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Pedersen M, Nobile F, Stayner LT, de Hoogh K, Brandt J, Stafoggia M. Ambient air pollution and hypertensive disorders of pregnancy in Rome. ENVIRONMENTAL RESEARCH 2024; 251:118630. [PMID: 38452913 DOI: 10.1016/j.envres.2024.118630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Ambient air pollution has been associated with hypertensive disorders of pregnancy (HDP), but few studies rely on assessment of fine-scale variation in air quality, specific subtypes and multi-pollutant exposures. AIM To study the impact of long-term exposure to individual and mixture of air pollutants on all and specific subtypes of HDP. METHODS We obtained data from 130,470 liveborn singleton pregnacies in Rome during 2014-2019. Spatiotemporal land-use random-forest models at 1 km spatial resolution assigned to the maternal residential addresses were used to estimate the exposure to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and ozone (O3). RESULTS For PM2.5, PM10 and NO2, there was suggestive evidence of increased risk of preeclampsia (PE, n = 442), but no evidence of increased risk for all subtypes of HDP (n = 2297) and gestational hypertension (GH, n = 1901). For instance, an interquartile range of 7.0 μg/m3 increase in PM2.5 exposure during the first trimester of pregnancy was associated with an odds ratio (OR) of 1.06 (95% confidence interval: 0.81, 1.39) and 1.04 (0.92, 1.17) after adjustment for NO2 and the corresponding results for a 15.7 μg/m3 increase in NO2 after adjustment for PM2.5 were 1.11 (0.92, 1.34) for PE and 0.83 (0.76, 0.90) for HDP. Increased risks for HDP and GH were suggested for O3 in single-pollutant models and for PM after adjustment for NO2, but all other associations were stable or attenuated in two-pollutant models. CONCLUSIONS The results of our study suggest that PM2.5, PM10 and NO2 increases the risk of PE and that these effects are robust to adjustment for O3 while the increased risks for GH and HDP suggested for O3 attenuated after adjustment for PM or NO2. Additional studies are needed to evaluate the effects of source-specific component of PM on subtypes as well as all types of HDP which would help to target preventive actions.
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Affiliation(s)
- Marie Pedersen
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy.
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Kees de Hoogh
- The Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Cavoretto PI, Farina A, Miglio R, Zamagni G, Girardelli S, Vanni VS, Morano D, Spinillo S, Sartor F, Candiani M. Prospective longitudinal cohort study of uterine arteries Doppler in singleton pregnancies obtained by IVF/ICSI with oocyte donation or natural conception. Hum Reprod 2021; 35:2428-2438. [PMID: 33099621 DOI: 10.1093/humrep/deaa235] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/18/2020] [Indexed: 12/28/2022] Open
Abstract
STUDY QUESTION Do uterine arteries Doppler studies show different pulsatility index (UtA-PI) measurements in IVF/ICSI pregnancies with oocyte donation (OD) as compared to natural conceptions? SUMMARY ANSWER In IVF/ICSI pregnancies with OD, UtA-PI is reduced by an average of about 40% as compared to pregnancies with natural conception. WHAT IS KNOWN ALREADY OD pregnancies present worse pregnancy outcomes as compared to natural conception, particularly for increased incidence of pre-eclampsia (PE). Recent evidence shows that IVF/ICSI pregnancies with frozen blastocyst transfer also present higher prevalence of PE and 15% lower UtA-PI as compared to pregnancies after fresh blastocyst transfers. STUDY DESIGN, SIZE, DURATION Prospective, longitudinal matched cohort study performed in the Fetal Medicine and Obstetric Departments of San Raffaele Hospital in Milan, between 2013 and 2018. The analysis is based on 584 Doppler observations collected from 296 women with different method of conception (OD n = 122; natural conception n = 174). PARTICIPANTS/MATERIALS, SETTING, METHODS IVF/ICSI viable singleton pregnancies with OD and natural conception control pregnancies matched for BMI and smoking, performing repeated UtA-PI measurements at 11-34 weeks. Miscarriages, abnormalities, twins, significant maternal diseases and other types of ARTs were excluded. Log mean left-right UtA-PI was used for analysis with