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Alemayehu A, Demissie A, Ibrahim I, Geremew A, Mohammed F, Gudeta M, Oljira L, Dessie Y, Assefa N. Burden, risk factors, and maternal postpartum and birth outcomes of hypertensive disorder of pregnancy in Ethiopia, 2024: A systematic review and meta-analysis. SAGE Open Med 2024; 12:20503121241274741. [PMID: 39420998 PMCID: PMC11483801 DOI: 10.1177/20503121241274741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/19/2024] [Indexed: 10/19/2024] Open
Abstract
Objectives This review aimed to report the estimated pooled level of prevalence, risk factors, and birth outcome of hypertensive disorder of pregnancy in Ethiopia, in 2024. Design A systematic review and meta-analysis approach was utilized. Data Sources and Methods PubMed/MEDLINE, Google Scholar, African Index Medicus, Web of Science, and CINHAL (EBSCO) search was carried out. The result was written according to the PRISMA-updated guidelines. To estimate the pooled prevalence and effect sizes, a random-effect model was used. Heterogeneity was assessed and investigated using I 2 test statistics and meta-regression, respectively. Publication bias was assessed using funnel plot and Egger's test statistics. Statistical tests result at p-value < 0.05 were declared as having significance. Result From a total of 52 primary studies with a total sample size of 269, 158 were included in this systematic review and meta-analysis. The pooled prevalence of hypertensive disorder in pregnancy was 8%. Egger's test statistics (p = 0.8013) showed there is no publication bias. Having a history of kidney disease (AOR: 3.47), being rural resident (AOR: 2.5), having fruit intake during pregnancy (AOR: 0.39), being overweight (AOR: 2.24), and having multiple pregnancy (AOR: 2.1) were found to have a significant association with hypertensive disorder of pregnancy. Conclusion Overall, the level of prevalence of hypertensive disorders of pregnancy in Ethiopia was significantly increasing. Having a history of kidney disease was found to have a strong association with hypertensive disorders of pregnancy among factors. The most common or dominant adverse maternal and childbirth outcomes were low birth weight, preterm birth, fifth minute low APGAR score; and eclampsia, hemolysis, elevated liver enzymes, and low platelets syndrome, and acute kidney injury. The governments and other stakeholders should work to broaden and strengthen the existing maternal and child health (MCH) practice by incorporating all possible risk factors of hypertensive disorders of pregnancy in MCH guidelines. In addition, a large-scale study is required that considers those important missed variables, especially, in the eastern part of Ethiopia.
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Affiliation(s)
- Astawus Alemayehu
- Department of Public Health, Harar Health Science College, Harar, Ethiopia
| | - Abebaw Demissie
- Department of Pediatrics and Child Health, Harar Health Science College, Harar, Ethiopia
| | | | - Addisalem Geremew
- Department of Anesthesia, Harar Health Science College, Harar, Ethiopia
| | - Feysal Mohammed
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Oromia, Ethiopia
| | - Mogos Gudeta
- Department of Midwifery, Salale University, Fitche, Oromia, Ethiopia
| | - Lamessa Oljira
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Kumsa H, Mergiyaw D. Obstetrical and perinatal outcomes of women with preeclampsia at Woldia Comprehensive Specialized Hospital, Northeast Ethiopia. Front Med (Lausanne) 2024; 11:1326333. [PMID: 39359928 PMCID: PMC11444998 DOI: 10.3389/fmed.2024.1326333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 08/28/2024] [Indexed: 10/04/2024] Open
Abstract
Background Preeclampsia is a multisystem disorder that affects pregnant women. Preeclampsia and its complications are the leading causes of maternal and perinatal morbidity and mortality in developing countries. Studies conducted in Ethiopia have primarily concentrated on preeclampsia's trends and prevalence rather than its obstetrical and perinatal consequences. Thus, this study aimed to determine the risk of adverse obstetric and perinatal outcomes among women with preeclampsia at Woldia Comprehensive Specialized Hospital, Northeast Ethiopia. Methods A retrospective cohort study was conducted among 140 preeclamptic women and 280 normotensive women who gave birth at Woldia Comprehensive Specialized Hospital between 30 December 2020 and 29 December 2022. Maternal records were retrieved using data-extraction tools. The data were entered into EpiData version 4.6.0.6 and analyzed using SPSS version 26. Binary and multivariable logistic regression models were used to test the associations between independent and outcome variables. The adjusted odds ratio (OR) with a 95% confidence interval (CI) and p-values <0.05 were used to measure the strength of the association and declare the level of statistical significance. Results The odds of at least one adverse obstetric outcome among preeclamptic women were 2.25 times higher than those among normotensive women [AOR: 2.25, 95% CI: (1.06, 4.77)]. In addition, babies born to preeclamptic women were at a higher risk of perinatal death [AOR: 2.90, 95% CI: (1.10, 8.17)], low birth weight [AOR: 3.11, 95% CI: (1.43, 6.7)], birth asphyxia [AOR: 2.53, 95% CI: (1.15, 5.5)], and preterm birth [AOR: 2.21, 95% CI: (1.02, 4.8)] than babies born to normotensive women. Conclusion More adverse obstetric and perinatal outcomes were observed in women with preeclampsia than those in normotensive women. This study highlights the significantly elevated level of at least one adverse obstetric outcome associated with preeclampsia, low hemoglobin level, and rural residents. Moreover, perinatal death, low birth weight, asphyxia, and preterm birth were significantly associated with preeclampsia.
