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Hypertensive disorders of pregnancy

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https://www.readbyqxmd.com/read/28817493/dna-methylation-of-the-glucocorticoid-receptor-gene-promoter-in-the-placenta-is-associated-with-blood-pressure-regulation-in-human-pregnancy
#1
Sulistyo E Dwi Putra, Christoph Reichetzeder, Martin Meixner, Karsten Liere, Torsten Slowinski, Berthold Hocher
BACKGROUND: Blood pressure (BP) regulation during pregnancy is influenced by hormones of placental origin. It was shown that the glucocorticoid system is altered in hypertensive pregnancy disorders such as preeclampsia. Epigenetic mechanism might influence the activity of genes involved in placental hormone/hormone receptor synthesis/action during pregnancy. METHOD: In the current study, we analyzed the association of 5'-C-phosphate-G-3' (CpG) site methylation of different glucocorticoid receptor gene (NR3C1) promoter regions with BP during pregnancy...
August 16, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28816365/hypertensive-disorders-in-pregnancy-and-the-risk-of-subsequent-cardiovascular-disease
#2
Sonia M Grandi, Karine Vallée-Pouliot, Pauline Reynier, Maria Eberg, Robert W Platt, Roxane Arel, Olga Basso, Kristian B Filion
BACKGROUND: Hypertensive disorders in pregnancy (HDP) have been shown to predict later risk of cardiovascular disease (CVD). However, previous studies have not accounted for subsequent pregnancies and their complications, which are potential confounders and intermediates of this association. METHODS: A cohort of 146 748 women with a first pregnancy was constructed using the Clinical Practice Research Datalink. HDP was defined using diagnostic codes, elevated blood pressure readings, or new use of an anti-hypertensive drug between 18 weeks' gestation and 6 weeks post-partum...
August 17, 2017: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/28815596/use-of-first-trimester-placenta-growth-factor-concentration-to-predict-hypertensive-disorders-of-pregnancy-in-a-low-risk-asian-population
#3
Manisha Kumar, Karuna Sharma, Shalini Singh, Ritu Singh, Abha Singh, Jayashree Bhattacharjee
OBJECTIVE: To determine the value of placenta growth factor (PlGF) for predicting hypertensive disorders of pregnancy (HDP) in a low-risk population when used either alone or in combination with other markers. METHODS: A prospective observational cohort study was conducted among women with singleton pregnancy in the first trimester in New Delhi, India, between October 1, 2013, and September 30, 2016. First-trimester measures included maternal history, body mass index (BMI), mean arterial pressure (MAP), Doppler uterine artery pulsatility index, and serum levels of biomarkers (including PlGF)...
August 17, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28805261/pregnancy-outcomes-and-impact-of-pregnancy-on-graft-function-in-women-after-kidney-transplantation
#4
Fa Mohammadi, M Borg, A Gulyani, S P Mcdonald, S Jesudason
BACKGROUND: Kidney transplantation facilitates pregnancy in women with end-stage kidney disease, however impact of pregnancy on short and longer-term graft function is uncertain. METHODS: Obstetric, foetal and graft outcomes for pregnancies from a large Australian transplant unit (1976-2015) were reviewed. RESULTS: There were 56 pregnancies in 35 women with mean age at conception 30.4±0.6 years and mean transplant-pregnancy interval 5.5±0...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28803548/gestational-hypertensive-disorders-and-retinal-microvasculature-the-generation-r-study
#5
Laura Benschop, Sarah Schalekamp-Timmermans, Jeanine E Roeters van Lennep, Vincent W V Jaddoe, Tien Yin Wong, Carol Y Cheung, Eric A P Steegers, Kamran M Ikram
BACKGROUND: Changes in the microvasculature associated with pre-eclampsia and gestational hypertension have been proposed as a potential pathway in the development of cardiovascular disease. We examined whether gestational hypertensive disorders, such as pre-eclampsia and gestational hypertension, are related to the maternal retinal microvasculature status after pregnancy. METHODS: This study is part of an ongoing population-based prospective cohort study. During pregnancy and 6...