linear mixed model (LMM) and correction for significant confounders. Pregnancy outcome was also analyzed. MAIN RESULTS AND THE ROLE OF CHANCE Participants after OD were older and more frequently nulliparous (mean age: OD 43.4, 95% CI from 42.3 to 44.6; natural conception 35.1, 95% CI from 34.5 to 35.7; P-value < 0.001; nulliparous: OD 96.6%; natural conception 56.2%; P-value < 0.001). Mean pulsatility index was lower in OD (UtA-PI: natural conception 1.22; 95% CI from 1.11 to 1.28; OD 1.04; 95% CI from 0.96 to 1.12; P-value < 0.001). A significant effect of parity, gestational age (GA) modeled with a cubic polynomial and BMI was described in the LMM. The mean Log UtA-PI was on average 37% lower in OD as compared to natural conception pregnancies at LMM (P-value < 0.001). We also found a significant interaction between longitudinal UtA-PI Doppler and GA. Therefore, at 11 weeks' gestation the Log UtA-PI was 42% lower and, at 34 weeks, the differences reduced to 32%. GA at delivery and birth weight were statistically lower in OD group; however, birthweight centile was not statistically different. Preeclampsia was 11-fold more common in the OD group (0.6% and 6.6%, P-value = 0.003). No other significant difference in pregnancy outcome was shown in the study groups (gestational diabetes mellitus, small or large for GA). LIMITATIONS, REASONS FOR CAUTION It was not possible to properly match for maternal age and to blind the assessment given the major differences between cohorts; however, we did not find significant within-groups effects related to maternal age. Future research is needed to reassess outcomes and correct them for maternal characteristics (e.g. cardiovascular function). WIDER IMPLICATIONS OF THE FINDINGS This finding reproduces our previous discovery of lower UtA-PI in frozen as compared to fresh blastocyst transfer. The vast majority of OD is obtained by the use of cryopreservation. We speculate that increased uterine perfusion may be the physiological response to compensate dysfunctions both in the mother and in the placenta. STUDY FUNDING/COMPETING INTEREST(S) This is a non-funded study. The authors do not declare competing interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- P I Cavoretto
- Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - A Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - R Miglio
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
| | - G Zamagni
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
| | - S Girardelli
- Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - V S Vanni
- Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - D Morano
- Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Cona, Ferrara, Italy
| | - S Spinillo
- Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - F Sartor
- Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - M Candiani
- Obstetrics and Gynecology Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
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De Oliveira LG, Diniz ALD, Prado CADC, Cunha Filho EVD, Souza FLPD, Korkes HA, Ramos JG, Costa ML, Corrêa Junior MD, Sass N, Cavalli RDC, Martins-Costa SHDA, Peraçoli JC. Pre-eclampsia: Universal Screening or Universal Prevention for Low and Middle-Income Settings? REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:61-65. [PMID: 33513638 PMCID: PMC10183869 DOI: 10.1055/s-0040-1713803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
AbstractPre-eclampsia (PE) is a severe disorder that affects up to 8% of all pregnancies and represents an important cause of maternal and perinatal morbidity and mortality. The screening of the disease is a subject of studies, but the complexity and uncertainties regarding its etiology make this objective a difficult task. In addition, the costs related to screening protocols, the heterogeneity of the most affected populations and the lack of highly effective prevention methods reduce the potential of current available algorithms for screening. Thus, the National Specialized Commission of Hypertension in Pregnancy of the Brazilian Association of Gynecology and Obstetrics Federation (Febrasgo, in the Portuguese acronym) (NSC Hypertension in Pregnancy of the Febrasgo) considers that there are no screening algorithms to be implemented in the country to date and advocates that Aspirin and calcium should be widely used.