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Affiliation(s)
- Henok Kumsa
- Department of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Thi Huyen Anh N, Manh Thang N, Thanh Huong T. Maternal and perinatal outcomes of hypertensive disorders in pregnancy: Insights from the National Hospital of Obstetrics and Gynecology in Vietnam. PLoS One 2024; 19:e0297302. [PMID: 38295097 PMCID: PMC10830052 DOI: 10.1371/journal.pone.0297302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/03/2024] [Indexed: 02/02/2024] Open
Abstract
INTRODUCTION Hypertension is the common disorder encountered during pregnancy, complicating 5% to 10% of all pregnancies. Hypertensive disorders in pregnancy (HDP) are also a leading cause of maternal and perinatal morbidity and mortality. The majority of feto-maternal complications due to HPD have occurred in the low- and middle-income countries. However, few studies have been done to assess the feto-maternal outcomes and the predictors of adverse perinatal outcome among women with HDP in these countries. METHODS A prospective cohort study was conducted on women with HDP who were delivered at National Hospital of Obstetrics and Gynecology, Vietnam from March 2023 to July 2023. Socio-demographic and obstetrics characteristics, and feto-maternal outcomes were obtained by trained study staff from interviews and medical records. Statistical analysis was performed using SPSS version 26.0. Bivariate and multiple logistic regressions were done to determine factors associated with adverse perinatal outcome. A 95% confidence interval not including 1 was considered statically significant. RESULTS A total of 255 women with HDP were enrolled. Regarding adverse maternal outcomes, HELLP syndrome (3.9%), placental abruption (1.6%), and eclampsia (1.2%) were three most common complications. There was no maternal death associated with HDP. The most common perinatal complication was preterm delivery developed in 160 (62.7%) of neonates. Eight stillbirths (3.1%) were recorded whereas the perinatal mortality was 6.3%. On bivariate logistic regression, variables such as residence, type of HDP, highest systolic BP, highest diastolic BP, platelet count, severity symptoms, and birth weight were found to be associated with adverse perinatal outcome. On multiple logistic regression, highest diastolic BP, severity symptoms, and birth weight were found to be independent predictors of adverse perinatal outcome. CONCLUSION Our study showed lower prevalence of stillbirth, perinatal mortality, and maternal complication compared to some previous studies. Regular antenatal care and early detection of abnormal signs during pregnancy help to devise an appropriate monitoring and treatment strategies for each women with HDP.
