This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy(HDP),covering epidemiology,potential mechanisms,and management strategies.HDP is the second leading cause ...This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy(HDP),covering epidemiology,potential mechanisms,and management strategies.HDP is the second leading cause of maternal and perinatal morbidity and mortality,encompassing subtypes such as gestational hypertension,preeclampsia,and eclampsia.Research indicates that anxiety is closely associated with the occurrence of HDP,potentially influencing blood pressure regulation and vascular function through neuroendocrine,inflammatory,genetic,and gut microbiota effects.Epidemiological data show that anxiety is prevalent during pregnancy and is linked to an increased risk of HDP.Biological mechanism studies reveal that anxiety can increase the risk of HDP by activating the hypothalamic-pituitary-adrenal axis,promoting inflammation,and affecting gut microbiota.In terms of treatment and management,psychological interventions(such as relaxation training,yoga,and mindfulness meditation)and pharmacological treatments(such as labetalol and nifedipine)play important roles in alleviating anxiety and improving the prognosis of HDP.Additionally,multidisciplinary collaboration and long-term postpartum follow-up are crucial for reducing the long-term risk of cardiovascular diseases.Despite significant progress in research on anxiety and HDP,many issues still require further exploration,including in-depth mechanism studies,optimization of clinical interventions,improvement of multidisciplinary collaboration models,long-term follow-up studies,and the impact of cultural and social factors.展开更多
BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),...BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),prediabetes,and mortality that are associated with hypertensive disorders of pregnancy.METHODS This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes,especially T2DM,prediabetes and mortality,related to hypertensive disorders of pregnancy in females aged 21-45.Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation.Propensity score matching was applied to balance covariates such as gestational diabetes,polycystic ovarian syndrome,chronic kidney disease,hy-perlipidemia,overweight/obesity,nicotine dependence,alcohol abuse,and healthcare utilization.This ensured comparability between groups and reduced potential confounding in outcome evaluation.RESULTS This study included 318544 females aged 21-45 with and without PIH.Females with PIH had higher risks of T2DM[hazard ratio(HR):1.907,95%confidence interval(CI):1.821-1.998),prediabetes(HR:1.610,95%CI:1.537-1.687),and mortality(HR:1.501,95%CI:1.361-1.655)over a follow-up of up to 18 years.Incidence rates for T2DM,prediabetes,and mortality were 3.2%,2.7%,and 0.6%,respectively.Subgroup analyses showed that the presence of gestational hypertension,preeclampsia,and eclampsia increased risks across all outcomes.Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality.Preventative aspirin use during pregnancy did not reduce the risks of T2DM,prediabetes,or mortality among those with PIH.CONCLUSION PIH significantly increases the long-term risks of T2DM,prediabetes,and mortality,highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.展开更多
Background:Hypertensive disorders of pregnancy(HDP)stands as a significant contributor to adverse maternal and fetal outcomes worldwide.However,current biomarkers lack specificity in distinguishing HDP from chronic hy...Background:Hypertensive disorders of pregnancy(HDP)stands as a significant contributor to adverse maternal and fetal outcomes worldwide.However,current biomarkers lack specificity in distinguishing HDP from chronic hypertension.Hence,we employed proteome-wide Mendelian randomization(MR)and colocalization analysis to decipher sensitive and specific markers for HDP via integrating multi-omics data.Methods:Genetic associations for plasma proteins were obtained from large-scale proteomic studies(e.g.,Iceland,Fenland,and UK Biobank).The summarized GWAS data of HDP and hypertension were acquired from the FinnGen consortium.A proteome-wide Mendelian randomization(MR)study was then implemented to identify the causal role of plasma proteins in HDP and hypertension.The results were further confirmed by transcriptome-wide association studies(TWAS)and colocalization analyses.Results:Proteome-wide MR identified 13 plasma proteins with potential causal links to HDP.Among them,peroxisomal acyl-coenzyme A oxidase 1(ACOX1)and glycine N-methyltransferase(GNMT)were classified as highly sensitive and specific markers differentiating from hypertension by integrating multi-omics evidence from expression quantitative trait loci(eQTL),protein quantitative trait loci(pQTL)and colocalization analyses.ACOX1 was identified as a risk factor,whereas GNMT demonstrated a protective effect.Enrichment analysis and protein-protein interaction(PPI)network mapping offered insights into underlying biological pathways.Conclusion:This study establishes the causal associations between 13 identified proteins and HDP,nominates that ACOX1 and GNMT are highly sensitive and specific markers for HDP distinguished from hypertension.Our findings offer valuable insights into the pathogenesis of HDP,paving the path for novel strategies in diagnosis and prevention.展开更多
Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital f...Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.展开更多
Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The...Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.展开更多
Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9...Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.展开更多
Summary： The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more in- formation regar...Summary： The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more in- formation regarding the risk factors for hypertensive disorders of pregnancy. A case-control study was performed on 373 hypertensive cases and 507 normotensive controls. Participants were recruited from 2008 to 2014 in Yichang Maternal and Child Health Care Center in Hubei province and Anyang Mater- nal and Child Health Care Hospital in Henan province, China. Socio-demographic factors, fam- ily-related factors, pregnancy-associated factors, factors related to daily life behaviors and psychosocial factors were investigated with respect to hypertensive disorders in pregnancy through well-designed questionnaire. Chi-square test, t-test, univariate logistic regression analysis, and multivariate logistic re- gression analysis were used to find the possible risk factors behind hypertensive disorders in pregnancy. The results showed that family history of cardiovascular diseases （OR=6.18, 95% CI, 2.37 to 16.14）, history of pregnancy-induced hypertension （OR=16.64, 95% CI, 5.74 to 48.22）, low maternal educa- tional level （OR=2.81, 95% CI, 1.30 to 6.04）, and poor relationship with their parents-in-law （OR=3.44, 95% CI, 1.55 to 7.59） had statistically significant associations with hypertensive disorders in pregnancy through multivariate logistic regression analysis. Increased maternal age, increased pre-pregnancy body mass index, living in rural area, low paternal education level, family history of hypertension, passive smoking one year before and/or in pregnancy, and poor sleeping quality were significantly associated with hypertensive disorders in pregnancy from univariate logistic regression analysis while the associa- tions became uncertain when they were entered for multivariate logistic regression analysis. It was con- cluded that family history of cardiovascular diseases, history of pregnancy-induced hypertension, low maternal educational level, and poor relationship with their parents-in-law were independent risk factors for hypertensive disorders among Chinese pregnant women.展开更多
Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with i...Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.展开更多
Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, w...Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.展开更多
Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal p...Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal prognosis of these women with Hypertension during pregnancy. Material and Method: We conducted a cross-sectional study, we interview patients and after discussion we transcripts in a database in Excel software before analysis with SPSS version 20.0 and Stata 14.0 The qualitative variables have been summarised by the Percentage and the quantitative variables will be summarised by Means and Standard Deviation. The associations of the variables were calculated by Pearson’s chi-square test with a significance level set at a p-value Result: The average age of the patients was 30.33 ± 7.020 years, 92.1% were married, 79.8% lived in urban areas, most of the patients were overweight (43%), 92.1% of them had monofetal pregnancies, 36% were multiparous, 34.2% had a previous history of preeclampsia in pregnancy and 14% were known to have hypertension. Pre-eclampsia was the most frequent form of hypertension in pregnancy with 73.68% of cases and represents 84.8% of severe forms of hypertension in pregnancy, 53.4% of the patients delivered vaginally. Eclampsia was the most frequent complication in our patients with 31.7% frequency and among the socio-demographic parameters, age and body mass index were significantly associated with maternal complications. Conclusion: Maternal age and body mass index are important socio-demographic factors associated with the occurrence of maternal complications in women with hypertensive disorders in pregnancy.展开更多
The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: ...The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had </span><span style="font-family:Verdana;">the hypertensive</span><span style="font-family:Verdana;"> disorders of pregnancy. </span><span style="font-family:Verdana;">The Gestational</span><span style="font-family:Verdana;"> HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> < 0.05). Conclusion: HDP </span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> common in Parakou. Some factors previously described in the literature are associated with them.展开更多
<strong><em>Introduction</em></strong><span style="white-space:normal;"><b><span style="font-family:;" "="">: </span></b></sp...<strong><em>Introduction</em></strong><span style="white-space:normal;"><b><span style="font-family:;" "="">: </span></b></span><span style="white-space:normal;"><span style="font-family:;" "="">Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. <b><i>Methods</i>: </b>The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. <b><i>Results</i>: </b>During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). <b><i>Conclusion</i>: </b>The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.</span></span>展开更多
