Maternal mortality predictors in women with hypertensive disorders of pregnancy: A retrospective cohort study

Abstract Purpose: To evaluate the association of hypertensive disorders of pregnancy with SARs-CoV-2 infection in pregnant women.Methods: We conducted a retrospective cohort study of all pregnant patients with positive SARs-CoV-2 molecular test at four participating hospitals located in a large metropolitan city and who delivered between February 1st and November 24th, 2020. Patients who tested positive during their pregnancy and delivered (index cases) were compared to the three subsequent deliveries of patients who tested negative (controls) at the same institution. We evaluated the impact of COVID-19 on the development of hypertensive disorders of pregnancy.Results: A total of 280 patients were included in the study: 70 patients who tested positive for Coronavirus Disease-2019 and 210 matched controls. Compared with pregnancies negative for SARS-CoV-2 infection, COVID-19 was associated with an increased risk of developing a hypertensive disorders of pregnancy (OR 3.68, 95% CI 1.67 -8.10). Overall rates of preeclampsia with severe features were significantly higher in patients with a COVID-19 diagnosis (18.6% vs 7.1%, p=0.006). Of COVID-19 positive patients, an early SARS-CoV-2 infection (prior to 32 week’s gestation) conferred a higher risk of hypertensive disorders in pregnancy (OR=6.29, CI 1.64-24.07; p=0.007). There was no difference in route of delivery, preterm birth, intrauterine growth restriction, intrauterine fetal demise, or pregnancy and fetal outcomes.Conclusion: COVID-19 is a risk factor for hypertensive disorders of pregnancy.Tweetable AbstractPatients who test positive for COVID-19 during their pregnancy are at increased risk of developing a hypertensive disorder of pregnancy compared to pregnant patients who test negative for COVID-19. Earlier SARs-CoV-2 infection results in increased risk of developing a hypertensive disorder. Furthermore, even patients who are asymptomatic but positive for SARs-CoV-2 during their pregnancy have a higher risk of developing a hypertensive disorder of pregnancy.

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Exposure to air pollution during preconceptional and prenatal periods and risk of hypertensive disorders of pregnancy: a retrospective cohort study in Seoul, Korea

BMC Pregnancy and Childbirth ◽

10.1186/s12884-018-1982-z ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 9

Author(s):

Seung-Ah Choe ◽

Yoon-Bae Jun ◽

Sun-Young Kim

Keyword(s):

Air Pollution ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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291: Prediction of recurrence of hypertensive disorders of pregnancy in the term period, a retrospective cohort study

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2013.10.324 ◽

2014 ◽

Vol 210 (1) ◽

pp. S152-S153

Author(s):

Miriam van Oostwaard ◽

Josje Langenveld ◽

Ewoud Schuit ◽

Kiki Wigny ◽

Hilde van Susante ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Thin endometrium is associated with the risk of hypertensive disorders of pregnancy in fresh IVF/ICSI embryo transfer cycles: a retrospective cohort study of 9,266 singleton births

Reproductive Biology and Endocrinology ◽

10.1186/s12958-021-00738-9 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Xiaojie Liu ◽

Jingwan Wang ◽

Xiao Fu ◽

Jing Li ◽

Meng Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hypertensive Disorders Of Pregnancy ◽