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Affiliation(s)
- Nguyen Thi Huyen Anh
- Hanoi Medical University, Hanoi, Vietnam
- National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam
| | - Nguyen Manh Thang
- Hanoi Medical University, Hanoi, Vietnam
- National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam
| | - Truong Thanh Huong
- Hanoi Medical University, Hanoi, Vietnam
- Phenikaa University, Hanoi, Vietnam
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Keshtkar L, Ranjkesh F, Habibi M, Rashvand F. Effects of Auriculotherapy on Gestational Hypertension: Randomized Controlled Trial Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2024; 29:40-45. [PMID: 38333341 PMCID: PMC10849284 DOI: 10.4103/ijnmr.ijnmr_403_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 09/12/2021] [Accepted: 04/17/2023] [Indexed: 02/10/2024]
Abstract
Background This study aims to observe how auriculotherapy acts as a nonpharmacological treatment for pregnant women's gestational hypertension. Materials and Methods This study was a randomized controlled trial. Eighty patients were with gestational hypertension recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group just received the usual perinatal care. The intervention group received one month of auriculotherapy in addition to the usual care. Blood pressure was measured before and 15 minutes after rest in both groups twice a week. The data were analyzed using descriptive statistics and inferential tests. Results The mean systolic blood pressure, based on the Mann-Whitney test, was not statistically significant between the two groups before the intervention and in the first two weeks after the intervention (p >0.05); however, after the third week of intervention, the mean systolic blood pressure in the intervention group was significantly lower than that in the control group (p <0.001). As per the Mann-Whitney test, the mean diastolic blood pressure was not statistically significant between the two groups before the intervention and the first week after the intervention (p <0.05). However, after the second week of intervention, the mean diastolic blood pressure in the intervention group was significantly lower than that in the control group, and this decrease was highest in the fourth week of the intervention (p <0.001). Conclusions This study demonstrated that auriculotherapy would reduce blood pressure in pregnant women suffering from hypertension.
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Affiliation(s)
- Ladan Keshtkar
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Fatemeh Ranjkesh
- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Farnoosh Rashvand
- Social Determinants of Health Research Center, Research Institute for Prevention of Non Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, Qazvin School of Nursing and Midwifery, Qazvin University of Medical Science, Qazvin, Iran
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Pi Z, Chen Y, Nie Z, Peng J, Jiang Z. Association between pre-pregnancy body mass index and the risk of preterm birth: a mediating effect of hypertensive disorders of pregnancy. J Matern Fetal Neonatal Med 2023; 36:2224489. [PMID: 37365012 DOI: 10.1080/14767058.2023.2224489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/29/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE We aim to explore the mediating effect of hypertensive disorders of pregnancy (HDP) on the relationship between pre-pregnancy body mass index (BMI) and the risk of preterm birth (PTB) in women with singleton live births. METHODS Demographic and clinical data of 3,249,159 women with singleton live births were extracted from the National Vital Statistics System (NVSS) database in this retrospective cohort study. The associations between pre-pregnancy BMI and HDP, HDP, and PTB, and pre-pregnancy BMI and PTB were evaluated using univariate and multivariate logistic regression analyses, with odds ratios (ORs) and 95% confidence intervals (CIs). Structural equation modeling (SEM) was used to explore the mediating effect of HDP on the relationship between pre-pregnancy BMI and PTB. RESULTS In total, 324,627 women (9.99%) had PTB. After adjustment for covariables, there were significant associations between pre-pregnancy BMI and HDP [OR = 2.07, 95% CI: 2.05-2.09)], HDP and PTB [OR = 2.54, 95% CI: (2.52-2.57)], and pre-pregnancy BMI and PTB [OR = 1.03, 95% CI: 1.02-1.03)]. The effect of pre-pregnancy BMI on PTB was significantly mediated by HDP with a mediation proportion of 63.62%, especially in women of different ages and having gestational diabetes mellitus (GDM) or not. CONCLUSION HDP may play a mediating role in the effect of pre-pregnancy BMI on PTB risk. Women preparing for pregnancy should pay close attention to BMI, and pregnant women should monitor and develop interventions for HDP to reduce the risk of PTB.
