Incidence Of Hypertensive Disorders Research Articles

Ambient air pollutants exposure during gestation and incidence risk of hypertensive disorders of pregnancy or preeclampsia in China

The relationships between the exposure to ambient air pollutants during gestation and the incidence of hypertensive disorders in pregnancy (HDPs) or preeclampsia are contradictory. This prospective cohort study enrolled the participants between January 2020 and December 2021 from the Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology. The exposure to ambient air pollutants and daily temperatures were obtained from the ChinaHighAirPollutants dataset and the Big Earth Data Platform for Three Poles, respectively. Logistic regression models were used as single- and two-pollutant models. Restricted cubic splines were applied to each ambient air pollutant exposure to further evaluate the exposure-response relationships. Quantile G-computation approaches were employed to evaluate the cumulative impact of mixed ambient air pollutants on the incidence risk HDPs and preeclampsia. Among 19,325 participants (median age: 30.2 years), 1669 (8.64%) were diagnosed with HDPs and 180 (0.94%) with preeclampsia. While mostly null risk estimates were observed, exposure to PM1, PM2.5, PM10, and NO2 correlated with a decreased incidence risk for HDPs and preeclampsia during most gestational periods. Additionally, our multi-pollutant model presented that an increase by one quartile in the cumulative effect of ambient air pollutants was associated with a significantly decreased incidence risk for HDPs in the trimester before gestation and in the third trimester during gestation, as well as for preeclampsia in the third trimester during gestation. These findings warrant further investigation into the mechanisms underlying these associations.

Pregnancy Outcomes Among Women With Sickle Cell Disease in Bahrain: A Case-Control Study.

Objectives The study sought to evaluate and compare the maternal and fetal outcomes of pregnancy in women with sickle cell disease (SCD) versus healthy pregnant women in Bahrain. The objective was to update the available data in order to come up with a strategy to implement a multidisciplinary management program, which will enhance pregnancy outcomes for the SCD patient population. Materials and methods This retrospective case-control study was conducted in the Obstetrics and Gynecology Department at Salmaniya Medical Complex (SMC) in Bahrain. The study group consisted of all pregnant women with homozygous SCD (HbSS) who delivered at SMC between January 1, 2019, and December 31, 2021. The control group comprised pregnant women who delivered at SMC during the same period but did not have SCD or trait. Data for the study were collected from the healthcare system records at SMC, specifically the I-Seha electronic medical record system and the labor room registry book. A thorough review and analysis of the data were conducted, encompassing 217 cases of SCD and 200 controls. The variables examined included nationality, age, gravidity, parity, gestational age, reason for admission, antenatal/postnatal complications (such as urinary tract infection, pneumonia, acute chest syndrome, thromboembolism, premature rupture of membranes, hypertension, pre-eclampsia, and intrauterine growth restriction), type of delivery, birth weight, newborn outcome, and postnatal complications. Results Pregnant women with SCD experienced significantly higher rates of antenatal hospitalization compared to controls - 69.6% were admitted at least twice versus only 16.5%. Vaso-occlusive crises were the primary reason for admission in over half of SCD patients, with 22.6% having one episode, 11.1% having two, and 20.3% having more than two during pregnancy. Low hemoglobin levels also necessitated admission in 11.1% of SCD women, while no controls required hospitalization for this. The burden of maternal morbidity was substantially greater in the SCD group, with only 20.3% free of complications versus 94% in controls. SCD women had elevated rates of blood transfusions, acute chest syndrome, and urinary tract infections. Adverse pregnancy outcomes were also more common, including higher risks of preterm birth, low birth weight, and intrauterine growth restriction. Despite these increased maternal and fetal risks, there was no significant difference in the incidence of hypertensive disorders between groups. Interestingly, our data showed a significantly lower incidence of gestational diabetes in the SCD group compared to controls (8.3% vs. 18%). Tragically, one maternal death occurred in the SCD group, although the overall maternal mortality did not differ significantly. Conclusion SCD poses substantial risks for mother and fetus. Careful monitoring with a multidisciplinary team and patient education are crucial. Early detection can reduce morbidity and mortality. Further research is needed on interventions to improve outcomes.

