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de Moreuil C, Pan-Petesch B, Trémouilhac C, Dupré PF, Merviel P, Anouilh F, Bellot C, Müller M, Drugmanne G, Nowak E, Coadic J, Bihan L, Gourhant L, Lemarié C, Robin S, Couturaud F, Moigne EL. Clinical risk factors for vasculo-placental disorders: results from a prospective case-control study nested in HEMOTHEPP French cohort study. J Gynecol Obstet Hum Reprod 2023; 52:102511. [PMID: 36417979 DOI: 10.1016/j.jogoh.2022.102511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Determine clinical risk factors for vasculo-placental disorders in singleton pregnancies. DESIGN Prospective case-control study nested in HEMOTHEPP French cohort. SETTING Women delivered between June, 2015 and January, 2019 in any maternity ward of Finistère. POPULATION Cases were women with vasculo-placental disorders (pre-eclampsia, intrauterine growth restriction (IUGR), placental abruption or stillbirth). Controls were women matched for age at delivery and parity. METHODS Clinical data were collected by obstetricians or midwives during antenatal care visits and delivery, and recorded by trained research assistants. MAIN OUTCOME MEASURES Occurrence of a vasculo-placental disorder. RESULTS 505 women with vasculo-placental disorder (299 pre-eclampsia, 253 IUGR, 44 placental abruptions, 11 stillbirths) and 1515 matched controls were selected out of 20,075 participants. In multivariable analysis, four clinical parameters were associated with pre-eclampsia: obesity (Odd ratio (OR) = 3.11, 95%CI 2.11-4.58), French overseas origin (OR = 4.41, 95%CI 1.87-10.42), previous vasculo-placental disorder (OR = 5.14, 95%CI 2.72-9.70), aspirin during pregnancy (OR = 10.10, 95%CI 1.99-51.08). Three clinical parameters were associated with IUGR: auto-immune/inflammatory disorder (OR = 3.75, 95%CI 1.83-7.68), previous vasculo-placental disorder (OR = 3.63, 95%CI 2.06-6.41), smoking during pregnancy (OR = 2.66, 95%CI 1.91- 3.71). A previous venous thromboembolism (VTE) was associated with IUGR in univariable but not in multivariable analysis (OR = 3.72, 95%CI 0.82-17.00, p = 0.09). CONCLUSIONS Clinical risk factors differ between IUGR and pre-eclampsia, the later, but not the former, being associated with cardiovascular risk factors.
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Affiliation(s)
- Claire de Moreuil
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Département de médecine interne, médecine vasculaire et pneumologie, CHU Brest - Brest (France), Boulevard Tanguy Prigent, F-29609 Brest Cedex, France.
| | - Brigitte Pan-Petesch
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Centre de traitement de l'hémophilie, Hématologie, CHU Brest - Brest (France), France
| | - Christophe Trémouilhac
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Service de Gynécologie Obstétrique, CHU Brest - Brest (France), France
| | - Pierre-François Dupré
- Service de Gynécologie Obstétrique, CHU Brest - Brest (France), France; INSERM 1078, équipe GTCA, France
| | - Philippe Merviel
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Service de Gynécologie Obstétrique, CHU Brest - Brest (France), France
| | - François Anouilh
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Ecole de Sage-femmes, UFR Santé - Brest (France), France
| | - Charles Bellot
- Service de Gynécologie Obstétrique, CHIC de Quimper - Quimper (France), France
| | - Matthieu Müller
- Service de Gynécologie Obstétrique, CH des Pays de Morlaix - Morlaix (France), France
| | | | | | | | - Line Bihan
- CIC1412, INSERM - Brest (France), France
| | - Lénaick Gourhant
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France
| | - Catherine Lemarié
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France
| | - Sara Robin
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Département de médecine interne, médecine vasculaire et pneumologie, CHU Brest - Brest (France), Boulevard Tanguy Prigent, F-29609 Brest Cedex, France
| | - Francis Couturaud
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Département de médecine interne, médecine vasculaire et pneumologie, CHU Brest - Brest (France), Boulevard Tanguy Prigent, F-29609 Brest Cedex, France
| | - Emmanuelle Le Moigne
- UMR 1304, GETBO, Université de Bretagne Occidentale - Brest (France), France; Département de médecine interne, médecine vasculaire et pneumologie, CHU Brest - Brest (France), Boulevard Tanguy Prigent, F-29609 Brest Cedex, France
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