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Sivaraj N, K VR, Suvvari TK, Prasad S, Sri Harsha B, Majji V, Vegi PK, Bunga PK. Evaluation of the Association of Single Nucleotide Polymorphism rs2229238 in Interleukin 6 Receptor Alpha (IL6RA) Gene With the Risk of Preeclampsia. Cureus 2022; 14:e24788. [PMID: 35673309 PMCID: PMC9165912 DOI: 10.7759/cureus.24788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 01/08/2023] Open
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A study of the association between long non coding RNA (ULBP1 and MICA/B) expression and preeclampsia in Egypt. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2022.101596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Katore FH, Gurara AM, Beyen TK. Determinants of Preeclampsia Among Pregnant Women in Chiro Referral Hospital, Oromia Regional State, Ethiopia: Unmatched Case-Control Study. Integr Blood Press Control 2021; 14:163-172. [PMID: 34880674 PMCID: PMC8646106 DOI: 10.2147/ibpc.s336651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/12/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Preeclampsia causes striking maternal, fetal, and neonatal mortality and morbidity both in developed and developing countries. However, evidence of risk factors of preeclampsia is limited in the study area. OBJECTIVE To identify determinants of preeclampsia among pregnant women attending antenatal care services in Ciro Referral Hospital, Ethiopia, 2020. METHODS A facility-based unmatched case-control study was conducted from July 1 to July 30, 2020, in Chiro Referral Hospital on a sample size of 306 (ie, 76 cases and 230 controls; with a 1:3 ratio). Data were coded and entered into Epi Info version 7 and then exported to SPSS version 21 for analysis. The odds ratio was calculated with 95% confidence intervals to show the strength of association and p-value<0.05 was used to declare statistical significance. RESULTS A total of 302 (75 cases and 227 controls) pregnant mothers were interviewed with a response rate of 98.7%. Being in the age group ≥35 years (AOR=4.00; 95% CI=1.25-12.80), rural residence (AOR=3.30; 95% CI=1.50-7.26), having a family history of hypertension (AOR=3.25; 95% CI=1.36-7.73), and being primigravida (AOR=3.71; 95% CI=1.49-9.22) were identified as risk factors for preeclampsia. However, consuming fruits more than 2-4 times per a week in their diet (AOR=0.38; 95% CI=0.15-0.98) was a protective predictor of preeclampsia. CONCLUSION Maternal age, residence, family history of hypertension, gravida, and frequency of fruit consumption were identified determinants of preeclampsia. Thus, healthcare providers should give emphasis for pregnant mothers in the older age category, primigravida, those who have a history of a family with hypertension, and those from a rural residence to diagnose the diseases as early as possible. Additionally, advising pregnant mothers attending antenatal care to consume fruits as early as possible in their daily diet reduces the risk of preeclampsia.
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Affiliation(s)
- Fikre Hambamo Katore
- Department of Maternal and Child Health, Mieso Woreda Health Bureau, Mieso Town, Oromia Regional State, Ethiopia
| | | | - Teresa Kisi Beyen
- Department of Public Health, Arsi University, Asella, Oromia Regional State, Ethiopia
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Babore GO, Aregago TG, Ermolo TL, Nunemo MH, Habebo TT. Determinants of pregnancy-induced hypertension on maternal and foetal outcomes in Hossana town administration, Hadiya zone, Southern Ethiopia: Unmatched case-control study. PLoS One 2021; 16:e0250548. [PMID: 33979338 PMCID: PMC8115896 DOI: 10.1371/journal.pone.0250548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 04/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Globally, 292,982 women die due to the complications of pregnancy and
childbirth per year, out of those deaths 85% occurs in Sub Saharan Africa.
In Ethiopia, pre-eclampsia accounts for 11% of direct maternal deaths. Objective To determine maternal and foetal outcomes of pregnancy-induced hypertension
among women who gave birth at health facilities in Hossana town
administration. Methods Institutional based unmatched case-control study was conducted among women,
who gave birth at health facilities from May 20 to October 30, 2018. By
using Epi-Info version 7; 207 sample size was estimated, for each case two
controls were selected. Two health facilities were selected using a simple
random sampling method. Sample sizes for each facility were allocated
proportionally. All cleaned & coded data were entered into Epi-info
version 3.5.1 and analysis was carried out using SPSS version 20.
Multivariate analysis was performed to determine predictors of
pregnancy-induced hypertension at a p-value of <0.05. Result Women between 18 to 41 years old had participated in the study with the mean
age of 26.00(SD ±4.42), and 25.87(SD ±5.02) for cases and controls
respectively. Out of participants 21(30.4%) among cases and 21(15.2%) among
controls had developed at least one complication following delivery. 12
(17.4%) and 8 (5.7%) foetal deaths were found in cases and controls groups
respectively whereas 15.6% from cases and 3.6% from controls groups women
gave birth to the foetus with intra-uterine growth retardation. Women
gravidity AOR = 0.32 [95% CI (0.12 0.86)], Previous history of
pregnancy-induced hypertension AOR = 22.50 [95% CI (14.95 16.52)] and
educational status AOR = 0.32[95% CI (0.12, 0.85)] were identified as
predictor of pregnancy-induced hypertension. Conclusion Women with a previous history of pregnancy-induced hypertension had increased
risk of developing pregnancy-induced hypertension, whilst ≥ 3 previous
pregnancies and informal educational status decrease odds of developing
pregnancy-induced hypertension.