SERUM 25 (OH) VITAMIN D AND CALCIUM LEVELS AND ADVERSE MATERNAL AND PERINATAL OUTCOMES IN PREGNANCY INDUCED HYPERTENSION

Objectives: Incidence of hypertensive disorders in pregnancy is about 5–10% of all pregnancies [1]. Pre-eclampsia alone or superimposed on chronic hypertension is the most threatening. This study is done to evaluate the levels of serum 25 (OH) Vitamin D and Calcium in normal antenatal patients and patients with pregnancy-induced hypertension and their effects on perinatal and maternal outcome. Hence, that timely intervention can prevent adverse perinatal and maternal outcomes. Methods: The present prospective observational study was done in the Department of Obstetrics and Gynecology, Government Medical College and Rajindra Hospital, Patiala, Punjab, India from May 2018 to April 2019. The study was conducted on 80 antenatal patients. Patients were divided into two groups with 40 patients in each group. Group I included patients with pregnancy-induced hypertension and Group II included normal antenatal patients. Serum levels of calcium and 25 (OH) Vitamin D were evaluated in both groups. Adverse perinatal and maternal outcomes were assessed in relation to the serum levels of calcium and 25 (OH) Vitamin D in patients with pregnancy-induced hypertension and normal antenatal patients. Categorical variables were analyzed by Chi-square test and Fisher’s exact test. The analysis of continuous variable was done by ANOVA. The data were analyzed using SPSS version 22 and Microsoft Excel. p≤0.05 is taken as statistically significant. Results: The mean value of serum Vitamin D level in Group I was 22.30±6.11 ng/ml and 36.68±9.34 ng/ml in Group II giving p=0.016 which was highly significant. In Group I, mean calcium levels were 8.58±0.63 mg/dl and 9.27±0.40 mg/dl in Group II giving p=0.018 which was highly significant. The Pearson’s correlation coefficient was −0.753 for serum Vitamin D and systolic blood pressure (BP) and the same for serum Vitamin D and diastolic BP with p=0.001 which was highly significant. The Pearson correlation coefficient was −0.537, −0.514 for serum calcium and systolic BP and serum calcium and diastolic BP, respectively, giving p=0.001. Conclusion: Serum levels of 25 (OH) Vitamin D and calcium have a significant relationship with pregnancy-induced hypertension. Low levels of calcium and 25 (OH) Vitamin D cause an increased risk of pregnancy-induced hypertension and supplementation of these reduces the incidence of pregnancy-induced hypertension. Hence, their supplementation can be used as a possible intervention strategy in preventing one of the most common causes of perinatal and maternal morbidity and mortality around the world.

The Impact of Undetected Hyperglycaemia During Pregnancy on Maternal and Neonatal Outcomes.

Despite clear diagnostic criteria for hyperglycaemia first detected in pregnancy, many pregnant women do not have the proper diagnosis. The following paper analyses the course of the perinatal period in pregnant women with undetected hyperglycaemia and their newborns. Medical data of patients hospitalized in the Department of Perinatology between 2020 and 2022 was verified: 1st group: 40 patients with undetected hyperglycaemia, 2nd group: 40 with the diagnosis of gestational diabetes during pregnancy and adequate therapeutic management. The course of the perinatal period, abnormalities in the oral glucose tolerance test (OGTT) and the compliance with recommended postpartum tests were analysed. There were significant differences in the newborn weights (p=0.039) - in the 1st group 15% large for gestational age (LGA) vs. 0% in the 2nd, and the occurrence of neonatal hyperbilirubinemia requiring phototherapy (p=0.007) - 22.5% in the 1st group vs. 2.5% in the 2nd. The most common mistake in the OGTT was evaluation of fasting plasma glucose. In the 1st group, no effect on incidence of hypertensive disorders, time or the route of delivery was observed. 75% from the 1st group and 36% from the 2nd did not perform postpartum OGTT (p=0.003). Hyperglycaemia in pregnancy is often undetected, which has a negative impact, especially on the neonates. In our study, LGA and hyperbilirubinaemia were significantly more common in neonates of mothers with undetected hyperglycaemia. These women had significantly more careless attitude to the postpartum diagnostic, which may influence future health and course of subsequent pregnancies. New and more effective methods of educating practitioners need to be implemented.