Objective Toinvestigate theepidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy(HDP)in Shenzhen,China.Methods This study was a cross-sectional study.Data were based on the Shenzh...Objective Toinvestigate theepidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy(HDP)in Shenzhen,China.Methods This study was a cross-sectional study.Data were based on the Shenzhen Birth Cohort.Pregnant women who gave birth from January 1,2018 to March 31,2023 were included.Incidence and change trends of HDP and its different pathological types were analyzed.The enrolled pregnant women were divided into the HDP group and the non-HDP group according to whether HDP occurred.General clinical data and pregnancy outcomes were collected from both groups.The incidence of adverse pregnancy outcomes among pregnant women with different pathological types of HDP was analyzed,and subgroup analyses were performed based on age and body mass index(BMI).Results A total of 90117 pregnant women were enrolled,aged(31.6±4.4)years.There were 4117 cases in the HDP group and 86000 in the non-HDP group.The overall incidence of HDP in the whole study population was 4.57%(4117/90117).From 2018—2023,the incidence of HDP in Shenzhen showed an increasing trend year by year,from 2.88%(523/18155)to 7.04%(271/3851).Specifically,the incidence of gestational hypertension increased from 0.93%(168/18155)to3.09%(119/3851),the incidence of preeclampsia-eclampsia increased from 1.78%(323/18155)to3.17%(122/3851),the incidence of chronic hypertension increased from 0.01%(1/18155)to 0.42%(16/3851),and the incidence of chronic hypertension with superimposed preeclampsia increased from 0.17%(31/18155)to 0.36%(14/3851).The age((32.8±4.8)years vs.(31.5±4.3)years,P<0.05)and BMI in the first trimester((23.37±3.77)kg/m^(2)vs.(21.35±2.91)kg/m^(2),P<0.05)of HDP group were higher than those of the non-HDP group.Subgroup analysis showed that the incidence of HDP in pregnant women aged≥50.0 years was the highest in all age subgroups(42.86%(6/14)).The incidence of HDP in pregnant women with BMI≥30.0 kg/m^(2)in the first trimester was the highest among all BMI subgroups(20.44%(241/1179)).The proportions of preterm birth,gestational diabetes,fetal growth restriction,small for gestational age,placental abruption,and late abortion in HDP group were 30.82%(1269/4117),30.46%(1254/4117),6.80%(280/4117),4.86%(200/4117),3.59%(148/4117),and 0.80%(33/4117),respectively.Conclusion The incidence of HDP among pregnant women has been increased year by year in Shenzhen,China.With the increase in age and BMI during early pregnancy,the incidence of HDP shows an overall upward trend.展开更多
Background： Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy （HDP） can easily compromise blood supply to vital organs including uteroplacental perfus...Background： Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy （HDP） can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy （GDFT） with LiDCOrapid system can improve well-being of both HDP parturient and their babies. Methods： Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer＇s solution （LR）, parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume （ASV） provided via LiDCO rapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. Results： The severity of HDP was similar between two groups. The total LR infusion （P 〈 0.01） and urine output （P 〈 0.05） were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group （P 〈 0.01）. There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased （P 〈 0.05）, and the incidences of neonatal hypercapnia and hypoxemia were statistically increased （P 〈 0.05） than in the GDFT group. Conclusions： Dynamic responsiveness guided fluid therapy with the LiDCOrapid system may provide potential benefits to stable HDP parturient and their babies.展开更多
Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high...Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy （HDP） and estimated the potential effect of anti-oxidants administration, including vitamin C （VC）, vitamin E （VE） and Salvia Miltiorrhiza L （SML）, a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy. Methods From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups： 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group. Results （1）The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups （P〉0.05）. （2） In anti-oxidants group, the HDP morbidities among three subgroups： VC ＋ VE ＋ SML, VC ＋ VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies （P 〉0.05）. （3） The related index of factors affecting HDP showed in intensity sequence as follows： family HDP history 〉 profession 〉 education level 〉 age 〉 body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women （family HDP history, heavy physical labor, low education level （middle school and below）, age 〉40, body mass index 〉24） was 5.84%, which was obviously higher than that in normal population （P 〈0.01）. In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% （P〈0.01）. （4） In control group, the morbidity of HDP in women with family HDP history （especially with sisters＇）, heavy physical labor, middle school and below, age 〉35 was： 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group. Conclusions The high-risk factors prone to induce HDP included： family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.展开更多
Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved problems.It is one of the major causes of maternal and perinatal morbidity and mortality.This study estimate...Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved problems.It is one of the major causes of maternal and perinatal morbidity and mortality.This study estimates the prevalence of hypertensive disorders of pregnancy,their associated risk factors and pregnancy complications in primiparous women.Methods:All primigravida who gave birth in our hospital from December 2020 to December 2021 were included in the study.The prevalence,risk factors,mode of delivery,and maternal and fetal outcomes of hypertensive disorders of pregnancy in primigravidae were collected from the patient's medical records.Statistical analysis was done using the SPSS 18.0 software package.The Chi-square test was used to analyse the association between the risk factors and hypertensive disorders of pregnancy in primigravida.Results:A total of 807 women were included in the study,and the mean age was 26.34±3.84 years.The prevalence of hypertensive disorders of pregnancy in primigravidae was found to be 18.6%.Among the prevalent population,79.3%of women had gestational hypertension.The findings indicate that hypertension in pregnancy has a significant relationship with risk factors such as increased maternal age(p<0.004),family history of hypertension in pregnancy(p<0.001),body mass index>30 kg/m^(2)(p<0.001),hyperglycaemia in pregnancy(p<0.001),IVF pregnancy(p<0.004)and polycystic ovary syndrome(p<0.001).The most reported adverse maternal and perinatal outcomes were placental abruption(p<0.001),postpartum haemorrhage(p<0.001),prematurity(p<0.001),and fetal growth restriction(p<0.001).Conclusion:The study emphasises the importance of knowledge and timely assessment of risk factors of HDP.It also highlights the need for pre-conceptional counselling,which includes early detection,careful monitoring and treatment of HDP for preventing morbidity and mortality related to this disorder and it should be followed up even in the postpartum period.展开更多
妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)是一类妊娠和血压升高并存的产科常见并发症,涵盖了妊娠期高血压(gestational hypertension,GH)、子痫前期(preeclampsia,PE)、妊娠合并慢性高血压(chronic hypertension)和...妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)是一类妊娠和血压升高并存的产科常见并发症,涵盖了妊娠期高血压(gestational hypertension,GH)、子痫前期(preeclampsia,PE)、妊娠合并慢性高血压(chronic hypertension)和慢性高血压并发子痫前期(chronic hypertension with superimposed pre-eclampsia)。这些疾病是导致孕产妇及围产儿死亡的主要原因之一。展开更多
Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically...Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.展开更多
Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of h...Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.展开更多
<strong>Introduction:</strong> Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive...<strong>Introduction:</strong> Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive pregnant women in Comè district hospital from 2014 to 2016. <strong>Methods:</strong> This is a retrospective, analytical study carried out in June 2016, involving a total of 345 hypertensive patients. Socio-demographic and medical features, including pregnancy and foetal outcomes parameters, were recorded in the case files. Top-down stepwise logistic regression was performed at the 5% threshold. <strong>Results:</strong> The frequency of hypertensive disorders during pregnancy was estimated at 7.32% and unfavourable outcomes at 35.65%. The adverse maternal outcomes recorded were postpartum death and haemorrhage whereas adverse foetal issues were prematurity, low birth weight, low Apgar scores, stillbirth and death. Factors statistically associated with pregnancy outcome were paucigravida (OR = 2.01 ([1.05 - 3.88]), p = 0.035), history of stillbirth (OR = 4.75 ([1.01 - 22.1]), p = 0.048) and anticonvulsant therapy (OR = 0.32 ([0.19 - 0.54]), p < 0.001). <strong>Conclusion:</strong> Adequate monitoring via Antenatal Care (ANC) check-ups, timely recourse to care and an effective communication strategy should reduce hypertensive disorders incidence and adverse outcomes in pregnant women.展开更多
文摘This article comprehensively explores the relationship between anxiety and hypertensive disorders of pregnancy(HDP),covering epidemiology,potential mechanisms,and management strategies.HDP is the second leading cause of maternal and perinatal morbidity and mortality,encompassing subtypes such as gestational hypertension,preeclampsia,and eclampsia.Research indicates that anxiety is closely associated with the occurrence of HDP,potentially influencing blood pressure regulation and vascular function through neuroendocrine,inflammatory,genetic,and gut microbiota effects.Epidemiological data show that anxiety is prevalent during pregnancy and is linked to an increased risk of HDP.Biological mechanism studies reveal that anxiety can increase the risk of HDP by activating the hypothalamic-pituitary-adrenal axis,promoting inflammation,and affecting gut microbiota.In terms of treatment and management,psychological interventions(such as relaxation training,yoga,and mindfulness meditation)and pharmacological treatments(such as labetalol and nifedipine)play important roles in alleviating anxiety and improving the prognosis of HDP.Additionally,multidisciplinary collaboration and long-term postpartum follow-up are crucial for reducing the long-term risk of cardiovascular diseases.Despite significant progress in research on anxiety and HDP,many issues still require further exploration,including in-depth mechanism studies,optimization of clinical interventions,improvement of multidisciplinary collaboration models,long-term follow-up studies,and the impact of cultural and social factors.
基金Supported by Chung Shan Medical University,No.CSMU-INT-113-14.