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Affiliation(s)
- Leandro Gustavo De Oliveira
- Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho,” Botucatu, SP, Brazil
| | - Angélica Lemos Debs Diniz
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Caio Antônio de Campos Prado
- Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Edson Vieira Da Cunha Filho
- Gynecology and Obstetrics Training Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Henri Augusto Korkes
- Department of Obstetrics and Gynecology, Faculty of Medicine, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brazil
| | - José Geraldo Ramos
- Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Maria Laura Costa
- Department of Gynecology and Obstetrics, Faculty of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Mário Dias Corrêa Junior
- Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Nelson Sass
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Ricardo De Carvalho Cavalli
- Department of Gynecology and Obstetrics, Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - José Carlos Peraçoli
- Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho,” Botucatu, SP, Brazil
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Pan X, Wei B, Wang H, Ma L, Du Z, Chen Y. Novel association between FOXO3 rs2232365 polymorphism and late-onset preeclampsia: a case-control candidate genetic study. BMC Pregnancy Childbirth 2020; 20:779. [PMID: 33317466 PMCID: PMC7737381 DOI: 10.1186/s12884-020-03479-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Both genetic susceptibility and dysregulated lipid metabolism are important susceptibilities to preeclampsia. In the study, we devote to investigate the associations of FOXO3 and TLR7 genetic polymorphisms with preeclampsia in a Chinese population. METHODS This case-control study involved 335 Han Chinese pregnant women, including 177 pregnant women with preeclampsia and 158 healthy controls. The preeclampsia group was further sub-grouped into early-onset preeclampsia (EOPE, n = 70)and late-onset preeclampsia (LOPE, n = 107. Three single nucleotide polymorphisms (SNPs), including FOXO3 (rs2232365, rs3761548), and TLR7 rs3853839 were genotyped by multiplex PCR for targeted next-generation sequencing. The χ2 test and multiple interaction effect analyses were performed to determine the association of three SNPs with serum lipid levels and thyroid function in women with preeclampsia. RESULTS The genotype (CC vs. TT + CT) distribution of rs2232365 revealed a significant association with LOPE (P = 0.004, odds ratio = 3.525 (0.95 CI: 1.498-8.164)). No significant difference was found in the genotype and allele frequencies of rs3761548 and rs3853839 between controls and cases (P > 0.05). Moreover, the genotype CT/TT of rs2232365 was significantly correlated with increased TG/HDL levels in the LOPE group (p = 0.014). CONCLUSIONS The polymorphisms of rs2232365 are associated with the risk of LOPE and may modulate TG/HDL levels in pregnant women with LOPE.
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Affiliation(s)
- Xuefeng Pan
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
| | - Benjie Wei
- Institute of Genetic Technology, Yinfeng Bilogical Group, No. Three Road No. 1109, Shandong, Ji’nan Hi Tech Development Zone Export Processing Zone, Jinan, Shandong Province 250014 China
| | - Hong Wang
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
| | - Lingyu Ma
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
| | - Zhaoli Du
- Institute of Genetic Technology, Yinfeng Bilogical Group, No. Three Road No. 1109, Shandong, Ji’nan Hi Tech Development Zone Export Processing Zone, Jinan, Shandong Province 250014 China
| | - Ying Chen
- Department of Obstetrics, The First Hospital of Jilin University, Xinmin Street 1, Changchun, Jilin Province 130021 China
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Accuracy of the FMF Bayes theorem-based model for predicting preeclampsia at 11-13 weeks of gestation in a Japanese population. Hypertens Res 2020; 44:685-691. [PMID: 33154593 DOI: 10.1038/s41440-020-00571-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/18/2020] [Accepted: 09/29/2020] [Indexed: 11/09/2022]
Abstract
This study aimed to investigate the diagnostic accuracy of the Fetal Medicine Foundation (FMF) Bayes theorem-based model for the prediction of preeclampsia (PE) at 11-13 weeks of gestation in the Japanese population. In this prospective cohort study, we invited 2655 Japanese women with singleton pregnancies at 11-13 weeks of gestation to participate, of whom 1036 women provided written consent. Finally, we included 913 women for whom all measurements and perinatal outcomes were available. Data on maternal characteristics and medical history were recorded. Mean arterial pressure (MAP), uterine artery pulsatility index, and maternal serum placental growth factor (PlGF) were measured. The patients delivered their babies at Showa University Hospital between June 2017 and December 2019. Participants were classified into high- and low-risk groups according to the FMF Bayes theorem-based model. Frequencies of PE were compared between groups. The screening performance of the model was validated using the area under receiver operating characteristic (AUROC) curve. A total of 26 patients (2.8%) developed PE, including 11 patients (1.2%) with preterm PE (delivery at <37 weeks). The frequency of preterm PE was significantly higher in the high-risk group than in the low-risk group (3.8% vs. 0.2%, p < 0.05). This population model achieved a 91% detection rate for the prediction of preterm PE at a screen-positive rate of 10% by a combination of maternal characteristics, MAP, and PlGF. The AUROC curve for the prediction of preterm PE was 0.962 (0.927-0.981). In conclusion, the prediction of preterm PE using the FMF Bayes theorem-based model is feasible in the Japanese population.