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Affiliation(s)
- Getachew Ossabo Babore
- Department of Nursing College of Medicine and Health Science, Wachemo
University, Hossana, Ethiopia
- * E-mail:
| | - Tsegaye Gebre Aregago
- Department of Nursing College of Medicine and Health Science, Wachemo
University, Hossana, Ethiopia
| | - Tadesse Lelago Ermolo
- Department of Nursing College of Medicine and Health Science, Wachemo
University, Hossana, Ethiopia
| | - Mangistu Handiso Nunemo
- Department of Public Health College of Medicine and Health Science,
Wachemo University, Hossana, Ethiopia
| | - Teshome Tesfaye Habebo
- Department of Health Management and Economics, School of Public Health,
Tehran University of Medical Science, Tehran, Iran
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Ayala-Ramírez P, Serrano N, Barrera V, Bejarano JP, Silva JL, Martínez R, Gil F, Olaya-C M, García-Robles R. Risk factors and fetal outcomes for preeclampsia in a Colombian cohort. Heliyon 2020; 6:e05079. [PMID: 33015399 PMCID: PMC7522495 DOI: 10.1016/j.heliyon.2020.e05079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/23/2020] [Accepted: 09/23/2020] [Indexed: 01/12/2023] Open
Abstract
In Latin America and the Caribbean, hypertensive pregnancy disorders are responsible for almost 26% of all maternal deaths [1] and, in Colombia, they account for 59% of all severe maternal morbidity (SMM) cases, and 59.7% of all SMM cases in adolescents [2]. One of the most important hypertensive pregnancy disorders is preeclampsia (PE). Lives can be saved, if PE is prevented, or detected early and properly managed. Prevention and detection depend on identifying the risk factors associated with PE, and, as these have been shown vary by population, they should be determined on a population-by-population basis. The following study utilized the nested case-control model to evaluate 45 potential PE risk factors of a cohort in Bogotá, Colombia, making it perhaps the most comprehensive study of its kind in Colombia. It found PE to have a statistically significant association with 7 of the 45 factors evaluated: 1) pre-gestational BMI >30 kg/m2, 2) pregnancy weight gain >12 kg, 3) previous history preeclampsia/eclampsia, 4) previous history of IUGR-SGA (Intrauterine Growth Restriction-Small for Gestational Age), 5) maternal age <20 or ≥35 years (20–34 was not associated), and 6) family history of diabetes. Finally, prenatal consumption of folic acid was found to lower the risk of PE. We recommend that, in Colombia, factors 1–6 be used to identify at risk mothers during pregnancy check-ups; that mothers be encouraged to take folic acid during pregnancy; and, that Colombia's health system and public policy address the problem of pregestational obesity.
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Affiliation(s)
- Paola Ayala-Ramírez
- Human Genetics Institute, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
- Corresponding author.
| | - Natalia Serrano
- Research Seedbed in Perinatal Medicine Pontificia Universidad Javeriana: Medical School Pontificia Universidad Javeriana and Medical Residents Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Viviana Barrera
- Research Seedbed in Perinatal Medicine Pontificia Universidad Javeriana: Medical School Pontificia Universidad Javeriana and Medical Residents Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Juan Pablo Bejarano
- Research Seedbed in Perinatal Medicine Pontificia Universidad Javeriana: Medical School Pontificia Universidad Javeriana and Medical Residents Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Jaime Luis Silva
- Department of Obstetrics and Gynecology, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Rodolfo Martínez
- Department of Obstetrics and Gynecology, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Fabian Gil
- Clinical Epidemiology and Biostatistics Department, Medical School, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Mercedes Olaya-C
- Department of Pathology, Faculty of Medicine, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Reggie García-Robles
- Department of Physiological Sciences, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
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Kay VR, Wedel N, Smith GN. Family History of Hypertension, Cardiovascular Disease, or Diabetes and Risk of Developing Preeclampsia: A Systematic Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:227-236.e19. [PMID: 33268309 DOI: 10.1016/j.jogc.2020.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/27/2022]
Abstract
Preeclampsia is a severe pregnancy complication with high potential for adverse effects on maternal and fetal health during the perinatal period. It is also associated with an increased risk of maternal cardiovascular disease later in life. Development of preeclampsia can be decreased by prescribing low-dose aspirin to high-risk women. At present, maternal and pregnancy factors are used to assess the risk of preeclampsia. One additional factor that could add to the assessment of risk is a family history of hypertension, cardiovascular disease, or diabetes, especially for nulliparous women who do not have a pregnancy history to inform treatment decisions. Therefore, we conducted a systematic review to assess the association between family history of the aforementioned conditions and preeclampsia. Four databases including MEDLINE, EMBASE, the Cochrane Library, and CINAHL/pre-CINAHL were searched for observational studies that examined a family history of hypertension, cardiovascular disease, or diabetes in women with preeclampsia and in a control population. Studies were evaluated for quality using the Newcastle-Ottawa Scale. A total of 84 relevant studies were identified. A meta-analysis was not conducted due to suspected heterogeneity in the included studies. Most studies reported a positive association between a family history of hypertension or cardiovascular disease and the development of preeclampsia. The majority of studies examining family history of diabetes reported non-significant associations. Overall, family history of hypertension or cardiovascular disease is associated with a higher risk for developing preeclampsia and should be considered when assessing women in the first trimester for low-dose aspirin.