Modeling risk factors in preeclampsia for late pregnancies using fuzzy cognitive maps

As women delay motherhood, concerns arise about the risks associated with pregnancy at advanced ages. Pregnant women aged 35 and older face an increased likelihood of complications, such as spontaneous abortions and preexisting conditions that can complicate pregnancy, such as hypertension and diabetes. The incidence of hypertensive disorders, such as preeclampsia, also significantly increases in this age group, which can lead to a higher use of cesarean sections and instrumental deliveries, as well as an increase in neonatal morbidity and mortality. This study aims to model the risk factors for preeclampsia in late pregnancies using fuzzy cognitive maps, seeking a better understanding of the complexity of this condition and facilitating the early identification of women at risk. Data collection will be conducted through the review of clinical records and structured interviews with participants, which will complement the existing clinical information. The identification of risk factors, such as obesity and a history of hypertension, is crucial for optimizing prenatal care and improving maternal-fetal outcomes. Additionally, prevention strategies are proposed that include education about the risks, promoting healthy lifestyle habits, and ensuring access to adequate prenatal care, in order to reduce the incidence of preeclampsia and its associated complications in pregnant women aged 35 and older

O-275 Becoming parents after hematopoietic stem cells transplantation: obstetrics outcomes of spontaneous pregnancies

Abstract Study question Are spontaneous pregnancies after hematopoietic stem cells transplantation (HSCT) of one of the two partners burdened with an increased risk of obstetric complications? Summary answer We found a higher risk of Intrauterine growth restriction (IUGR) and preterm delivery after both maternal and paternal HSCT and of pre-eclampsia after maternal HSCT. What is known already Conditioning therapies for HSCT are highly gonadotoxic and result in permanent amenorrhea or azoospermia in 70% of patients. Small cohorts of pregnancies after HSCT show an increased risk of complications such as dysfunctional placentation, IUGR or preterm birth. With no more than 9% of survivors reporting a spontaneous pregnancy and the others using of cryopreserved material or gametes donation, it is difficult to untangle the effect of assisted reproduction techniques, gametes donation, radiation on the uterus, and HSCT itself. Study design, size, duration This is a retrospective analysis of all spontaneous pregnancies among patients who underwent HSCT for haematological malignancies in a single national referral centre between 1990 and 2016. Obstetric and neonatal outcomes are reported to be compared to the expected incidence in the general population. All patients signed a general informed consent for the use of their anonymized data for research and we obtained the local ethics committee approval. Participants/materials, setting, methods We collected the outcome of 53 pregnancies in 30 women after HSCT and 33 pregnancies from 22 men after HSCT. The malignancies treated with HSCT were leukaemia (15 females and 14 males), severe aplastic anaemia (12 and 10), Hodgkin’s lymphoma (2 and 1) and myelofibrosis (1 and 1). The conditioning regimen included total body irradiation (TBI) in 20 women (66.7%) and 8 men (36.4%). All patients we included conceived spontaneously after HSCT. Main results and the role of chance We observed 53 pregnancies (52 singletons and 1 monochorionic diamniotic twin pregnancy) in women, 12±5.3 years after HSCT. Nine (16.9%) resulted in an early miscarriage. Of the other 44, 15 (34.1%) were uneventful and resulted in a healthy baby born at term. We observed 10 (22.7%) preterm deliveries: 4 very preterm births (1 at 29 and 3 at 31 weeks; 2 spontaneous 2 iatrogenic for pre-eclampsia); 5 moderate preterm births (32 weeks; 4 spontaneous and 1 iatrogenic for pre-eclampsia); 1 late preterm birth (36 weeks, iatrogenic for pre-eclampsia). The incidence of hypertensive disorders in all pregnancies was high (10, 22.7%). In 9 pregnancies (20.5%) there was evidence of IUGR, one of which resulted in an intrauterine foetal death at 35 weeks of gestation. Half of the patients delivered through caesarean section (20, 45.5%). We also reported 33 pregnancies fathered by 22 men who underwent HSCT 7.3±4.3 years earlier. Two pregnancies (6.1%) ended in an early miscarriage. Sixteen of the other 31 pregnancies (51.6%) were uneventful. In 12 cases (38.7%) there was evidence of IUGR, leading to 5 iatrogenic preterm births (16.1%). No maternal hypertensive disorder of pregnancy was reported. Limitations, reasons for caution While this is, as far as we know, the largest cohort of spontaneous pregnancies after HSCT present in the literature, the numerosity is still low and we cannot exclude larger numbers would have produced different results. Wider implications of the findings HSCT has consequences on reproduction, behind infertility. Pregnancies after HSCT should be followed in a high-risk setting, collecting data collaboratively. The next research effort should be focused on understanding the specific action of the different conditioning therapies used in females and males, to unveil the biological rationale behind these findings. Trial registration number not applicable

Comparison of four-coagulation-tests values in normal pregnant women during early and late pregnancy and the influence of age