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Affiliation(s)
- Zixin Pi
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Yinghui Chen
- Department of Obstetrics and Gynecology, Central People's Hospital of Zhanjiang, Zhanjiang, Guangdong, P.R. China
| | - Zhimin Nie
- Department of Science and Education, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Jing Peng
- Department of Obstetrics and Gynecology, The First People's Hospital of Jiangxia District, Wuhan City. Union Jiangnan Hospital Huazhong University of Science and Technology, Wuhan, Hubei, P.R. China
| | - Zhaoyang Jiang
- Department of Obstetrics and Gynecology, Shenzhen Maternity &Child Healthcare Hospital, Shenzhen, Guangdong, P.R. China
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Soobryan N, Kumar A, Moodley J, Mackraj I. The role and expression of pro/antiangiogenic factors and microRNAs in gestational hypertension and pre-eclampsia. Eur J Obstet Gynecol Reprod Biol 2023; 290:38-42. [PMID: 37716201 DOI: 10.1016/j.ejogrb.2023.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/12/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE Pre-eclampsia and gestational hypertension are two common hypertensive disorders of pregnancy with pre-eclampsia accounting for high foetal and maternal morbidity and mortality rate. These disorders have an unknown aetiology and their hypertensive and end-organ pathophysiology may present too late in pregnancy. This makes the identification of early detection and differentiation markers vital. MicroRNAs have strongly been associated with pregnancy and their imbalance has been associated with the angiogenic dysregulation seen in pre-eclampsia. This study assesses the expression of pro- and antiangiogenic factors and their corresponding microRNAs in the maternal circulation of patients with pre-eclampsia and gestational hypertension. STUDY DESIGN We analyzed angiogenic factors expression (sEng, TGF-β, VEGF) normalized against housekeeping gene β-actin and microRNAs (miRs: 210, 29B, 126) normalized against miR U6, potentially associated with pre-eclampsia and gestational hypertension using the targeted qPCR technique. These analytes were examined from early-onset (<34 weeks) (EOPE) (n = 12), late-onset (>34 weeks) (LOPE) (n = 12) pre-eclampsia, gestational hypertension (GH) (n = 12) and two gestationally matched normotensive groups (NG1 and 2) (n = 12) each in South African women of African ancestry. Group comparisons of experimental vs. control groups were assessed using t-test analysis for significance and represented as fold change expression. RESULTS The relative expression in group comparisons showed significant (p < 0.05) fold change of VEGF, TGF-β, sEng and miR126 in the EOPE vs. NG1. The GH vs. NG1 exhibited significant changes in VEGF, TGF-β, miR126, miR210 and miR29B. The LOPE vs. NG2 showed significant relative expression in all the angiogenic factors (VEGF, TGF-β and sEng). The GH vs. NG2 showed significant expression in VEGF and miR29B. The LOPE vs. EOPE showed significant fold changes in VEGF and miR210. Finally, only the GH vs. EOPE showed significant differences in miR210 and miR29B (p < 0.05). CONCLUSION This study provides better insights into angiogenic factors and microRNAs specificity to the subtypes of gestational hypertensive disorders in pregnancy. Relative expression analysis of angiogenic factors and microRNAs showed possible novel characteristics of gestational hypertension, and potential common molecular and pathological profiles with pre-eclampsia. Furthermore, we postulate that sEng and miR29B could be early detection markers for pre-eclampsia and gestational hypertension, respectively.
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Affiliation(s)
- Nerolen Soobryan
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Ajit Kumar
- Discipline of Microbiology, School of Life Sciences, College of Agriculture, Engineering and Science, University of KwaZulu-Natal (Westville Campus), Durban 4000, South Africa
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa
| | - Irene Mackraj
- Discipline of Human Physiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
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Das S, Maharjan R, Bajracharya R, Shrestha R, Karki S, Das R, Odland JØ, Odland ML. Pregnancy outcomes in women with gestational hypertension and preeclampsia at Paropakar Maternity and Women's Hospital, Nepal: A retrospective study. PLoS One 2023; 18:e0286287. [PMID: 37267349 DOI: 10.1371/journal.pone.0286287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/13/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Gestational hypertension and preeclampsia are the most common types of hypertensive disorder in pregnancy and these conditions are associated with adverse maternal and fetal outcomes. This study aims to determine the differences in pregnancy outcomes in women with gestational hypertension and preeclampsia. METHODS A retrospective study was done at The Paropakar Maternity and Women's Hospital, a tertiary level hospital, in the Kathmandu, Nepal. Pregnant women who had given birth at the hospital between September 17 and December 18 of 2017 were included. Data were obtained from the non-digitalized hospital records. The adjusted odds ratio (AOR) and 95% confidence interval were computed using logistic regression analysis. Multivariable analysis of pregnancy outcomes (cesarean sections, low birth weight, and preterm birth) was adjusted for maternal age, parity, twin birth, gestational age, calcium supplementation, and maternal co-morbidity. RESULTS Preeclampsia was strongly associated with cesarean section compared to normal pregnancies (OR = 8.11, p<0.001). Whereas the odds of cesarean section among women with gestational hypertension was almost 2 times (OR = 1.89, p<0.001). Preterm birth was not significantly associated with gestational hypertension but was associated with preeclampsia (OR = 3.39, p<0.001). Gestational hypertension and preeclampsia were not associated with low birth weight. CONCLUSION In Nepal, women who develop preeclampsia seem at higher risk of having adverse pregnancy outcomes than women with gestational hypertension. These findings should be considered by national health authorities and other health organizations when setting new priorities to improve pregnancy outcomes.