文摘BACKGROUND The impact of varying degrees of pregnancy-induced hypertension(PIH)on the risk of developing diabetes later in life is currently unknown.AIM To assess the long-term risks of type 2 diabetes mellitus(T2DM),prediabetes,and mortality that are associated with hypertensive disorders of pregnancy.METHODS This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes,especially T2DM,prediabetes and mortality,related to hypertensive disorders of pregnancy in females aged 21-45.Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation.Propensity score matching was applied to balance covariates such as gestational diabetes,polycystic ovarian syndrome,chronic kidney disease,hy-perlipidemia,overweight/obesity,nicotine dependence,alcohol abuse,and healthcare utilization.This ensured comparability between groups and reduced potential confounding in outcome evaluation.RESULTS This study included 318544 females aged 21-45 with and without PIH.Females with PIH had higher risks of T2DM[hazard ratio(HR):1.907,95%confidence interval(CI):1.821-1.998),prediabetes(HR:1.610,95%CI:1.537-1.687),and mortality(HR:1.501,95%CI:1.361-1.655)over a follow-up of up to 18 years.Incidence rates for T2DM,prediabetes,and mortality were 3.2%,2.7%,and 0.6%,respectively.Subgroup analyses showed that the presence of gestational hypertension,preeclampsia,and eclampsia increased risks across all outcomes.Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality.Preventative aspirin use during pregnancy did not reduce the risks of T2DM,prediabetes,or mortality among those with PIH.CONCLUSION PIH significantly increases the long-term risks of T2DM,prediabetes,and mortality,highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.
基金supported by grants from the Natural Science Foundation of Gansu Province(24JRRA937 and 25JRRA1234)grants from the National Natural Science Foundation of China(82360469)+1 种基金Scientific research projects in the health industry of Gansu Province(GSWSKY2025-23)Research Project for Introduced Talents of Northwest Minzu University(xbmuyjrc2023020).
文摘Background:Hypertensive disorders of pregnancy(HDP)stands as a significant contributor to adverse maternal and fetal outcomes worldwide.However,current biomarkers lack specificity in distinguishing HDP from chronic hypertension.Hence,we employed proteome-wide Mendelian randomization(MR)and colocalization analysis to decipher sensitive and specific markers for HDP via integrating multi-omics data.Methods:Genetic associations for plasma proteins were obtained from large-scale proteomic studies(e.g.,Iceland,Fenland,and UK Biobank).The summarized GWAS data of HDP and hypertension were acquired from the FinnGen consortium.A proteome-wide Mendelian randomization(MR)study was then implemented to identify the causal role of plasma proteins in HDP and hypertension.The results were further confirmed by transcriptome-wide association studies(TWAS)and colocalization analyses.Results:Proteome-wide MR identified 13 plasma proteins with potential causal links to HDP.Among them,peroxisomal acyl-coenzyme A oxidase 1(ACOX1)and glycine N-methyltransferase(GNMT)were classified as highly sensitive and specific markers differentiating from hypertension by integrating multi-omics evidence from expression quantitative trait loci(eQTL),protein quantitative trait loci(pQTL)and colocalization analyses.ACOX1 was identified as a risk factor,whereas GNMT demonstrated a protective effect.Enrichment analysis and protein-protein interaction(PPI)network mapping offered insights into underlying biological pathways.Conclusion:This study establishes the causal associations between 13 identified proteins and HDP,nominates that ACOX1 and GNMT are highly sensitive and specific markers for HDP distinguished from hypertension.Our findings offer valuable insights into the pathogenesis of HDP,paving the path for novel strategies in diagnosis and prevention.
文摘Objective:To evaluate the effect of labetalol combined with aspirin on improving blood pressure in patients with hypertensive disorders of pregnancy(HDP).Methods:Eighty-two patients with HDP who visited the hospital from August 2022 to August 2024 were selected as samples and randomly divided into two groups.Group A was treated with labetalol and aspirin,while Group B was treated with labetalol only.The efficacy,blood pressure,vascular endothelial function,coagulation indexes,and pregnancy outcomes were compared between the two groups.Results:The efficacy of Group A was higher than that of Group B(P<0.05).The systolic blood pressure(SBP),diastolic blood pressure(DBP),and endothelin-1(ET-1)in Group A were lower than those in Group B(P<0.05).The prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)in Group A were all better than those in Group B(P<0.05).The rate of adverse pregnancy outcomes in Group A was lower than that in Group B(P<0.05).Conclusion:The combination of labetalol and aspirin for the treatment of HDP can stabilize blood pressure,optimize vascular endothelial function,improve coagulation indexes and pregnancy outcomes,which is highly effective and feasible.
文摘Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.
文摘Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.