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Affiliation(s)
- Vanessa R Kay
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON.
| | - Naomi Wedel
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
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Meazaw MW, Chojenta C, Muluneh MD, Loxton D. Factors associated with hypertensive disorders of pregnancy in sub-Saharan Africa: A systematic and meta-analysis. PLoS One 2020; 15:e0237476. [PMID: 32813709 PMCID: PMC7437911 DOI: 10.1371/journal.pone.0237476] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are common complications of pregnancy globally, including sub-Saharan African (SSA) countries. Although it has a high burden of maternal and neonatal mortality and morbidity, evidence on the risk of the problem is limited. Therefore, the aim of this review was to systematically examine factors associated with HDP among women in SSA countries. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. Articles conducted in SSA and published in English from January 2000 to May 2020 from electronic databases including MEDLINE, EMBASE, PubMed, and CINAHL were included. Articles, which focused on HDP and found to be relevant through the reference check, were included. Additional articles found through a hand search of reference lists were also included. The quality of papers was appraised using the Critical Appraisal Skills Programme (CASP) scale. Two reviewers independently screened, extracted, and assessed the quality of the articles. STATA 16 software was used to compute the pooled estimated odds ratios for each of the identified associated factor. Both random and fixed effect models were used for analysis. Heterogeneity of the studies and small study bias were checked by I2 and asymmetric test, respectively. RESULTS Twenty-seven studies met the inclusion criteria and included in the systematic review and meta-analysis. Significant associations with HDP were identified through meta-analysis for the following variables: being primiparous (OR: 1.78; 95% CI: 1.11, 2.44), having previous HDP (OR: 3.75; 95% CI: 2.05, 5.45), family history of HDP (OR: 2.73; 95% CI: 1.85, 3.6), and lower maternal educational level (OR: 1.65; 95% CI: 1.17, 2.13). Due to the limited number of studies found specific to each variable, there was inconclusive evidence for a relationship with a number of factors, such as maternal nutrition, antenatal care visits, birth spacing, multiple birth, physical activity during pregnancy, use of contraceptives, place of residency, family size, and other related associated factors. CONCLUSIONS The risk of developing HDP is worse among women who have a history of HDP (either themselves or their family), are primiparous, or have a lower maternal educational level. Therefore, investment in women's health needs considered to reduce the problem, and health service providers need to give due attention to women with at increased risk to HDP. Additionally, interventions need to focus on increasing women's access to education and their awareness of potential associated factors for HDP.
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Affiliation(s)
- Maereg Wagnew Meazaw
- Federal Ministry of Health, Addis Ababa, Ethiopia
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Muluken Dessalegn Muluneh
- School of Nursing and Midwifery, Western Sydney University, Parramatta, Australia
- Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
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Fikadu K, G/Meskel F, Getahun F, Chufamo N, Misiker D. Family history of chronic illness, preterm gestational age and smoking exposure before pregnancy increases the probability of preeclampsia in Omo district in southern Ethiopia: a case-control study. Clin Hypertens 2020; 26:16. [PMID: 32821425 PMCID: PMC7429780 DOI: 10.1186/s40885-020-00149-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/18/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Preeclampsia is a complex syndrome that is considered a disorder specific to pregnancy. However, research indicates that diffuse maternal endothelial damage may persist after childbirth. On the other hand, women who had a history of pre-eclampsia are at an increased risk of vascular disease. Considering that the multifactorial nature of pre-eclampsia in a remote health setting, knowledge of risk factors of preeclampsia gives epidemiological significance specific to the study area. Therefore, this study aimed to identify the determinants of preeclampsia among pregnant women attending perinatal service in Omo district Hospitals in southern Ethiopia. METHODS An institution-based unmatched case-control study design was conducted among women visiting for perinatal service in Omo District public hospitals between February to August 2018. A total of 167 cases and 352 controls were included. Data were collected via face-to-face interviews. Bivariable and multivariable logistic regression analysis were computed to examine the effect of the independent variable on preeclampsia using Statistical Package for Social Sciences version 26 window compatible software. Variables with a p-value of less than 0.05 were considered statistically significant. RESULTS Factors that were found to have a statistically significant association with pre-eclampsia were primary relatives who had history of chronic hypertension (AOR 2.1, 95% CI: 1.06-4.21), family history of diabetes mellitus (AOR 2.35; 95% CI: 1.07-5.20), preterm gestation(AOR = 1.56, 95%CI, 1.05-2.32), and pre-conception smoking exposure (AOR = 4.16, 95%CI, 1.1-15.4). CONCLUSIONS The study identified the risk factors for pre-eclampsia. Early detection and timely intervention to manage pre-eclampsia, and obstetric care providers need to emphasize women at preterm gestation and a history of smoking before pregnancy.