August 14, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28799164/preconception-care-for-diabetic-women-for-improving-maternal-and-infant-health
#6
REVIEW
Joanna Tieu, Philippa Middleton, Caroline A Crowther, Emily Shepherd
BACKGROUND: Infants born to mothers with pre-existing type 1 or type 2 diabetes mellitus are at greater risk of congenital anomalies, perinatal mortality and significant morbidity in the short and long term. Pregnant women with pre-existing diabetes are at greater risk of perinatal morbidity and diabetic complications. The relationship between glycaemic control and health outcomes for both mothers and infants indicates the potential for preconception care for these women to be of benefit...
August 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28796684/maternal-and-infant-outcomes-after-human-papillomavirus-vaccination-in-the-periconceptional-period-or-during-pregnancy
#7
Heather S Lipkind, Gabriela Vazquez-Benitez, James D Nordin, Paul A Romitti, Allison L Naleway, Nicola P Klein, Rulin C Hechter, Michael L Jackson, Simon J Hambidge, Grace M Lee, Lakshmi Sukumaran, Elyse O Kharbanda
OBJECTIVE: To evaluate whether quadrivalent human papillomavirus (HPV) vaccine administered during the periconceptional period or during pregnancy was associated with increased risks for adverse obstetric events, adverse birth outcomes, or selected major structural birth defects. METHODS: We conducted a retrospective, observational cohort study using administrative and health care data from the Vaccine Safety Datalink. Insured women 13-27 years old with singleton pregnancies and a live birth from January 1, 2007, through September 1, 2013, who received quadrivalent HPV vaccine during the periconceptional period (2 weeks before to 2 weeks after their last menstrual period), during pregnancy, or during both periods combined were compared with women who had a live birth during the same time period and received quadrivalent HPV vaccine 4-18 months before their last menstrual period...
August 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28796394/maternal-haemodynamics-in-normal-pregnancies-and-in-pregnancies-affected-by-pre-eclampsia
#8
Daniel Stott, Obianuju Nzelu, Kypros H Nicolaides, Nikos A Kametas
OBJECTIVES: To determine if in a high risk group in the first half of pregnancy, women who developed pre-eclampsia (PE) with fetal growth restriction (PE-FGR) demonstrate distinct haemodynamics compared to those with PE in the absence of FGR (PE-only). METHODS: Cardiac output (CO), peripheral vascular resistance (PVR) and mean arterial pressure (MAP) were measured at the first hospital visit at 9-24 weeks' gestation in 69 women who had chronic hypertension and 67 who had a hypertensive disorder in a previous pregnancy...
August 10, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28793129/clinical-characteristics-of-women-with-gestational-diabetes-comparison-of-two-cohorts-enrolled-20-years-apart-in-southern-brazil
#9
Angela Jacob Reichelt, Letícia Schwerz Weinert, Livia Silveira Mastella, Vanessa Gnielka, Maria Amélia Campos, Vânia Naomi Hirakata, Maria Lúcia Rocha Oppermann, Sandra Pinho Silveiro, Maria Inês Schmidt
CONTEXT AND OBJECTIVE: The prevalence and characteristics of gestational diabetes mellitus (GDM) have changed over time, reflecting the nutritional transition and changes in diagnostic criteria. We aimed to evaluate characteristics of women with GDM over a 20-year interval. DESIGN AND SETTING: Comparison of two pregnancy cohorts enrolled in different periods, in university hospitals in Porto Alegre, Brazil: 1991 to 1993 (n = 216); and 2009 to 2013 (n = 375). METHODS: We applied two diagnostic criteria to the cohorts: International Association of Diabetes and Pregnancy Study Groups (IADPSG)/World Health Organization (WHO); and National Institute for Health and Care Excellence (NICE)...
July 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28791264/prediction-of-pregnancy-complication-occurrence-using-fetal-cardiac-output-assessments-made-by-ultrasonography-at-20-to-24-weeks-of-gestation
#10
Ji Yeon Lee, Young Li Kim, Ji Eun Jeong, Jun Woo Ahn
OBJECTIVE: To evaluate the importance of assessment of fetal cardiac output (CO) for the prediction of complications of pregnancy. METHODS: We evaluated 65 fetuses and all of them had a fetal cardiac scan at 20 to 24 weeks of pregnancy. To measure CO, diameters (d) of the left right ventricle outflow tract were measured just above the valves. Each left CO (LCO) and right CO (RCO) was derived using the following equation: CO = velocity time integral × π × d(2)/4 × heart rate...