基金supported by National Natural Science Foundation of China(No.81172679/H2605)
文摘Summary： The prevalence of hypertensive disorders in China was much higher than that in the United States. Considering the large population with wide geographic area of China, we aimed to add more in- formation regarding the risk factors for hypertensive disorders of pregnancy. A case-control study was performed on 373 hypertensive cases and 507 normotensive controls. Participants were recruited from 2008 to 2014 in Yichang Maternal and Child Health Care Center in Hubei province and Anyang Mater- nal and Child Health Care Hospital in Henan province, China. Socio-demographic factors, fam- ily-related factors, pregnancy-associated factors, factors related to daily life behaviors and psychosocial factors were investigated with respect to hypertensive disorders in pregnancy through well-designed questionnaire. Chi-square test, t-test, univariate logistic regression analysis, and multivariate logistic re- gression analysis were used to find the possible risk factors behind hypertensive disorders in pregnancy. The results showed that family history of cardiovascular diseases （OR=6.18, 95% CI, 2.37 to 16.14）, history of pregnancy-induced hypertension （OR=16.64, 95% CI, 5.74 to 48.22）, low maternal educa- tional level （OR=2.81, 95% CI, 1.30 to 6.04）, and poor relationship with their parents-in-law （OR=3.44, 95% CI, 1.55 to 7.59） had statistically significant associations with hypertensive disorders in pregnancy through multivariate logistic regression analysis. Increased maternal age, increased pre-pregnancy body mass index, living in rural area, low paternal education level, family history of hypertension, passive smoking one year before and/or in pregnancy, and poor sleeping quality were significantly associated with hypertensive disorders in pregnancy from univariate logistic regression analysis while the associa- tions became uncertain when they were entered for multivariate logistic regression analysis. It was con- cluded that family history of cardiovascular diseases, history of pregnancy-induced hypertension, low maternal educational level, and poor relationship with their parents-in-law were independent risk factors for hypertensive disorders among Chinese pregnant women.
基金This study was funded by the Indonesia Endowment Fund for Education(LPDP)with Reference number S-422/LPDP.3/2018.
文摘Objective:To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women.Methods:A literature search was conducted using three categories of terms with its synonyms or related words:"iron","supplement",“hypertensive disorders in pregnancy”through MEDLINE(OVID),CINAHL,PubMed,Cochrane Library,Scopus,Web of Science,ICTRP,and ClinicalTrials.gov,and manual search of references was used in seven potential resources.The inclusion criteria were randomized control trials(RCTs),published in English,full-text available,having healthy pregnant women without anaemia for study participants,and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome.The risk of bias assessment tool was used for quality appraisal.Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio(OR)for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy.The range of the study’s estimation accuracy was reflected by a 95%confidence interval(CI).Results:Four RCTs were included in the meta-analysis.The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy(OR 0.93,95%CI 0.81-1.07;P=0.30),gestational hypertension(OR 1.37,95%CI 0.69-2.73;P=0.36)as well as on the development of preeclampsia(OR 1.45,95%CI 0.71-2.97;P=0.31).Conclusions:Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women.In general,there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women,and further studies are needed.
基金The present study was supported by the National Natural Science Foundation of China(Grant No.82003415)the National Key Research&Development(R&D)Program of China(Grant No.2021YFC2700705).
文摘Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.
文摘Background: Hypertensive disease in pregnancy is an important cause of morbidity, long-term disability, and maternal and neonatal mortality. The aim is to determine the socio-demographic characteristics and maternal prognosis of these women with Hypertension during pregnancy. Material and Method: We conducted a cross-sectional study, we interview patients and after discussion we transcripts in a database in Excel software before analysis with SPSS version 20.0 and Stata 14.0 The qualitative variables have been summarised by the Percentage and the quantitative variables will be summarised by Means and Standard Deviation. The associations of the variables were calculated by Pearson’s chi-square test with a significance level set at a p-value Result: The average age of the patients was 30.33 ± 7.020 years, 92.1% were married, 79.8% lived in urban areas, most of the patients were overweight (43%), 92.1% of them had monofetal pregnancies, 36% were multiparous, 34.2% had a previous history of preeclampsia in pregnancy and 14% were known to have hypertension. Pre-eclampsia was the most frequent form of hypertension in pregnancy with 73.68% of cases and represents 84.8% of severe forms of hypertension in pregnancy, 53.4% of the patients delivered vaginally. Eclampsia was the most frequent complication in our patients with 31.7% frequency and among the socio-demographic parameters, age and body mass index were significantly associated with maternal complications. Conclusion: Maternal age and body mass index are important socio-demographic factors associated with the occurrence of maternal complications in women with hypertensive disorders in pregnancy.
文摘The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had </span><span style="font-family:Verdana;">the hypertensive</span><span style="font-family:Verdana;"> disorders of pregnancy. </span><span style="font-family:Verdana;">The Gestational</span><span style="font-family:Verdana;"> HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> < 0.05). Conclusion: HDP </span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> common in Parakou. Some factors previously described in the literature are associated with them.