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Affiliation(s)
- Kassahun Fikadu
- Clinical Midwifery, Department of Midwifery, Arba Minch University, P.O. Box: 21, Arab Minch, Ethiopia
| | - Feleke G/Meskel
- Department of Public Health, Arbaminch University, Arab Minch, Ethiopia
| | - Firdawek Getahun
- Department of Public Health, Arbaminch University, Arab Minch, Ethiopia
| | - Nega Chufamo
- Department of Obstetrics and Gynecology, Arba Minch University, Arab Minch, Ethiopia
| | - Direslign Misiker
- Department of Public Health, Arbaminch University, Arab Minch, Ethiopia
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Lopez-Jaramillo P, Barajas J, Rueda-Quijano SM, Lopez-Lopez C, Felix C. Obesity and Preeclampsia: Common Pathophysiological Mechanisms. Front Physiol 2018; 9:1838. [PMID: 30618843 PMCID: PMC6305943 DOI: 10.3389/fphys.2018.01838] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/06/2018] [Indexed: 01/25/2023] Open
Abstract
Preeclampsia is a disorder specific of the human being that appears after 20 weeks of pregnancy, characterized by new onset of hypertension and proteinuria. Abnormal placentation and reduced placental perfusion associated to impaired trophoblast invasion and alteration in the compliance of uterine spiral arteries are the early pathological findings that are present before the clinical manifestations of preeclampsia. Later on, the endothelial and vascular dysfunction responsible of the characteristic vasoconstriction of preeclampsia appear. Different nutritional risk factors such as a maternal deficit in the intake of calcium, protein, vitamins and essential fatty acids, have been shown to play a role in the genesis of preeclampsia, but also an excess of weight gain during pregnancy or a pre-pregnancy state of obesity and overweight, which are associated to hyperinsulinism, insulin resistance and maternal systemic inflammation, are proposed as one of the mechanism that conduce to endothelial dysfunction, hypertension, proteinuria, thrombotic responses, multi-organ damage, and high maternal mortality and morbidity. Moreover, it has been demonstrated that pregnant women that suffer preeclampsia will have an increased risk of future cardiovascular disease and related mortality in their later life. In this article we will discuss the results of studies performed in different populations that have shown an interrelationship between obesity and overweight with the presence of preeclampsia. Moreover, we will review some of the common mechanisms that explain this interrelationship, particularly the alterations in the L-arginine/nitric oxide pathway as a crucial mechanism that is common to obesity, preeclampsia and cardiovascular diseases.
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Affiliation(s)
- Patricio Lopez-Jaramillo
- Clinic of Metabolic Syndrome, Prediabetes, and Diabetes, Research Department, FOSCAL, Floridablanca, Colombia.,Masira Institute, Medical School, Universidad de Santander, Bucaramanga, Colombia.,Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnologica Equinoccial, Quito, Ecuador
| | - Juan Barajas
- Clinic of Metabolic Syndrome, Prediabetes, and Diabetes, Research Department, FOSCAL, Floridablanca, Colombia
| | - Sandra M Rueda-Quijano
- Clinic of Metabolic Syndrome, Prediabetes, and Diabetes, Research Department, FOSCAL, Floridablanca, Colombia
| | | | - Camilo Felix
- Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnologica Equinoccial, Quito, Ecuador
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Tabatabaeian M, Kordi M, Dadgar S, Esmaeily H, Khadivzadeh T. Comparing the effects of simulation-based training, blended, and lecture on the simulated performance of midwives in preeclampsia and eclampsia. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:110. [PMID: 30271795 PMCID: PMC6149116 DOI: 10.4103/jehp.jehp_116_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Preeclampsia is the most common medical complication in pregnancy; along with bleeding and infection, it is one of the three causes of death in pregnant women. Most of these deaths were due to delays in the diagnosis and improper midwifery management and care. On the other hand, the quality of midwifery education has a profound effect on the proper provision of services. Therefore, the present study has been done to compare the effect of simulation-, blended-, and lecture-based education on simulated midwife performance in the management of preeclampsia and eclampsia. MATERIALS AND METHODS This three-group clinical trial study was performed on 90 midwives of selected hospitals in Mashhad in 2016. Midwives were divided into three groups of simulation-, blended-, and lecture-based education using the random number table. The simulation group was trained for 6 h at the Center for Clinical Skills, the blended group was trained for 4 h by lecture, and 6 weeks through the educational website, and the lecture group was trained for 6 h through lecture. An objective structured clinical test was performed before and 2 weeks after the intervention. Data were analyzed using SPSS Version 16 software and descriptive statistics, paired t-test, one-way ANOVA, and Wilcoxon and Kruskal-Wallis tests. Significance level was considered to be P < 0.05 in all cases. RESULTS The mean score of midwives' performance was not statistically significant before education in all three groups (P < 0.05). The mean score of midwives' performance was significantly increased in all three groups 2 weeks after education (P < 0.001), and the results of intergroup comparison showed that the mean score of performance in the simulation group was significantly higher than the blended group and the lecture group (P < 0.001), and it was higher in the blended group compared to the lecture group (P < 0.001). CONCLUSION Education increased the midwives' simulated performance in preeclampsia and eclampsia. The performance of the management of preeclampsia and eclampsia in the simulation educational group is more than that of the blended and lecture groups, so we can use the simulation education which is a self-centered method.