Thin Endometrium ◽

Hypertensive Disorders ◽

Increased Risk ◽

Confounding Variables

Abstract Background Thin endometrial thickness (EMT) has been suggested to be associated with reduced incidence of pregnancy rate after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment, but the effect of thin endometrium on obstetric outcome is less investigated. This study aims to determine whether EMT affects the incidence of obstetric complications in fresh IVF/ICSI-embryo transfer (ET) cycles. Methods We conducted a retrospective cohort study collecting a total of 9266 women who had singleton livebirths after fresh IVF/ICSI-ET treatment cycles at the Center for Reproductive Medicine Affiliated to Shandong University between January 2014 and December 2018. The women were divided into three groups according to the EMT: 544 women with an EMT ≤8 mm, 6234 with an EMT > 8–12 mm, and 2488 with an EMT > 12 mm. The primary outcomes were the incidence of obstetric complications including hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), placental abruption, placenta previa, postpartum hemorrhage (PPH) and cesarean section. Multivariable logistic regression analysis was performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for associations between the EMT measured on the day of human chorionic gonadotropin (HCG) trigger and the risk of the outcomes of interest. Results The HDP incidence rate of pregnant women was highest in EMT ≤ 8 mm group and significantly higher than those in EMT from > 8–12 mm and EMT > 12 mm group, respectively (6.8% versus 3.6 and 3.5%, respectively; P = 0.001). After adjustment for confounding variables by multivariate logistic regression analysis, a thin EMT was still statistically significant associated with an increased risk of HDP. Compared with women with an EMT > 8–12 mm, women with an EMT ≤8 mm had an increased risk of HDP (aOR = 1.853, 95% CI 1.281–2.679, P = 0.001). Conclusion A thin endometrium (≤8 mm) was found to be associated with an increased risk of HDP after adjustment for confounding variables, indicating that the thin endometrium itself is a risk factor for HDP. Obstetricians should remain aware of the possibility of HDP when women with a thin EMT achieve pregnancy through fresh IVF/ICSI–ET treatment cycles.

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Prediction of recurrence of hypertensive disorders of pregnancy between 34 and 37 weeks of gestation: a retrospective cohort study

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2012.03312.x ◽

2012 ◽

Vol 119 (7) ◽

pp. 840-847 ◽

Cited By ~ 7

Author(s):

MF van Oostwaard ◽

J Langenveld ◽

R Bijloo ◽

KM Wong ◽

I Scholten ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Hypertensive Disorders Of Pregnancy ◽

Hypertensive Disorders

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Perinatal outcomes of women with hypertensive disorders of pregnancy in Jimma Medical Center, southwest Ethiopia: Retrospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0256520 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256520

Author(s):

Debela Dereje Jaleta ◽

Tadesse Gebremedhin ◽

Mulusew Gerbaba Jebena

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Medical Center ◽

Perinatal Outcomes ◽

Hypertensive Disorder ◽

Hypertensive Disorders Of Pregnancy ◽

Southwest Ethiopia ◽

Hypertensive Disorders ◽

Adverse Perinatal Outcomes

Background Hypertensive disorders of pregnancy (HDP) increases adverse perinatal outcomes in women with the disorder. About 16% of all still births and 10% of early neonatal deaths are accounted by HDP. In Ethiopia, HDP complicates about 6% of all pregnancies. Hence, the objective of this study was to determine the risk of adverse perinatal outcomes among women with HDP in Jimma Medical Center, southwest Ethiopia. Methods A retrospective cohort study was conducted on a total of 777 women who gave birth from June 2017 to March 2020 at Jimma Medical Center, southwest Ethiopia. Women with HDP and normotensive women who gave birth at or after 28 weeks of gestation were enrolled as exposed and unexposed respectively. Simple random sampling technique was used to select study participants. Data were reviewed using structured data collection performa that was prepared after reviewing relevant literatures. Data were entered to Epi-Data then exported to STATA version 13 for analysis. The adverse perinatal outcomes risk were examined using log binomial and modified Poisson regression model with robust standard errors. Results In this study, the overall incidence of adverse perinatal outcome was higher among women with hypertensive disorders of pregnancy (HDP) than normotensive women (64.1% versus 32.8%). After adjusting for confounders, women with HDP were at higher risk of babies with low birth weight (adjusted RR = 2.88 (2.2, 3.75)), preterm birth(aRR = 2.31(1.7, 3.14)), fifth minute low Apgar score (aRR = 2.6(1.53, 4.42)), admission to neonatal intensive care unit (aRR = 1.77(1.32, 2.37), stillbirth (aRR = 2.02(1.11, 3.01)), and perinatal mortality (aRR = 3.88(1.97, 7.66)) than normotensive women. Conclusion Women with hypertensive disorder of pregnancy were at higher risk of adverse perinatal outcomes than normotensive women who gave birth at Jimma Medical Center, southwest Ethiopia. Therefore, health care providers should strengthen prevention, early diagnosis and prompt management of HDP in order to reduce adverse perinatal outcomes.

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