Objective: To explore and compare the reference ranges of four coagulation tests in normal pregnant women during early and late pregnancy and the influence of age. Methods: Values of four coagulation tests from 4 974 pregnant women, who gave single birth at Peking University First Hospital, Obstetrics and Gynecology Hospital of Fudan University, West China Second University Hospital, Peking University Third Hospital and Shengjing Hospital of China Medical University from February 2017 to July 2020, were measured and analyzed in this study, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and thrombin time (TT). The four normal reference ranges of coagulation during early and late pregnancy phases were expressed as P2.5-P97.5. The difference of two pregnancy phases was compared by non-parametric test of two related samples. And the difference between pregnant women of advanced and non-advanced age in the same pregnancy phase was compared by independent sample non-parametric test. Chi-square test was used to compare the incidence of pregnancy complications in different coagulation reference ranges. Results: The reference ranges of PT of normal pregnant women's early and late pregnancy were 10.0-13.9 s and 9.6-12.3 s, the reference ranges of APTT were 22.6-35.3 s and 22.4-30.9 s, the reference ranges of Fib were 2.4-5.0 g/L and 3.0-5.7 g/L, the reference ranges of TT were 12.0-19.0 s and 11.5-18.4 s. Compared with early pregnancy, PT, APTT and TT shortened significantly, while the Fib significantly increased in late pregnancy (all P<0.001). PT, APTT and TT of advanced and non-advanced age pregnant women were significantly different (all P<0.01). Compared with the ranges of non-pregnant population, more pregnant women were included in the normal pregnant reference ranges of PT in early pregnancy and APTT in the early and late pregnancy, while the incidence of pregnancy complications had no significant differences (all P>0.05). The incidence of fetal distress was higher and the incidence of preterm birth was lower in the reference range of PT in late pregnancy. The incidence of gestational diabetes mellitus was higher in the early and late gestational Fib reference ranges, and the incidence of hypertensive disorders in pregnancy was higher in the late gestational Fib reference range (all P<0.05). Conclusions: The coagulation function of pregnant women increases significantly with the growth of pregnancy, and there is a significant difference between advanced significantly and non-advanced age pregnant women. The recommended ranges of normal pregnant women's early and late pregnancy PT are 10.0-13.9 s and 9.6-12.3 s, the recommended ranges of APTT are 22.6-35.3 s and 22.4-30.9 s, the recommended ranges of TT are 12.0-19.0 s and 11.5-18.4 s. The appropriate ranges of normal pregnant women's early and late pregnancy Fib still need further exploration.

Iron supplementation for non-anaemic pregnant women and the incidence of hypertensive disorders in pregnancy

Objective: To investigate effect of iron supplementation on the risk of hypertensive disorders in pregnancy in non-anaemic pregnant women. Methods: A literature search was conducted using three categories of terms with its synonyms or related words: “iron”, “supplement”, “hypertensive disorders in pregnancy” through MEDLINE (OVID), CINAHL, PubMed, Cochrane Library, Scopus, Web of Science, ICTRP, and ClinicalTrials.gov, and manual search of references was used in seven potential resources. The inclusion criteria were randomized control trials (RCTs), published in English, full-text available, having healthy pregnant women without anaemia for study participants, and having hypertensive disorders in pregnancy at the end of pregnancy as the outcome. The risk of bias assessment tool was used for quality appraisal. Meta-analysis was conducted by calculating the fixed and random effects of the odds ratio (OR) for iron supplementation among non-anaemic pregnant women compared with the incidence of hypertensive disorders in pregnancy. The range of the study's estimation accuracy was reflected by a 95% confidence interval (CI). Results: Four RCTs were included in the meta-analysis. The pooled results showed that iron supplementation possibly had no effect on the incidence of hypertensive disorders in pregnancy (OR 0.93, 95% CI 0.81-1.07; P=0.30), gestational hypertension (OR 1.37, 95% CI 0.69-2.73; P=0.36) as well as on the development of preeclampsia (OR 1.45, 95% CI 0.71-2.97; P=0.31). Conclusions: Iron supplementation has no effect on the incidence of hypertension in non-anaemic pregnant women. In general, there is a lack of evidence for the association between iron supplementation and the incidence of hypertensive disorders in pregnancy among non-anaemic pregnant women, and further studies are needed.