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Affiliation(s)
- Seema Das
- Research and Development Division, Department of Public Health and Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Renusha Maharjan
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, United States of America
| | - Rashmita Bajracharya
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Rabina Shrestha
- Research and Development Division, Department of Public Health and Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Sulata Karki
- Research and Development Division, Department of Public Health and Community Programs, Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Rupesh Das
- Department of Medicine, Janaki Medical College Teaching Hospital, Janakpur, Nepal
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Maria Lisa Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Obstetrics and Gynecology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Malawi-Liverpool-Wellcome Trust Research Institute, Blantyre, Malawi
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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Raina J, Elgbeili G, Montreuil T, Nguyen TV, Beltempo M, Kusuma D, Tulandi T, Dayan N, Bahroen FY, Caccese C, Badageish A, Suarthana E. The effect of maternal hypertension and maternal mental illness on adverse neonatal outcomes: A mediation and moderation analysis in a U.S. cohort of 9 million pregnancies. J Affect Disord 2023; 326:11-17. [PMID: 36657493 DOI: 10.1016/j.jad.2023.01.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/08/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND While hypertensive disorders of pregnancy (HDP) coexist with maternal anxiety and depression, it is unclear how these conditions affect neonatal outcomes. We evaluated the prevalence as well as associations and potential mechanisms between HDP, maternal anxiety and depression, preterm birth (PTB), and small for gestational age (SGA). METHODS We conducted a retrospective population-based study using the Healthcare Cost and Utilization Project (HCUP) database from 2004 to 2014. Preterm birth (<37 weeks), SGA (<10th percentile for gestational age and sex), HDP, and mental disorders (anxiety and depression) were extracted using the International Classification of Diseases, Ninth Revision (ICD-9). Mediation and moderation models were constructed separately to evaluate potential mechanisms between maternal anxiety and depression, HDP, and adverse neonatal outcomes. Multivariate logistic regressions were used to determine their associations. RESULTS Of 9,097,355 pregnant women, the prevalence of HDP was 6.9 %, anxiety 0.91 %, depression 0.36 %, preterm birth 7.2 %, and SGA 2.1 %. Anxiety increased the probability of having HDP (OR = 1.242, 95 % CI 1.235-1.250), and HDP mediated the association between anxiety and preterm birth (mediation effect = 0.048, p-value<0.001). Depression significantly moderated the effect of HDP on preterm birth (moderation effect = -0.126, p-value = 0.027). HDP also mediated the association between anxiety and SGA (mediation effect = 0.042, p-value<0.001), but depression did not moderate the association between HDP and SGA (p-value = 0.29). CONCLUSION Our study suggests that women with anxiety are more likely to have HDP, and HDP mediates the associations between anxiety and adverse neonatal outcomes. Depression moderates associations between HDP and preterm birth but not between HDP and SGA.
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Affiliation(s)
- Jason Raina
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | | | - Tina Montreuil
- Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Tuong-Vi Nguyen
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada; Department of Pediatrics, McGill University, Montréal, Québec, Canada
| | - Marc Beltempo
- McGill University Health Center, Montréal, Québec, Canada
| | - Dian Kusuma
- Douglas Mental Health University Institute, Montréal, Québec, Canada
| | - Togas Tulandi
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Natalie Dayan
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada; Department of Health Services Research and Management, School of Health & Psychological Sciences, City University of London, London, UK
| | - Femmy Yunia Bahroen
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | | | - Ahmad Badageish
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada
| | - Eva Suarthana
- Department of Obstetrics and Gynecology, McGill University, Montréal, Québec, Canada.