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Brunelli E, Seidenari A, Germano C, Prefumo F, Cavoretto P, Di Martino D, Masturzo B, Morano D, Rizzo N, Farina A. External validation of a simple risk score based on the ASPRE trial algorithm for preterm pre-eclampsia considering maternal characteristics in nulliparous pregnant women: a multicentre retrospective cohort study. BJOG 2020; 127:1210-1215. [PMID: 32275798 DOI: 10.1111/1471-0528.16246] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To validate the performance of a first-trimester simple risk score based on the ASPRE trial algorithm for pre-eclampsia. DESIGN Multicentre retrospective cohort analysis. SETTING Four Italian hospitals. POPULATION Unselected nulliparous women at 11-13 weeks of gestation from January 2014 through to January 2018. METHODS Model performance was evaluated based on discrimination and calibration. MAIN OUTCOME MEASURES Delivery before 37 weeks of gestation with a diagnosis of pre-eclampsia. RESULTS Based on 73 preterm pre-eclampsia cases and 7546 controls (including 101 cases of late pre-eclampsia), the area under the receiver operating characteristics curve was 0.659 (95% CI 0.579-0.726). The sensitivity was 32.9% (95% CI 22.1-43.7) at a false-positive rate of 8.8%. The positive likelihood ratio was 3.74 (95% CI 2.67-5.23), the positive predictive value was 3.49% (95% CI 2.12-4.86%) and the negative predictive value was 99.3% (95% CI 99.1-99.5%). The sensitivity and positive likelihood ratio were approximately 40% lower than in the original study. The calibration analysis showed a good agreement between observed and expected risks (P = 0.037). Comparison with the Fetal Medicine Foundation (FMF) algorithm yielded a difference in the area under the curve of 0.084 (P = 0.007). CONCLUSIONS In our Italian population, the simple risk score had a lower performance than expected for the prediction of preterm pre-eclampsia in nulliparous women. The FMF algorithm applied to the same data set resulted in a better prediction. TWEETABLE ABSTRACT Simple risk score predicts preterm pre-eclampsia in Italy.
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Affiliation(s)
- E Brunelli
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - A Seidenari
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - C Germano
- Department of Surgical Sciences, OIRM Sant'Anna Hospital University of Turin, Turin, Italy
| | - F Prefumo
- Division of Obstetrics and Gynaecology, Department of Clinical and Experimental Sciences, University of Brescia, Italy.,Division of Obstetrics and Gynaecology, ASST Spedali Civili, Brescia, Italy
| | - P Cavoretto
- Gynaecology and Obstetrics Department, IRCCS San Raffaele Hospital, Vita-Salute University, Segrate (Milan), Italy
| | - D Di Martino
- Department of Woman, Child and Neonate, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - B Masturzo
- Department of Surgical Sciences, OIRM Sant'Anna Hospital University of Turin, Turin, Italy
| | - D Morano
- Department of Obstetrics and Gynecology S, Anna University Hospital, Cona, Ferrara, Italy
| | - N Rizzo
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - A Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Schaller S, Knippel AJ, Verde PE, Kozlowski P. Concordance-analysis and evaluation of different diagnostic algorithms used in first trimester screening for late-onset preeclampsia. Hypertens Pregnancy 2020; 39:172-185. [PMID: 32306791 DOI: 10.1080/10641955.2020.1750627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: Concordance-analysis and evaluation of existing algorithms detecting late-onset preeclampsia during first trimester screeningMethods: Retrospective cohort study investigating risk algorithms of late-onset preeclampsia during first trimester screening in a German prenatal center. Three previously developed algorithms including anamnestic factors (Apriori) and biophysical markers (BioM) were investigated by using detection rates (DR) with fixed FPR 10% and fixed cutoff >1:100. Furthermore, we set up a concordance-analysis of test results in late-onset preeclampsia cases to examine the effect of influencing factors and to detect potential weaknesses of the algorithms. Therefore, we modeled the probability of discordances as a function of the influencing factors based on a logistic regression, that was fitted using a Bayesian approach.Results: 6,113 pregnancies were considered, whereof 700 have been excluded and 5,413 pregnancies were analyzed. 98 (1.8%) patients developed preeclampsia (79 late-onsets, 19 early-onsets). The Apriori-algorithm reaches a DR of 34.2%, by adding BioM (MAP and UtA-PI) the DR improves to 57.0% (FPR of 10%). In concordance-analysis of Apriori algorithm and Apriori+BioM algorithms, influencing factor BMI<25 increases the chance of discordances sigificantly. Additional, in the subgroup of late-onset preeclampsias with BMI<25 the DR is higher in Apriori+BioM algorithms than in Apriori algorithm alone. If both compared algorithms include BioM, influencing factor MAP decreases the chance of discordances significantly. All other tested influencing factors do not have a statistically significant effect on discordancesConclusion: Normal-weight patients benefit more from the integration of MAP and UtA-PI compared to overweight/obese patients.