P-754 Perinatal outcomes and congenital anomalies after clomiphene citrate based minimal ovarian stimulation in vitro fertilisation stratified by embryo transfer method: a 10-year cohort study

Abstract Study question Is the embryo transfer method associated with perinatal outcomes and congenital anomalies after minimal ovarian stimulation in vitro fertilisation (IVF) with clomiphene citrate (CC)? Summary answer Single vitrified-warmed blastocyst transfers in natural cycles had a lower incidence of pregnancy complications compared to single fresh cleaved embryo transfers after CC-based ovarian stimulation. What is known already Pregnancies resulting from IVF are associated with a higher risk of adverse perinatal outcomes compared to spontaneous conception; therefore, the next focus in reproductive medicine is to assess whether the increased risks are attributable to the IVF. Perinatal outcomes and congenital anomalies should be considered in addition to pregnancy outcomes in selecting the embryo transfer method. However, studies describing the influence of transfer methods on perinatal and maternal outcomes are limited. Study design, size, duration This study retrospectively analysed a single centre 10-year cohort. A total of 82,491 clinical records of women who underwent oocyte retrieval during a CC-based minimal stimulation cycle followed by single fresh cleaved embryo transfer (SFCT), single vitrified-warmed cleaved embryo transfer (SVCT), or single vitrified-warmed blastocyst transfer (SVBT) at the Kato Ladies Clinic between January 2008 and December 2017 were retrospectively analysed. Participants/materials, setting, methods The oocyte retrievals were performed in CC-based minimal ovarian stimulation. The embryos were transferred 2–3 days after retrieval, or vitrified at the cleavage or blastocyst stages. The vitrified embryos were warmed and transferred within the natural cycles. Perinatal outcomes and congenital anomalies were stratified by the transfer method. Multivariate logistic regression analysis was performed to evaluate the effect of transfer methods on pregnancy complications and congenital anomalies. Main results and the role of chance The perinatal outcomes and congenital anomalies in 19,069 singleton pregnancies were analysed. Multivariate logistic regression analysis revealed that the incidence of hypertensive disorders of pregnancy was significantly lower in the SVBT group compared with the SFCT group (adjusted odds ratio [AOR], 0.628; P &amp;lt; 0.0001). The incidence of low-lying placenta (AOR 0.359 P = 0.0483; AOR 0.452 P &amp;lt; 0.0001, respectively) and placenta previa (AOR 0.300 P = 0.0021; AOR 0.542 P &amp;lt; 0.0001, respectively) were lower in the SVCT and SVBT groups than in the SFCT group. The rate of preterm delivery was lower in SVBT compared with SFCT (AOR 0.732 P &amp;lt; 0.0001). The rate of low birth weight was significantly lower after SVCT and SVBT, compared with the SFCT group (AOR 0.751; P = 0.0261: AOR, 0.560; P &amp;lt; 0.0001: respectively). A lower incidence of small for gestational age (AOR 0.720 P = 0.0436; AOR 0.494 P &amp;lt; 0.0001, respectively) and higher incidence of large for gestational age (AOR 1.287 P = 0.0332; AOR 1.706 P &amp;lt; 0.0001, respectively) were observed in the SVCT and SVBT groups compared to the SFCT group. The incidence of each congenital anomaly was similar among the groups. Limitations, reasons for caution The data was collected through self-reported parental questionnaires on neonatal outcomes and congenital malformations. Furthermore, this study was retrospective in nature; further studies are necessary to ascertain the generalisability of these findings to other clinics with different protocols and/or patient demographics. Wider implications of the findings This study demonstrated reassuring outcomes for SVBT, in terms of a lower incidence of pregnancy complications compared with SFCT. Our findings provide valuable knowledge to improve perinatal outcomes in CC-based stimulation and to inform couples of the possible benefits and harms of each type of embryo transfer method. Trial registration number not applicable

Hypertensive disorders in pregnancy - Trends over eight years: A population-based cohort study.

To describe the incidence and trends of hypertensive disorders of pregnancy and adverse pregnancy outcomes in recent years in Victoria, Australia. Retrospective population-based cohort study, 2010 to 2017. State of Victoria, Australia. Population-based cohort study. Incidence of hypertensive disorders and its subtypes over time. Composite of major adverse maternal and perinatal outcome. The incidence of hypertensive disorders (n=36,406/614,524 pregnancies with 624,193 births) and all its subtypes has been stable, (n=4,192/73,235=5.7% in 2010 to 4,601/78,576=5.9% in 2017). Compared to no hypertension, hypertensive disorders were associated with medically-initiated birth (aOR 4.70 [4.56, 4.84]), caesarean section (aOR 1.46 [1.43, 1.50]), placental abruption (aOR 1.94 [1.69, 2.22]), maternal intensive care or high-dependency unit admission (aOR 6.80 [6.45, 7.17]), composite of major adverse maternal outcome (aOR 3.87 [3.70, 4.04]), and composite of major adverse perinatal outcome (aOR 1.63 [1.56, 1.70]). The worst maternal and perinatal outcomes were among women with superimposed and early preterm preeclampsia. The incidence of all hypertensive disorders in pregnancy has remained stable over time. Early-onset preeclampsia and superimposed preeclampsia were most strongly associated with adverse pregnancy outcomes.