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Wassie AY, Anmut W. Prevalence of Eclampsia and Its Maternal-Fetal Outcomes at Gandhi Memorial Hospital, Addis Ababa Ethiopia, 2019: Retrospective Study. Int J Womens Health 2021; 13:231-237. [PMID: 33654436 PMCID: PMC7910079 DOI: 10.2147/ijwh.s298463] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background Eclamptic disorder during pregnancy is one of the common problems in sub-Saharan countries and forms one of the deadly triads along with hemorrhage and infection which complicates feto-maternal outcomes of pregnancy. So, the purpose of this study was to assess the prevalence of eclampsia and its maternal and fetal outcome in Gandhi Memorial Hospital, Addis Ababa Ethiopia, 2019. Methods A descriptive retrospective cross-sectional study was employed on a review of all cases of women who were delivered at Gandhi memorial Hospital from 1st of September 2017 to –last of August 2018. Data were analyzed using SPSS version 25 software. Descriptive statistics were used to calculate frequencies and percentages and data was presented using texts and, tables. Results Out of the total deliveries, the prevalence of eclampsia was found to be 6.2%. In our experience of a very high rate of eclampsia, fortunately, we had only 3 maternal deaths out of the total cases. However, neonatal mortality and stillbirths had been extremely high: 41 (22.1%) of stillbirths and 30.3% neonatal deaths (a total burden of 52.4% of perinatal mortality). About 70.8% had reported a history of prior pregnancy-induced hypertension and 73.5% induced their current pregnancy following eclampsia. From mothers who required interventions to terminate the pregnancy by induction, 47.8% ended by cesarean section secondary to non-reassuring fetal status (29.2%). The majority (91.9%) had taken magnesium sulfate for the management of convulsion and 86.5% had taken hydralazine for hypertension management. Abruption of the placenta (96.2%), postpartum-hemorrhage (89.2%), and HELLP syndrome (83.8%) were major maternal adverse outcomes reported, and 22.1% of pregnancy was ended as stillbirth. Over 53.6% of delivered babies, 18.4% of neonates required admission to nursery/NICU referral. Conclusion The prevalence of eclampsia was relatively high, with corresponding high maternal and perinatal morbidity and mortality. Increasing early detection before pregnancy, antenatal screening, and the use of magnesium sulfate to control convulsions will reduce the disorder and associated morbidity and mortality for both mother and fetus.
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Affiliation(s)
- Addisu Yeshambel Wassie
- Department of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Walellign Anmut
- Department of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Zhou Y, Yang C. Effects of Midwifery Care on Mode of Delivery, Duration of Labor and Postpartum Hemorrhage of Elderly Parturients. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:93-100. [PMID: 34178767 PMCID: PMC8213635 DOI: 10.18502/ijph.v50i1.5075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: We aimed to explore the influence of midwifery care on the mode of delivery (MOD), duration of labor and postpartum hemorrhage (PPH) of elderly parturients. Methods: A total of 165 elderly parturients admitted to Tongde Hospital of Zhejiang Province, China from May 2018 to Aug 2019 were allocated into a study group (n=85, midwifery care) and a control group (n=80, conventional nursing care). Visual analogue scale (VAS) was employed to estimate the pain of parturients, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were employed to evaluate the anxiety and depression status. The satisfaction of patients on nursing care was scored by a self-made satisfaction questionnaire. Results: The parturients in the study group presented higher spontaneous vaginal delivery (SVD) rate (P < 0.05), and had shortened duration of first and second stages of labor and total duration of labor (P < 0.05). The incidence of both PPH and neonatal asphyxia in the study group was lower than that in the control group (both P < 0.05). The VAS, SAS and SDS scores in the study group were significantly lower than those in the control group (P < 0.05), and the patients’ satisfaction in the study group was significantly higher (P < 0.05). Conclusion: Midwifery care is effective for the delivery of elderly parturients, which significantly improves VSD rate, shortens duration of labor, reduces incidence of PPH and neonatal asphyxia, as well as relives labor pain, anxiety and depression, and increases satisfaction of parturients.
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Affiliation(s)
- Yuefang Zhou
- Tongde Hospital of Zhejiang Province, Hangzhou 310024, China
| | - Chunping Yang
- Tongde Hospital of Zhejiang Province, Hangzhou 310024, China
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