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Affiliation(s)
- Sabrina Schaller
- Praenatal-Medizin und Genetik Ärztliche Partnerschaftsgesellschaft Kozlowski und Partner, Düsseldorf
| | | | - Pablo Emilio Verde
- Coordination Center for Clinical Trials, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Peter Kozlowski
- Praenatal-Medizin und Genetik Ärztliche Partnerschaftsgesellschaft Kozlowski und Partner, Düsseldorf
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Masturzo B, Di Martino D, Prefumo F, Cavoretto P, Germano C, Gennarelli G, Roletti E, Bottazzoli E, Fusè F, Ferrazzi E, Morano D, Farina A. Higher rate of early-onset preeclampsia in pregnancies following oocyte donation according to increasing maternal age. Arch Gynecol Obstet 2019; 300:861-867. [PMID: 31520261 DOI: 10.1007/s00404-019-05291-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/03/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the influence of maternal age on the incidence of early-onset preeclampsia requiring delivery before 34 weeks of gestation in pregnancies obtained after oocyte donation. METHODS We carried out a prospective cohort analysis of 431 single and twin pregnancies, admitted to 3 Tertiary Referral Hospital in Northern Italy between 2008 and 2017. The rate of early-onset PE was calculated and stratified according to maternal age (from 30 to 49 years). A reference population of 11,197 single pregnancies collected prospectively at the first trimester of pregnancy in the same geographic area of Italy and in same hospitals was used to calculate the expected incidence of early-onset PE. RESULTS In women who delivered after 24 weeks of gestation, the rate of early-onset PE was much higher in oocyte-donation pregnancies, reaching 6.7% (29/431), than the expected rate of 0.5% of the cohort of reference. The mean early PE rate was 4.1% (10/242) in singletons and 10.1% (19/189) in twin pregnancies. According to maternal age, the rate of early PE was 1.16% and 3.12% at 30 years, and 4.98% and 13.14% at 49 years in single and twin pregnancies obtained after oocyte donation, respectively. CONCLUSION Pregnancies obtained after oocyte donation delivering after 24 weeks had a higher risk of early-onset PE requiring delivery before 34 weeks of gestation, than the general population. The risk is directly correlated with the increase of maternal age and is also higher in twin pregnancies.
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Affiliation(s)
- Bianca Masturzo
- Department of Surgical Sciences, OIRM S. Anna Hospital, University of Turin, Turin, EU, Italy
| | - Daniela Di Martino
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, EU, Italy
| | - Federico Prefumo
- Department of Obstetrics and Gynecology, University of Brescia, Brescia, EU, Italy
| | - Paolo Cavoretto
- Gynecology and Obstetrics Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, EU, Italy
| | - Chiara Germano
- Department of Surgical Sciences, OIRM S. Anna Hospital, University of Turin, Turin, EU, Italy
| | - Gianluca Gennarelli
- Department of Surgical Sciences, OIRM S. Anna Hospital, University of Turin, Turin, EU, Italy
| | - Enrica Roletti
- Gynecology and Obstetrics Department, Maggiore University Hospital, Parma, EU, Italy
| | - Elisa Bottazzoli
- Department of Woman, Mother and Neonate, Buzzi Children's Hospital, University of Milan, Milan, Eu, Italy
| | - Federica Fusè
- Department of Woman, Mother and Neonate, Buzzi Children's Hospital, University of Milan, Milan, Eu, Italy
| | - Enrico Ferrazzi
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, EU, Italy
| | - Danila Morano
- Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Cona, Ferrara, EU, Italy
| | - Antonio Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC) Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, EU, Italy.
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