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Affiliation(s)
- Maryam Tabatabaeian
- Department of Midwifery, School of Nursing and Midwifery, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Kordi
- Department of Midwifery, Evidence-Based Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Salameh Dadgar
- Ovulation Disorders Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeily
- Department of Medical Statistics, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Berhe AK, Kassa GM, Fekadu GA, Muche AA. Prevalence of hypertensive disorders of pregnancy in Ethiopia: a systemic review and meta-analysis. BMC Pregnancy Childbirth 2018; 18:34. [PMID: 29347927 PMCID: PMC5774029 DOI: 10.1186/s12884-018-1667-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 01/11/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although hypertensive disorders of pregnancy are the leading cause of poor perinatal outcomes in Ethiopia, there is no study that shows the national prevalence. Therefore, the aim of this study was to estimate the national pooled prevalence of hypertensive disorders of pregnancy from studies conducted in different parts of the country. METHODS Databases; MEDLINE, PubMed, HINARI, EMBASE, Google Scholar and African Journals Online were searched by using different search terms on HDP and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal of studies. The analysis was done using STATA 14 software. The Cochran Q test and I2 test statistics were used to test heterogeneity of studies. Egger's test was used to show the publication bias. The pooled prevalence of HDP and the odds ratio (OR) with 95% confidence interval was presented using forest plots. RESULT Seventeen studies were included in this review, with a total of 258,602 pregnant women. The overall pooled prevalence of hypertensive disorders of pregnancy in Ethiopia was 6.07% (95% CI: 4.83%, 7.31%). The Subgroup analysis by region and year of study showed a higher prevalence of hypertensive disorders of pregnancy in Southern Nations, Nationalities, and Peoples' Region, 10.13% (95% CI = (8.5, 12.43)), and reduction in the rate of HDP from 1990's to 2010's, 8.54% reducing to 5.71% respectively. The pooled prevalence of pregnancy-induced hypertension (PIH) and preeclampsia/eclampsia alone were 6.29 and 5.47 respectively. Pregnant women ≥ 35 years old are more likely to develop hypertensive disorders of pregnancy, OR = 1.64 (95% CI = (1.18, 2.28)). No statistically significant difference was observed between HDP and younger maternal age (less than 20 years old); OR = 2.92 (95% CI = (0.88, 9.70)). There was no association between hypertensive disorders of pregnancy and number of pregnancy, OR = 1.37 (95% CI = 0.78, 2.41)). CONCLUSIONS The prevalence of hypertensive disorders of pregnancy is high in Ethiopia. The problem is more common among older pregnant women (> 35 years old). Government and other stakeholders should give due attention to an early screening of hypertension during pregnancy.
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Affiliation(s)
| | | | - Gedefaw Abeje Fekadu
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O.Box 79, Bahir Dar, Ethiopia
| | - Achenef Asmamaw Muche
- Department of Epidemiology and Biostatistics, Institute of public health, University of Gondar, Gondar, Ethiopia
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12
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Mahran A, Fares H, Elkhateeb R, Ibrahim M, Bahaa H, Sanad A, Gamal A, Zeeneldin M, Khalifa E, Abdelghany A. Risk factors and outcome of patients with eclampsia at a tertiary hospital in Egypt. BMC Pregnancy Childbirth 2017; 17:435. [PMID: 29272998 PMCID: PMC5741945 DOI: 10.1186/s12884-017-1619-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 12/07/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Eclampsia is a major cause of maternal and neonatal morbidity and mortality in low and middle income countries. The aim of this study was to assess the risk factors and maternal and perinatal outcome in patients with eclampsia in order to get reliable data that helps in reducing the incidence and improving the outcome in an area with high incidence of eclampsia. METHODS Retrospective study including 250 patients diagnosed with eclampsia at Minia Maternity University Hopsital, Minia, Egypt in the period between January 2013 and December 2014.We analyzed the data obtained from medical records of these patients including patient characteristics, medical, obstetric, current pregnancy history, data on hospital admission, treatment given at hospital and maternal and perinatal outcome. Statistical analysis was done using SPSS version 21. RESULTS During the study period, 21690 women gave birth in the hospital; of which 250 cases of eclampsia were diagnosed (1.2%).Four women died (case fatality rate 1.6%). The main risk factors identified were young age, nulliparity, low level of education, poor ante-natal attendance and pre-existing medical problems. The most common complication was HELLP syndrome (15.6%). Magnesium sulphate therapy was given to all patients but there was lack of parenteral anti-hypertensive therapy. Forty six cases delivered vaginally (18.4%). Assisted delivery was performed in 22 (8.8%) cases and caesarean section in 177 (70.8%) cases; 151(60.4%) primary caesarean sections and 26 (10.4%) intra-partum. Perinatal deaths occurred in 11.9% on cases. Prematurity and poor neonatal services were the main cause. CONCLUSION Morbidity and mortality from eclampsia are high in our setting. Improving ante-natal and emergency obstetric and neonatal care is mandatory to improve the outcome.
