcome. The disease profile was classified using WHO pneumonia criteria, with tachypnoea or chest indrawing as defining clinical signs. Adverse outcome was defined as death, intensive care unit admission, tertiary care transfer or hospital stay >10 days.Of 4206 admissions, 1758 (41.8%) were classified as “no pneumonia” using WHO criteria and only 252 (6.0%) met revised criteria for “severe pneumonia”. The inpatient death rate was low (0.4% of admissions) with most deaths (11 out of 16; 68.8%) occurring in the “severe pneumonia” group. An adverse outcome was recorded in 18.7% of all admissions and 60.7% of the “severe pneumonia” group. Children were hospitalised for a median of 7 days at an average cost of 253 USD per admission. Risk factors for adverse outcome included WHO-classified “severe pneumonia”, age <1 year, low birth weight, previous recent admission with an acute respiratory infection and recent tuberculosis exposure. Breastfeeding, day-care attendance and pre-admission antibiotic use were associated with reduced risk.Few hospital admissions met WHO criteria for “severe pneumonia”, suggesting potential unnecessary hospitalisation and use of intravenous antibiotics. Better characterisation of the underlying diagnosis requires careful consideration.

Download Full-text

The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-01273-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Ileana Desormais ◽

Salimanou Ariyoh Amidou ◽

Yessito Corine Houehanou ◽

Stephan Dismand Houinato ◽

Gwladys Nadia Gbagouidi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Large Population ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Rural Setting ◽

World Health ◽

Cross Sectional ◽

Men And Women ◽

Sub Saharan

Abstract Background Due to epidemiological transitions, Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs). Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5 ± 16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p = 0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p = 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

Download Full-text

Elevated Systolic Blood Pressure and Low Fetal Hemoglobin Are Risk Factors for Silent Cerebral Infarcts in Children with Sickle Cell Anemia.

Blood ◽

10.1182/blood.v114.22.262.262 ◽

2009 ◽

Vol 114 (22) ◽

pp. 262-262

Author(s):

Sharada A. Sarnaik ◽

James F. Casella ◽

Bruce A Barton ◽

Michele Afif ◽

Gladstone Airewele ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Sickle Cell ◽

Sickle Cell Anemia ◽

Conflicts Of Interest ◽

Beta Thalassemia ◽

Cerebral Infarcts ◽

Hemoglobin F ◽

Elevated Systolic Blood Pressure

Abstract Abstract 262 Introduction: The most common cause of neurological injury in sickle cell anemia is silent cerebral infarcts (SCI). In the Silent Cerebral Infarct Multi-Center Clinical Trial (SIT Trial) cohort, we sought to identify risk factors associated with SCI. Patients and Methods: In this cross-sectional study, we evaluated the clinical history, baseline laboratory values and performed magnetic resonance imaging of the brain. For those children with SCI-like lesions, a pediatric neurologist examined the child and neuroradiology and neurology committees adjudicated the presence of SCI. Children between the ages of 5 and 15 years with hemoglobin SS or S-beta° thalassemia and no history of overt strokes or seizure were evaluated. Results: A total of 542 children were evaluated; 173 (31.9%) had SCI. The mean age of the children was 9.3 years, with 280 males (51.7%). In a multivariate logistic analysis, two covariates were significant: a single systolic blood pressure (SBP) obtained during a baseline well-visit, p = 0.015 and hemoglobin F (Hgb F) level obtained after three years of age, p = 0.038. Higher values of SBP and lower values of Hgb F increased the odds of SCI; Figure. Baseline values of white blood cell count, hemoglobin level, oxygen saturation, reticulocytes, pain, or ACS event rates were not associated with SCI. Conclusion: SBP and Hgb F level are two previously unidentified risk factors for SCI in children with sickle cell disease. Modulation of SBP and Hgb F levels might decrease the risk of SCI. Disclosures: No relevant conflicts of interest to declare.