Endometriosis does not seem to be an influencing factor of hypertensive disorders of pregnancy in IVF / ICSI cycles

IntroductionTo evaluate whether the incidence of hypertensive disorders of pregnancy (HDP) in pregnant women was related to endometriosis (EM), ovulation and embryo vitrification technology.MethodsA retrospective cohort study was conducted on the clinical data of 3674 women who were treated with IVF / ICSI in the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-sen University and maintained clinical pregnancy for more than 20 weeks. All pregnancies were followed up until the end of pregnancy. The follow-up consisted of recording the course of pregnancy, pregnancy complications, and basic situation of newborns.ResultsCompared with NC-FET without EM, HRT-FET without EM was found to have a higher incidence of HDP during pregnancy (2.7% V.S. 6.1%, P<0.001); however, no significant difference was found in the incidence of HDP between NC-FET and HRT-FET combined with EM (4.0% V.S. 5.7%, P>0.05). In total frozen-thawed embryo transfer (total-FET), the incidence of HDP in the HRT cycle without ovulation (HRT-FET) was observed to be higher than that in the NC cycle with ovulation (NC-FET) (2.8% V.S. 6.1%, P<0.001). In patients with EM, no significant difference was found in the incidence of HDP between fresh ET and NC-FET (1.2% V.S. 4.0%, P>0.05).ConclusionEM does not seem to have an effect on the occurrence of HDP in assisted reproductive technology. During the FET cycle, the formation of the corpus luteum may play a protective role in the occurrence and development of HDP. Potential damage to the embryo caused by cryopreservation seems to have no effect on the occurrence of HDP.

Maternal and Perinatal Outcome in Adolescent Pregnancies as Compared to Adult Pregnancies

Introduction: Adolescence is the period between the ages of 10-19 years that encompasses time from onset of puberty to full legal ages (WHO 2002).&#x0D; Objective: The objective of the study was to explore effect of maternal ages on fetomaternal and perinatal outcome.&#x0D; Methods: This is a hospital based retrospective case-control study conducted over 1 year (March 2017 to February 2018) in the department of Obstetrics and Gynaecology in Tribhuvan University Teaching Hospital to study the antenatal complications and perinatal outcome in adolescent pregnant women as compared to pregnant women of age 20-30 years.&#x0D; Results: During this study period, there were 4980 deliveries out of which adolescent pregnancy were 140(2.8%). Anemia was significantly more in teenage group (16.42% vs 8.57%, p=0.047). Incidence of hypertensive disorders was 5.71% and 1.42% (p=0.05) in teenage and adult group. Proportion of babies with intrauterine growth restriction was 5.71% in teenage and 1.42% (p=0.05) in adult group. Low birth weight babies were significantly higher in teenage group than adult group 16.42% vs 8.57% (p=0.047). NNU admission and apgar score were significantly higher in teenage group 5.71% vs 1.42%.&#x0D; Conclusion: Teenage pregnancies are associated with adverse obstetric and perinatal outcome.

Hypertensive disorders of pregnancy by oocyte donation pregnancy in Japanese women aged 40 years or older: a single-center retrospective cohort study

ABSTRACT This study aimed to examine the incidence of hypertensive disorders of pregnancy (HDP) among Japanese women with oocyte donation pregnancy (ODP) aged 40 years or older and estimate whether the women with ODP were more likely to develop HDP than those with autologous oocyte pregnancy (AOP) and spontaneous pregnancy (SP). In our study (N = 1361), the proportions of women who developed HDP were 20.5%, 12.8%, and 7.6% for ODP, AOP, and SP, respectively. After adjustment of covariables, the women with ODP were more likely to develop HDP than those with AOP or SP.

Prevalence of Hypertensive Disorder of Pregnancy in North India

Aims and Objective: Hypertensive disorders of pregnancy (HDP) are among the commonest medical disorders during pregnancy constituting one of the greatest causes of maternal and perinatal morbidity and mortality worldwide . This study aimed to analyze the prevalence of hypertensive disorder of pregnancy in North India&#x0D; Material and Method: The study group consisted of a total of 150 pregnant women attending Maharaja Agrasen hospital OPD/IPD during their second trimester (14-20 weeks) of pregnancy from Dec 2016 to Nov 2017.&#x0D; Results: Out of 146 cases studied , 129 cases remained normotensive and 17 cases developed HDP. Out of 17 cases ,8 cases had mild HDPs and 9 cases had severe HDPs. The prevalence of HDP was 11.7% in present study.&#x0D; Conclusion: The study concluded that the incidence of hypertensive disorders in pregnancy was higher than worldwide average and hence early diagnosis and intervention through regular antenatal checkup is pivotal to prevent hypertensive disorders of pregnancy and its complications.