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Affiliation(s)
- Ahmad Mahran
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Hashem Fares
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Reham Elkhateeb
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mahmoud Ibrahim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Haitham Bahaa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ahmad Sanad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Alaa Gamal
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Mohamed Zeeneldin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Eissa Khalifa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ahmed Abdelghany
- Department of Obstetrics and Gynecology, Faculty of Medicine, Minia University, Minia, Egypt
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13
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Effect of Probiotic Supplementation on Blood Pressure of Females with Gestational Diabetes Mellitus: A Randomized Double Blind Controlled Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.55662] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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14
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Alma LJ, Bokslag A, Maas AHEM, Franx A, Paulus WJ, de Groot CJM. Shared biomarkers between female diastolic heart failure and pre-eclampsia: a systematic review and meta-analysis. ESC Heart Fail 2017; 4:88-98. [PMID: 28451444 PMCID: PMC5396047 DOI: 10.1002/ehf2.12129] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 10/25/2016] [Accepted: 11/15/2016] [Indexed: 12/11/2022] Open
Abstract
Evidence accumulates for associations between hypertensive pregnancy disorders and increased cardiovascular risk later. The main goal of this study was to explore shared biomarkers representing common pathogenic pathways between heart failure with preserved ejection fraction (HFpEF) and pre‐eclampsia where these biomarkers might be potentially eligible for cardiovascular risk stratification in women after hypertensive pregnancy disorders. We sought for blood markers in women with diastolic dysfunction in a first literature search, and through a second search, we investigated whether these same biochemical markers were present in pre‐eclampsia.This systematic review and meta‐analysis presents two subsequent systematic searches in PubMed and EMBASE. Search I yielded 3014 studies on biomarkers discriminating women with HFpEF from female controls, of which 13 studies on 11 biochemical markers were included. Cases had HFpEF, and controls had no heart failure. The second search was for studies discriminating women with pre‐eclampsia from women with non‐hypertensive pregnancies with at least one of the biomarkers found in Search I. Search II yielded 1869 studies, of which 51 studies on seven biomarkers were included in meta‐analyses and 79 studies on 12 biomarkers in systematic review.Eleven biological markers differentiated women with diastolic dysfunction from controls, of which the following 10 markers differentiated women with pre‐eclampsia from controls as well: C‐reactive protein, HDL, insulin, fatty acid‐binding protein 4, brain natriuretic peptide, N terminal pro brain natriuretic peptide, adrenomedullin, mid‐region pro adrenomedullin, cardiac troponin I, and cancer antigen 125.Our study supports the hypothesis that HFpEF in women shares a common pathogenic background with pre‐eclampsia. The biomarkers representing inflammatory state, disturbances in myocardial function/structure, and unfavourable lipid metabolism may possibly be eligible for future prognostic tools.
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Affiliation(s)
- Lisa J Alma
- Department of Obstetrics and GynecologyVU University Medical CenterAmsterdamThe Netherlands
| | - Anouk Bokslag
- Department of Obstetrics and GynecologyVU University Medical CenterAmsterdamThe Netherlands
| | - Angela H E M Maas
- Department of CardiologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
| | - Arie Franx
- Division Woman and BabyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Walter J Paulus
- Department of PhysiologyVU University Medical CenterAmsterdamThe Netherlands
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15
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Saadati F, Sehhatiei Shafaei F, Mirghafourvand M. Sleep quality and its relationship with quality of life among high-risk pregnant women (gestational diabetes and hypertension). J Matern Fetal Neonatal Med 2017; 31:150-157. [DOI: 10.1080/14767058.2016.1277704] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Fatemeh Saadati
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fahimeh Sehhatiei Shafaei
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mozhgan Mirghafourvand
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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16
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Ferriols E, Rueda C, Gamero R, Vidal M, Payá A, Carreras R, Flores-le Roux JA, Pedro-Botet J. [Relationship between lipid alterations during pregnancy and adverse pregnancy outcomes]. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2016; 28:232-244. [PMID: 26088001 DOI: 10.1016/j.arteri.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
Lipids play an important role during pregnancy, and in this period major changes occur in lipoprotein metabolism. During the third trimester plasma cholesterol and triglyceride levels are substantially increased, returning to normal after delivery. Described associations between increased morbidity during pregnancy and excessive increases in plasma cholesterol and triglycerides. For this reason we have reviewed the relationship between lipid alterations, preeclampsia, gestational diabetes and preterm birth. The overall metabolic control can improve pregnancy outcomes, and the assessment of supraphysiological changes in lipid profile will classify pregnancy risk at a higher level, which would entail a stricter control.
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Affiliation(s)
- Elena Ferriols
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España.
| | - Carolina Rueda
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Rocío Gamero
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Mar Vidal
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España
| | - Antonio Payá
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España; Departament de Pediatria, d'Obstetrícia i Ginecologia, i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Ramón Carreras
- Servicio de Ginecología y Obstetricia, Hospital del Mar, Barcelona, España; Departament de Pediatria, d'Obstetrícia i Ginecologia, i de Medicina Preventiva, Universitat Autònoma de Barcelona, Barcelona, España
| | - Juana A Flores-le Roux
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - Juan Pedro-Botet
- Servicio de Endocrinología y Nutrición, Hospital del Mar, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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17
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Mechanism of vascular dysfunction due to circulating factors in women with pre-eclampsia. Clin Sci (Lond) 2016; 130:539-49. [DOI: 10.1042/cs20150678] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/05/2016] [Indexed: 02/07/2023]
Abstract
Circulating factors in the plasma of pre-eclamptic women contribute to vascular dysfunction by increasing oxidative stress, which is associated with a reduction in nitric oxide bioavailability and an increase in prostaglandin H synthase-dependent vasoconstrictors.