文摘<strong><em>Introduction</em></strong><span style="white-space:normal;"><b><span style="font-family:;" "="">: </span></b></span><span style="white-space:normal;"><span style="font-family:;" "="">Hypertensive disorders of pregnancy (HDP) are often accompanied by cardiovascular sequelae. The objective of this study was to describe the prognosis in the postpartum period of patients with HDP in Departmental University Hospital of Borgou CHUD-B from Parakou in 2020. <b><i>Methods</i>: </b>The study was prospective with a descriptive and analytical design and was conducted from January 2020 to September 2020. Patients with HDP were recruited from the gynecology-obstetrics department and each followed for 3 months in the cardiology department. HDP was classified according to the International Society for the Study of Hypertension in Pregnancy, and blood pressure (BP) was taken according to WHO recommendations. Self-measurement of BP at home was performed to assess blood pressure control outside the hospital. Epidata 3.1 and SPSS 21 software were used for data processing and analysis. P values < 5% were considered statistically significant. <b><i>Results</i>: </b>During the study period, the hospital frequency of HDP was 15.6%. The frequency of maternal complications in the postpartum period was 28% (severe hypertension: 23.2%;eclampsia: 3.6%;puerperal psychosis: 1.2%). At the end of the three-month follow-up, blood pressure returned to normal in 73.2% of cases;it persisted in 26.8% of women. Factors associated with persistence of hypertension after multivariate analysis were, overweight/obesity RRa 8.664 [1.566 - 47.941], (p = 0.013);family history of hypertension RRa 6.499 [1.493 - 28.289], (p = 0.013);history of hypertension in previous pregnancies RRa 7.764 [1.561 - 38.601], (p < 0.012). <b><i>Conclusion</i>: </b>The frequency of HDP is not negligible at CHUD-B/A. The evolution of these HDP was marked in more than a quarter of cases by complications in the postpartum period followed by a persistence of hypertension 3 months after childbirth predicted by cardiovascular risk factors.</span></span>
文摘Objective Toinvestigate theepidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy(HDP)in Shenzhen,China.Methods This study was a cross-sectional study.Data were based on the Shenzhen Birth Cohort.Pregnant women who gave birth from January 1,2018 to March 31,2023 were included.Incidence and change trends of HDP and its different pathological types were analyzed.The enrolled pregnant women were divided into the HDP group and the non-HDP group according to whether HDP occurred.General clinical data and pregnancy outcomes were collected from both groups.The incidence of adverse pregnancy outcomes among pregnant women with different pathological types of HDP was analyzed,and subgroup analyses were performed based on age and body mass index(BMI).Results A total of 90117 pregnant women were enrolled,aged(31.6±4.4)years.There were 4117 cases in the HDP group and 86000 in the non-HDP group.The overall incidence of HDP in the whole study population was 4.57%(4117/90117).From 2018—2023,the incidence of HDP in Shenzhen showed an increasing trend year by year,from 2.88%(523/18155)to 7.04%(271/3851).Specifically,the incidence of gestational hypertension increased from 0.93%(168/18155)to3.09%(119/3851),the incidence of preeclampsia-eclampsia increased from 1.78%(323/18155)to3.17%(122/3851),the incidence of chronic hypertension increased from 0.01%(1/18155)to 0.42%(16/3851),and the incidence of chronic hypertension with superimposed preeclampsia increased from 0.17%(31/18155)to 0.36%(14/3851).The age((32.8±4.8)years vs.(31.5±4.3)years,P<0.05)and BMI in the first trimester((23.37±3.77)kg/m^(2)vs.(21.35±2.91)kg/m^(2),P<0.05)of HDP group were higher than those of the non-HDP group.Subgroup analysis showed that the incidence of HDP in pregnant women aged≥50.0 years was the highest in all age subgroups(42.86%(6/14)).The incidence of HDP in pregnant women with BMI≥30.0 kg/m^(2)in the first trimester was the highest among all BMI subgroups(20.44%(241/1179)).The proportions of preterm birth,gestational diabetes,fetal growth restriction,small for gestational age,placental abruption,and late abortion in HDP group were 30.82%(1269/4117),30.46%(1254/4117),6.80%(280/4117),4.86%(200/4117),3.59%(148/4117),and 0.80%(33/4117),respectively.Conclusion The incidence of HDP among pregnant women has been increased year by year in Shenzhen,China.With the increase in age and BMI during early pregnancy,the incidence of HDP shows an overall upward trend.
文摘Background： Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy （HDP） can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy （GDFT） with LiDCOrapid system can improve well-being of both HDP parturient and their babies. Methods： Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer＇s solution （LR）, parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume （ASV） provided via LiDCO rapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. Results： The severity of HDP was similar between two groups. The total LR infusion （P 〈 0.01） and urine output （P 〈 0.05） were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group （P 〈 0.01）. There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased （P 〈 0.05）, and the incidences of neonatal hypercapnia and hypoxemia were statistically increased （P 〈 0.05） than in the GDFT group. Conclusions： Dynamic responsiveness guided fluid therapy with the LiDCOrapid system may provide potential benefits to stable HDP parturient and their babies.