July 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28781906/cystatin-c-as-a-marker-for-renal-impairment-in-preeclampsia
#11
Apeksha Niraula, Madhab Lamsal, Nirmal Baral, Shankar Majhi, Seraj Ahmed Khan, Pritha Basnet, Kashyap Dahal
Preeclampsia is a devastating pregnancy-associated disorder characterized by the onset of hypertension, proteinuria, and edema with limited plausible pathophysiology known. Cystatin-C, a novel marker for the detection of renal impairment, is increased in preeclampsia at an early stage. This study was aimed to evaluate the diagnostic efficiency of Cystatin-C as an early marker of renal function in preeclampsia comparing it to the traditional renal markers. A hospital based comparative cross-sectional study was performed on 104 women (52 diagnosed cases of preeclampsia and 52 healthy pregnant women)...
2017: Journal of Biomarkers
https://www.readbyqxmd.com/read/28771289/screening-for-gestational-diabetes-mellitus-based-on-different-risk-profiles-and-settings-for-improving-maternal-and-infant-health
#12
REVIEW
Joanna Tieu, Andrew J McPhee, Caroline A Crowther, Philippa Middleton, Emily Shepherd
BACKGROUND: Gestational diabetes mellitus (GDM) is a form of diabetes that occurs in pregnancy. Although GDM usually resolves following birth, it is associated with significant morbidities for mothers and their infants in the short and long term. There is strong evidence to support treatment for GDM. However, there is uncertainty as to whether or not screening all pregnant women for GDM will improve maternal and infant health and if so, the most appropriate setting for screening. This review updates a Cochrane Review, first published in 2010, and subsequently updated in 2014...
August 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28761717/physical-activity-during-pregnancy-and-infant-s-birth-weight-results-from-the-3d-birth-cohort
#13
Michèle Bisson, Jordie Croteau, Benjamin C Guinhouya, Emmanuel Bujold, François Audibert, William D Fraser, Isabelle Marc
AIM: To evaluate the association between maternal physical activity and infant's birth weight or risk of inappropriate weight for gestational age (GA), and whether this association differs by infant's sex, maternal body mass index (BMI) or pregnancy complications in a prospective cohort study. METHODS: 1913 pregnant women from the 3D Birth Cohort (Québec, Canada) completed the Pregnancy Physical Activity Questionnaire at each trimester. Energy expenditure (metabolic equivalent of task (MET)*hours/week) for total activity, sports and exercise and vigorous intensity activities was calculated...
2017: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/28754161/a-cross-sectional-study-of-maternal-near-miss-and-mortality-at-a-rural-tertiary-centre-in-southern-nigeria
#14
Ikechukwu Innocent Mbachu, Chukwuemeka Ezeama, Kelechi Osuagwu, Osita Samuel Umeononihu, Chibuzor Obiannika, Nkeiru Ezeama
BACKGROUND: The study evaluated the pattern of severe maternal outcome, near miss indicators and associated patient and healthcare factors at a private referral hospital in rural Nigeria. METHODS: This was a cross sectional study conducted from September 2014 to August 2015 in Madonna University Teaching Hospital Elele, Rivers State, Nigeria. Pregnant and postpartum women were recruited for the study using Nigeria near miss network proforma which was adopted from the WHO near miss proforma...
July 28, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28747173/uptake-of-external-cephalic-version-for-term-breech-presentation-an-australian-population-study-2002-2012
#15
Yu Sun Bin, Christine L Roberts, Michael C Nicholl, Jane B Ford
BACKGROUND: The safety, efficacy, and cost-effectiveness of external cephalic version (ECV) for term breech presentation has been demonstrated. Clinical guidelines recommend ECV for all eligible women, but the uptake of this procedure in the Australian healthcare setting is unknown. This study aimed to describe ECV uptake in New South Wales, the most populous state of Australia, during 2002 to 2012. METHODS: Data from routine hospital and birth records were used to identify ECVs conducted at ≥36 weeks' gestation...