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18
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POLAT M, BİBEROĞLU EH, GÜLER İ, BİBEROĞLU ÖK. Coexistence of preeclampsia and inherited thrombophilia in Turkish pregnant women. Turk J Med Sci 2016; 46:1094-100. [DOI: 10.3906/sag-1502-132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 10/10/2015] [Indexed: 11/03/2022] Open
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Zhou A, Xiong C, Hu R, Zhang Y, Bassig BA, Triche E, Yang S, Qiu L, Zhang Y, Yao C, Xu S, Wang Y, Xia W, Qian Z, Zheng T, Zhang B. Pre-Pregnancy BMI, Gestational Weight Gain, and the Risk of Hypertensive Disorders of Pregnancy: A Cohort Study in Wuhan, China. PLoS One 2015; 10:e0136291. [PMID: 26305565 PMCID: PMC4548954 DOI: 10.1371/journal.pone.0136291] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/02/2015] [Indexed: 11/24/2022] Open
Abstract
Background Hypertensive disorders of pregnancy (HDP) are major causes of maternal death worldwide and the risk factors are not fully understood. Few studies have investigated the risk factors for HDP among Chinese women. A cohort study involving 84,656 women was conducted to investigate pre-pregnancy BMI, total gestational weight gain (GWG), and GWG during early pregnancy as risk factors for HDP among Chinese women. Methods The study was conducted between 2011–2013 in Wuhan, China, utilizing data from the Maternal and Children Healthcare Information Tracking System of Wuhan. A total of 84,656 women with a live singleton pregnancy were included. Multiple unconditional logistic regression was conducted to evaluate associations between putative risk factors and HDP. Results Women who were overweight or obese before pregnancy had an elevated risk of developing HDP (overweight: OR = 2.66, 95% CI = 2.32–3.05; obese: OR = 5.53, 95% CI = 4.28–7.13) compared to their normal weight counterparts. Women with total GWG above the Institute of Medicine (IOM) recommendation had an adjusted OR of 1.72 (95% CI = 1.54–1.93) for HDP compared to women who had GWG within the IOM recommendation. Women with gestational BMI gain >10 kg/m2 during pregnancy had an adjusted OR of 3.35 (95% CI = 2.89–3.89) for HDP, compared to women with a gestational BMI gain <5 kg/m2. The increased risk of HDP was also observed among women with higher early pregnancy (up to 18 weeks of pregnancy) GWG (>600g/wk: adjusted OR = 1.48, 95% CI = 1.19–1.84). Conclusion The results from this study show that maternal pre-pregnancy BMI, early GWG, and total GWG are positively associated with the risk of HDP. Weight control efforts before and during pregnancy may help to reduce the risk of HDP.
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Affiliation(s)
- Aifen Zhou
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Chao Xiong
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
- Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Ronghua Hu
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Yiming Zhang
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Bryan A. Bassig
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America
| | - Elizabeth Triche
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, United States of America
| | - Shaoping Yang
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Lin Qiu
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Yaqi Zhang
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Cong Yao
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Youjie Wang
- Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Wei Xia
- Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China
| | - Zhengmin Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, MO, United States of America
| | - Tongzhang Zheng
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States of America
- * E-mail: (BZ); (TZ)
| | - Bin Zhang
- Wuhan Women and Children Health Care Center, Wuhan, Hubei, People’s Republic of China
- * E-mail: (BZ); (TZ)
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20
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Spracklen CN, Smith CJ, Saftlas AF, Robinson JG, Ryckman KK. Maternal hyperlipidemia and the risk of preeclampsia: a meta-analysis. Am J Epidemiol 2014; 180:346-58. [PMID: 24989239 DOI: 10.1093/aje/kwu145] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Published reports examining lipid levels during pregnancy and preeclampsia have been inconsistent. The objective of this meta-analysis was to test the association between preeclampsia and maternal total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and triglyceride levels measured during pregnancy. We conducted a systematic search for studies published between the index date until July 2013 reporting maternal lipid levels in women with preeclampsia and normotensive pregnant women. Seventy-four studies met all eligibility criteria and were included in the meta-analysis. Weighted mean differences in lipid levels were calculated using a random-effects model. Statistical heterogeneity was investigated using the I(2) statistic. Meta-regression was used to identify sources of heterogeneity. Preeclampsia was associated with elevated total cholesterol, non-HDL-C, and triglyceride levels, regardless of gestational age at the time of blood sampling, and with lower levels of HDL-C in the third trimester. A marginal association was found with LDL-C levels. Statistical heterogeneity was detected in all analyses. Meta-regression analyses suggested that differences in body mass index (weight (kg)/height (m)(2)) across studies may be partially responsible for the heterogeneity in the triglyceride and LDL-C analyses. This systematic review and meta-analysis demonstrates that women who develop preeclampsia have elevated levels of total cholesterol, non-HDL-C, and triglycerides during all trimesters of pregnancy, as well as lower levels of HDL-C during the third trimester.