文摘Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy （HDP） and estimated the potential effect of anti-oxidants administration, including vitamin C （VC）, vitamin E （VE） and Salvia Miltiorrhiza L （SML）, a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy. Methods From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups： 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group. Results （1）The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups （P〉0.05）. （2） In anti-oxidants group, the HDP morbidities among three subgroups： VC ＋ VE ＋ SML, VC ＋ VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies （P 〉0.05）. （3） The related index of factors affecting HDP showed in intensity sequence as follows： family HDP history 〉 profession 〉 education level 〉 age 〉 body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women （family HDP history, heavy physical labor, low education level （middle school and below）, age 〉40, body mass index 〉24） was 5.84%, which was obviously higher than that in normal population （P 〈0.01）. In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% （P〈0.01）. （4） In control group, the morbidity of HDP in women with family HDP history （especially with sisters＇）, heavy physical labor, middle school and below, age 〉35 was： 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group. Conclusions The high-risk factors prone to induce HDP included： family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.
文摘Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved problems.It is one of the major causes of maternal and perinatal morbidity and mortality.This study estimates the prevalence of hypertensive disorders of pregnancy,their associated risk factors and pregnancy complications in primiparous women.Methods:All primigravida who gave birth in our hospital from December 2020 to December 2021 were included in the study.The prevalence,risk factors,mode of delivery,and maternal and fetal outcomes of hypertensive disorders of pregnancy in primigravidae were collected from the patient's medical records.Statistical analysis was done using the SPSS 18.0 software package.The Chi-square test was used to analyse the association between the risk factors and hypertensive disorders of pregnancy in primigravida.Results:A total of 807 women were included in the study,and the mean age was 26.34±3.84 years.The prevalence of hypertensive disorders of pregnancy in primigravidae was found to be 18.6%.Among the prevalent population,79.3%of women had gestational hypertension.The findings indicate that hypertension in pregnancy has a significant relationship with risk factors such as increased maternal age(p<0.004),family history of hypertension in pregnancy(p<0.001),body mass index>30 kg/m^(2)(p<0.001),hyperglycaemia in pregnancy(p<0.001),IVF pregnancy(p<0.004)and polycystic ovary syndrome(p<0.001).The most reported adverse maternal and perinatal outcomes were placental abruption(p<0.001),postpartum haemorrhage(p<0.001),prematurity(p<0.001),and fetal growth restriction(p<0.001).Conclusion:The study emphasises the importance of knowledge and timely assessment of risk factors of HDP.It also highlights the need for pre-conceptional counselling,which includes early detection,careful monitoring and treatment of HDP for preventing morbidity and mortality related to this disorder and it should be followed up even in the postpartum period.
文摘妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)是一类妊娠和血压升高并存的产科常见并发症,涵盖了妊娠期高血压(gestational hypertension,GH)、子痫前期(preeclampsia,PE)、妊娠合并慢性高血压(chronic hypertension)和慢性高血压并发子痫前期(chronic hypertension with superimposed pre-eclampsia)。这些疾病是导致孕产妇及围产儿死亡的主要原因之一。
文摘Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.
文摘Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.
文摘<strong>Introduction:</strong> Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive pregnant women in Comè district hospital from 2014 to 2016. <strong>Methods:</strong> This is a retrospective, analytical study carried out in June 2016, involving a total of 345 hypertensive patients. Socio-demographic and medical features, including pregnancy and foetal outcomes parameters, were recorded in the case files. Top-down stepwise logistic regression was performed at the 5% threshold. <strong>Results:</strong> The frequency of hypertensive disorders during pregnancy was estimated at 7.32% and unfavourable outcomes at 35.65%. The adverse maternal outcomes recorded were postpartum death and haemorrhage whereas adverse foetal issues were prematurity, low birth weight, low Apgar scores, stillbirth and death. Factors statistically associated with pregnancy outcome were paucigravida (OR = 2.01 ([1.05 - 3.88]), p = 0.035), history of stillbirth (OR = 4.75 ([1.01 - 22.1]), p = 0.048) and anticonvulsant therapy (OR = 0.32 ([0.19 - 0.54]), p < 0.001). <strong>Conclusion:</strong> Adequate monitoring via Antenatal Care (ANC) check-ups, timely recourse to care and an effective communication strategy should reduce hypertensive disorders incidence and adverse outcomes in pregnant women.