Download Full-text

Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection - Surveillance for Emerging Threats to Mothers and Babies Network, 20 state, local, and territorial health departments, March 29, 2020 -January 8, 2021

10.1101/2021.02.27.21252169 ◽

2021 ◽

Author(s):

Romeo R Galang ◽

Suzanne M Newton ◽

Kate R Woodworth ◽

Isabel Griffin ◽

Titilope Oduyebo ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Asymptomatic Infection ◽

Illness Severity ◽

World Health ◽

Severe Illness ◽

Molecular Testing ◽

Chronic Hypertension ◽

Adjusted Risk ◽

Increased Risk

Background: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk for severe illness compared with nonpregnant women. Data to assess risk factors for illness severity among pregnant women with COVID-19 are limited. This study aimed to determine risk factors associated with COVID-19 illness severity among pregnant women with SARS-CoV-2 infection. Methods: Pregnant women with SARS-CoV-2 infection confirmed by molecular testing were reported during March 29, 2020-January 8, 2021 through the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). Criteria for illness severity (asymptomatic, mild, moderate-to-severe, or critical) were adapted from National Institutes of Health and World Health Organization criteria. Crude and adjusted risk ratios for moderate-to-severe or critical COVID-19 illness were calculated for selected demographic and clinical characteristics. Results: Among 5,963 pregnant women with SARS-CoV-2 infection, moderate-to-severe or critical COVID-19 illness was associated with age 30-39 years, Black/Non-Hispanic race/ethnicity, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, cardiovascular disease, pregestational diabetes mellitus or gestational diabetes. Risk of moderate-to-severe or critical illness increased with the number of underlying medical or pregnancy-related conditions. Conclusions: Pregnant women with moderate-to-severe or critical COVID-19 illness were more likely to be older and have underlying medical conditions compared to pregnant women with asymptomatic infection or mild COVID-19 illness. This information might help pregnant women understand their risk for moderate-to-severe or critical COVID-19 illness and inform targeted public health messaging.

Download Full-text

The Prevalence, Awareness, Management and Control of Hypertension in Men and Women in Benin, West Africa: the TAHES study.

10.21203/rs.2.14078/v2 ◽

2019 ◽

Author(s):

ILEANA DESORMAIS ◽

Salimanou Ariyoh Amidou ◽

Yessito Corine Houehanou ◽

Stephan Dismand Houinato ◽

Gwladys Nadia Gbagouidi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Large Population ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Rural Setting ◽

World Health ◽

Cross Sectional ◽

Men And Women ◽

Sub Saharan

Abstract Background Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs), due to epidemiological transitions. Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5±16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p=0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p= 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

Download Full-text

Malnutrition Precipitated Measles Outbreak in Gewane District, Afar Regional State, Northeastern Ethiopia, 2016

10.21203/rs.3.rs-32423/v1 ◽

2020 ◽

Author(s):

Wolde Melese Ayele

Keyword(s):

Risk Factors ◽

Multivariable Analysis ◽

Clinical Signs ◽

Immunization Coverage ◽

Public Health Problem ◽

Binary Logistic Regression ◽

Developed Countries ◽

High Rate ◽

World Health ◽

Vaccination History

Abstract Background: Measles is a contagious viral and vaccine-preventable disease that is continuing a public health problem. It is occurring as an outbreak not only in developing but also in developed countries.Methods: A 1:2 ratios, unmatched case-control study was conducted from September 19/2016- October 08/2016 in Undufo Kebele, Gewane district, Northeastern Ethiopia. Both confirmed by laboratory and epidemiologically linked measles cases were involved. Controls were those who had no clinical signs of measles during the data collection period and residents of the same community where cases were identified. An interviewer-administered questionnaire was used to collect data. Nutritional status was measured using MUAC and the result decided based on the world health organization's nutritional categorization of children by MUAC. Data were entered into Epi-info 7 and analyzed using SPSS-21. Binary logistic regression was done to identify risk factors for measles infection with 95% confident level of Odds ratio.Result: Fifty cases and 100 controls have participated in this investigation. Four out of five samples collected were positive for measles IgM antibody. There were three deaths reported. There was no vaccination history of cases and controls. The majority of cases were female and between 6–15 years of age. In multivariable analysis, malnutrition (AOR = 3.21; 95%CI 1.871,6.334), and contact history (AOR = 12.24; 95%CI 6.992,28.121) increased the risk of contracting measles infection.Conclusion: children under 15-year age were more affected groups. The absence of vaccination in the area precipitated by a high rate of malnutrition was the main cause that aggravates the number of new infections. Contact history and malnutrition were the identified risk factors for measles infection. Therefore, increasing immunization coverage of more than 80%, and securing food security decrease the susceptibility of outbreak occurrence.

Download Full-text