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21
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Luo ML, Tan HZ, Xie RH, Zhou SJ, Retnakaran R, Smith G, Walker MC, Davidge ST, Trasler J, Wen SW. Maternal exposure to the production of fireworks and reduced rate of new onset hypertension in pregnancy. Hypertens Pregnancy 2014; 33:457-66. [PMID: 25068526 DOI: 10.3109/10641955.2014.938752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Carbon monoxide (CO) is one of the main substances contained in fireworks. Previous studies suggested that CO may have protective effect on the development of hypertension of pregnancy. METHOD The authors conducted a prospective cohort study in Liuyang, Hunan, China between January 2010 and December 2011. Demographic and life-style variables of the participating pregnant women were obtained through structured interview with the women and clinical data were retrieved from antenatal medical records. Density of fireworks factories was defined as the number of fireworks factories per 1000 residents in the township where the mothers resided during pregnancy. Multiple logistic regression analysis was used to analyze the independent association between maternal exposure to the production of fireworks and new onset hypertension in pregnancy. RESULTS A total of 5976 pregnant women were included in the final analysis. Density of fireworks factories was inversely correlated with incidence of new onset hypertension in pregnancy (Pearson correlation coefficient = -0.29, p < 0.001). Multiple logistic regression analysis showed that, compared with women who resided during pregnancy in a township with 0-0.25 fireworks factories per 1000 residents, the rates of new onset hypertension in pregnancy in women who resided in a township with 0.26-1.00 fireworks factories per 1000 residents (Odds Ratio = 0.66, 95% confidence interval: 0.46, 0.96) and >1.5 fireworks factories per 1000 residents (Odds Ratio = 0.65, 95% confidence interval: 0.44, 0.97) were reduced by more than 30%. CONCLUSION Maternal exposure to the high density of fireworks factories is associated with reduced risk of developing new onset hypertension in pregnancy.
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Affiliation(s)
- Mei-Ling Luo
- School of Public Health, Central South University , Changsha , China
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22
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Zhang C, Wang Y, Wang Y, Li J, Liu R, Liu H. Decreased levels of serum nesfatin-1 in patients with preeclampsia. Biomarkers 2014; 19:402-6. [DOI: 10.3109/1354750x.2014.919027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | - Yunhai Wang
- Department of Clinical Laboratory, The Affiliated Hospital of Weifang Medical University
WeifangPR China
| | - Jie Li
- The Second Department of Obstetrics
| | | | - Hong Liu
- The Second Department of Obstetrics
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Bilano VL, Ota E, Ganchimeg T, Mori R, Souza JP. Risk factors of pre-eclampsia/eclampsia and its adverse outcomes in low- and middle-income countries: a WHO secondary analysis. PLoS One 2014; 9:e91198. [PMID: 24657964 PMCID: PMC3962376 DOI: 10.1371/journal.pone.0091198] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 02/06/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pre-eclampsia has an immense adverse impact on maternal and perinatal health especially in low- and middle-income settings. We aimed to estimate the associations between pre-eclampsia/eclampsia and its risk factors, and adverse maternal and perinatal outcomes. METHODS We performed a secondary analysis of the WHO Global Survey on Maternal and Perinatal Health. The survey was a multi-country, facility-based cross-sectional study. A global sample consisting of 24 countries from three regions and 373 health facilities was obtained via a stratified multi-stage cluster sampling design. Maternal and offspring data were extracted from records using standardized questionnaires. Multi-level logistic regression modelling was conducted with random effects at the individual, facility and country levels. RESULTS Data for 276,388 mothers and their infants was analysed. The prevalence of pre-eclampsia/eclampsia in the study population was 10,754 (4%). At the individual level, sociodemographic characteristics of maternal age ≥30 years and low educational attainment were significantly associated with higher risk of pre-eclampsia/eclampsia. As for clinical and obstetric variables, high body mass index (BMI), nulliparity (AOR: 2.04; 95%CI 1.92-2.16), absence of antenatal care (AOR: 1.41; 95%CI 1.26-1.57), chronic hypertension (AOR: 7.75; 95%CI 6.77-8.87), gestational diabetes (AOR: 2.00; 95%CI 1.63-2.45), cardiac or renal disease (AOR: 2.38; 95%CI 1.86-3.05), pyelonephritis or urinary tract infection (AOR: 1.13; 95%CI 1.03-1.24) and severe anemia (AOR: 2.98; 95%CI 2.47-3.61) were found to be significant risk factors, while having >8 visits of antenatal care was protective (AOR: 0.90; 95%CI 0.83-0.98). Pre-eclampsia/eclampsia was found to be a significant risk factor for maternal death, perinatal death, preterm birth and low birthweight. CONCLUSION Chronic hypertension, obesity and severe anemia were the highest risk factors of preeclampsia/eclampsia. Implementation of effective interventions prioritizing risk factors, provision of quality health services during pre-pregnancy and during pregnancy for joint efforts in the areas of maternal health are recommended.
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Affiliation(s)
- Ver Luanni Bilano
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Erika Ota
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- * E-mail:
| | - Togoobaatar Ganchimeg
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - João Paulo Souza
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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