July 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28742216/the-fetuses-at-risk-approach-survival-analysis-from-a-fetal-perspective
#16
K S Joseph, Michael S Kramer
Several phenomena in contemporary perinatology create challenges for analyzing pregnancy outcomes. These include recent increases in iatrogenic delivery at late preterm and early term gestation which are incongruent with the belief that stillbirth and neonatal death risk decrease exponentially with advancing gestational age. Perinatal epidemiologists have also puzzled over the paradox of intersecting birth weight- and gestational age-specific perinatal mortality curves for decades. For example, neonatal mortality rates among preterm infants of women who smoke are substantially lower than neonatal mortality rates among preterm infants of non-smoking women, whereas the reverse pattern occurs at term gestation...
July 25, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28733057/clinical-validation-of-non-invasive-cardiac-output-monitoring-in-healthy-pregnant-women
#17
Kelsey McLaughlin, Stephen P Wright, John C P Kingdom, John D Parker
OBJECTIVE: Non-invasive hemodynamic monitoring has the potential to be a valuable clinical tool for the screening and management of hypertensive disorders of pregnancy. The objective of this study was to validate the clinical utility of the non-invasive cardiac output monitoring (NICOM) system in pregnant women. METHODS: Twenty healthy pregnant women with a singleton pregnancy at 22 to 26 weeks' gestation were enrolled in this study. Measures of heart rate, stroke volume, and cardiac output were obtained through NICOM and compared with Doppler echocardiography...
July 18, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28731036/stroke-in-women-from-evidence-to-inequalities
#18
REVIEW
Charlotte Cordonnier, Nikola Sprigg, Else Charlotte Sandset, Aleksandra Pavlovic, Katharina S Sunnerhagen, Valeria Caso, Hanne Christensen
Stroke is the second largest cause of disability-adjusted life-years lost worldwide. The prevalence of stroke in women is predicted to rise rapidly, owing to the increasing average age of the global female population. Vascular risk factors differ between women and men in terms of prevalence, and evidence increasingly supports the clinical importance of sex differences in stroke. The influence of some risk factors for stroke - including diabetes mellitus and atrial fibrillation - are stronger in women, and hypertensive disorders of pregnancy also affect the risk of stroke decades after pregnancy...
July 21, 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28729012/evidence-that-children-born-at-early-term-37-38-6-7-weeks-are-at-increased-risk-for-diabetes-and-obesity-related-disorders
#19
Dorit Paz Levy, Eyal Sheiner, Tamar Wainstock, Ruslan Sergienko, Daniella Landau, Asnat Walfisch
BACKGROUND: Prematurity is known to be associated with high rates of endocrine and metabolic complications in the offspring. Offspring born early term (37-38 6/7 weeks' gestation) were also shown to exhibit long-term morbidity resembling that of late preterm, in several health categories. OBJECTIVE: We aimed to determine whether early term delivery impacts on the long-term endocrine and metabolic health of the offspring. STUDY DESIGN: A population-based cohort analysis was performed, including all term singleton deliveries occurring from 1991 through 2013 at a single regional tertiary medical center...
July 18, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28723784/thrombocytopenia-in-pregnancy-with-different-diagnoses-differential-clinical-features-treatments-and-outcomes
#20
MULTICENTER STUDY
Xiaoyue Wang, Yan Xu, Wenxiang Luo, Hui Feng, Yizhou Luo, Yanli Wang, Hui Liao
To investigate the clinical features and perinatal treatment of thrombocytopenia induced by different causes during pregnancy.Clinical data from 195 pregnant women with thrombocytopenia attending 2 tertiary hospitals from January 2014 to October 2016 were retrospectively studied. The obtained data were analyzed with SPSS 19.0 software.There were 117 (60.0%), 55 (28.2%), and 23 cases (11.8%) of pregnancy-associated thrombocytopenia (PAT), idiopathic thrombocytopenia (ITP), and hypertensive disorder in pregnancy (PIH), respectively...
July 2017: Medicine (Baltimore)
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