Changes of second-time mothers and their infants under the universal two-child policy in Changsha, China

BackgroundChina announced the implementation of the universal two-child policy in Oct, 2015; every couple was allowed to have two children. However, its influences on maternal well-being and infants’ outcomes are still to be discovered. ObjectivesTo detect influences of the universal two-child policy. To provide information for maternal health care under the new policy. Study designThis study enrolled 859 and 1230 women who delivered their second child (hereafter second-time mothers) before and after the policy's implementation, respectively, and the data included maternal demographic characteristics, gestational complications, delivery mode and infants’ outcomes. ResultsAfter the policy's implementation, the proportion of second-time mothers with advanced age increased significantly. The advanced gestational age is well acknowledged to correlate with higher risk during the pregnancy, both for pregnant women and their babies. However, in our study, the incidence of hypertensive disorders in pregnancy, placenta previa and postpartum haemorrhage decreased significantly after the introduction of the policy and no differences were noted in other gestational complications. Moreover, the hospitalization time was shortened, and caesarean delivery was chosen less frequently. As for the infants, foetal distress exhibited an alleviation and the incidence of premature labour and low birth weight decreased as well. ConclusionsEven though the age of second-time mothers increased after the introduction of the universal two-child policy, their general gestational health condition improved and their infants also exhibited a better outcome, which might be attributed to the improvement of China's maternal medical care system.

Hyperglycemia recognised in early pregnancy is phenotypically type 2 diabetes mellitus not gestational diabetes mellitus: a case control study

Objective: Gestational diabetes mellitus is defined as “diabetes recognized in the second or third trimester that is not clearly overt diabetes”. Evidence relating to women with hyperglycemia early in pregnancy is limited. We aimed to evaluate women diagnosed with hyperglycemia early in pregnancy (eGDM) and compared them to those with pregestational established type 2 diabetes mellitus (T2DM) and gestational diabetes diagnosed routinely at 24–28-week gestation (rtGDM) to determine if the length of exposure to hyperglycemia adversely affected outcomes.Methods: Forty consecutive women with eGDM who attended a multidisciplinary antenatal clinic were reviewed. Two separate BMI-matched control groups were identified, recognized pregestational T2DM (n = 80) and rtGDM (n = 80). Baseline demographics and outcomes were compared.Results: A higher proportion of women in the eGDM and T2DM group required insulin and the incidence of hypertensive disorders was similarly increased compared with the rtGDM group (88.6, 77.0 versus 8.1%, p < .001 and 42.5%, 37.5 versus 12.5% p < .001, respectively). The proportion of infants born small for gestational age varied (eGDM 11.1%, T2DM 13.0%, and rtGDM 2.5%, p=.049). Postpartum, 7.5% of eGDM women were diagnosed with T2DM versus 1.3% in the rtGDM group (p<.001).Conclusions: These novel data demonstrate that the length of exposure to glucose adversely affects materno-foetal outcomes independent of maternal adiposity.

Essential Mineral Intake During Pregnancy and Its Association With Maternal Health and Birth Outcomes in South East Queensland, Australia.

Micronutrient supplements are often recommended during pregnancy, yet their role and necessity remain poorly understood in the Australian population. This study aimed to determine the essential mineral intake of a population of pregnant women in South East Queensland and investigate the effects of supplements on their micronutrient status and birth outcomes. Women completing the Oral Glucose Tolerance Test at two South East Queensland hospitals between 180 and 210 days gestation provided fasting blood samples and dietary data using the Maternal Outcomes and Nutrition Tool (n = 127). Birth outcomes were sourced from medical records. Serum elemental profiles were determined by inductively coupled plasma mass spectrometry (ICP-MS) analysis. Intake of 8 essential minerals was compared with Australian dietary recommendations; matched serum mineral levels were compared with the current Queensland pregnancy reference ranges. Data were examined using cross-sectional cohort design and independent sample t-tests. Supplement use had no significant influence on serum values of trace elements or the incidence of hypertensive disorders, gestational diabetes, preterm birth or infant birthweight. Dietary selenium, zinc and iodine were significantly higher in women birthing beyond 41 completed weeks; selenium (P = .026) and zinc (P = .034) both made unique contributions to the regression models when controlling for confounders. Women exhibited adequate to excessive serum micronutrient levels compared with pregnancy reference ranges, a finding consistent with dietary intake calculations. Data suggest that excessive essential mineral intake contributed to prolonged pregnancy in this cohort, supporting previous studies in this population. Further research is required to determine individual needs and eliminate the potential for harm before recommending pregnancy supplements.

Effect of pre-gravid body mass index on outcomes of pregnancies following in vitro fertilization.

To examine the effect of pre-gravid body mass index (BMI) on perinatal outcomes in in vitro fertilization (IVF) singleton pregnancies. Retrospective population-based cohort study. All singleton pregnancies delivered at ≥ 22weeks' in Slovenia between 2002 and 2015 were included. Logistic regression analysis was used to examine the relationship between BMI category and outcomes, controlling for potential confounding variables. Interaction term was included to evaluate whether effects of obesity on perinatal outcomes differ in IVF vs. non-IVF pregnancies. We counted the frequencies of hypertensive disorders of pregnancy, gestational diabetes, cesarean delivery, preterm births, and small as well as large for gestational age neonates, neonatal respiratory distress syndrome, neonatal intraventricular hemorrhage, and perinatal deaths. Pre-gravid overweight and obesity were associated with higher rates of hypertensive disorders, gestational diabetes, and cesarean deliveries in both IVF and non-IVF pregnancies. Pre-gravid underweight was associated with small for gestational age neonates in IVF and non-IVF pregnancies. There was a significantly lower effect of pre-gravid obesity on the incidence of hypertensive disorders (odds ratio (OR) 0.7; 95% confidence interval (CI) 0.5-0.9) and cesarean delivery (OR 0.8; 95% CI 0.7-0.99) in IVF vs. non-IVF pregnancies. The effect of pre-gravid obesity on neonatal mortality was significantly greater in IVF compared to non-IVF pregnancies (OR 4.6; 95% CI 1.4-15.8). Pre-gravid BMI has an important effect on perinatal outcomes in pregnancies following IVF.

Nutritional Status of Pregnant Women and Urine Calcium-to-Creatinine Ratio During 24th - 28th Weeks of Pregnancy and Their Relationship with the Incidence of Hypertensive Disorders During Pregnancy

Background: Considering that gestational hypertension may have severe effects on the mother and fetus, this study was conducted to examine the nutritional status of pregnant women and urine calcium-to-creatinine ratio during 24th - 28th weeks of pregnancy and their relationship with the incidence of hypertensive disorders during pregnancy. Methods: This prospective longitudinal study recruited 538 pregnant women attending prenatal clinics in Tehran, Iran in 2011. A food frequency questionnaire (FFQ) was completed for all mothers at the baseline for nutritional intake assessment, and a random urine sample was taken between 24th - 28th weeks of pregnancy to calculate the Ca/Cr-ratio. Hypertensive disorders were classified into two groups: a, gestational hypertension in case of detecting a blood pressure ≥ 140/90; and b, preeclampsia in case of increased proteinuria. Data were analyzed using SPSS V.16 and N4 software programs. Results: In this study, 14 (6.2%) pregnant women had hypertensive disorders during pregnancy. The desired nutritional status and Ca/Cr-ratio had no significant relationship with hypertensive disorders during pregnancy. The regression test was used to investigate the variables affecting hypertensive disorders, which showed the significant relationship of pre-pregnancy BMI and mother’s age with hypertensive disorders during pregnancy (P ≤ 0.05). Conclusions: In this study, the incidence of hypertensive disorders had no relationship with the Ca/Cr-ratio and the nutritional status of the pregnant women. However, since more than 80% of the participants had undesirable nutrition, mothers’ nutrition in the first half of pregnancy is necessary to be under observed.

Эффективность медикаментозной профилактики преэклампсии у беременных группы риска

Objective: To analyze the effectiveness of preeclampsia drug prevention using aspirin in pregnant women of risk group. Materials and methods: A comparative longitudinal prospective study of 854 pregnant women at risk was conducted. The main group consisted of 687 high- and medium-risk patients who received aspirin 75 mg per day from 12 weeks of pregnancy to delivery. The comparison group consisted of 167 high-and medium-risk pregnant women who did not receive aspirin. Results: The incidence of hypertensive disorders in women of the main group was 1.4 times (p<0.05), preeclampsia - 1.8 times (p<0.01), severe preeclampsia - 3.2 times (p<0.001) less than in patients of the comparison group.