Prevalence Of Pregnancy-induced Hypertension Research Articles

Pregnancy-induced hypertension awareness, knowledge and its risk factors: A cross-sectional study.

Pregnancy-induced hypertension (PIH) has severe implications for maternal morbidity and mortality; thus, boosting pregnant women's awareness and knowledge of this medical condition is crucial for improving the mother's and foetus's health. This study assessed the awareness and knowledge of PIH and its risk factors among pregnant women in Mdantsane, South Africa. This cross-sectional study involved 249 conveniently selected and consenting pregnant women attending antenatal care clinics in Mdantsane, Buffalo City Metropolitan Municipality, South Africa. A self-designed questionnaire was utilised to collect data. Descriptive statistics, chi-square (χ2) test and multivariate logistic regression analysis were performed. The significance level was 0.05. Over 50% of the women were knowledgeable about PIH and associated risk factors ((χ2=4.92; p = 0.04). The prevalence of PIH was 51.8%, and married women were more aware of the PIH risk factors (71.1%). Women with previous pregnancies were more likely to be aware of PIH (OR = 17.1, 95%; CI = 9.09 to 32.15) compared to first time mothers. Women in age group 36-45 were 2.5 times more likely to be aware of PIH (OR = 2.5, 95% CI: 1.19-3.24) compared to women aged <35 years. Likewise, women aged 36-45 years were two times more likely to be knowledgeable about risk factors for PIH (OR = 2.3, 95% CI: 1.14-2.81) compared to women aged <35 years. Married women were more likely to be aware of PIH risk factors (OR = 2.70, 95% CI = 1.35-5.47) than unmarried women. Moreover, pregnancy increases the likelihood (OR=12.8, 95% CI: 6.97-23.58) of being aware of PIH risk factors. There was a significant difference between the mean ages of women who knew about PIH risk factors and those who do not (t=3.49, Mean difference = 3.49, p=0.0001, 95% CI (2.54; 4.44)). The prevalence of PIH was high. Age, history of PIH, previous pregnancy, and marital status were predictors of PIH knowledge/awareness and risk factors for PIH. Context-specific health education programmes during prenatal visits are crucial to improving pregnant women's knowledge of PIH.

SERUM ACTIVIN A &amp; INHIBIN A: POSSIBLE BIOCHEMICAL MARKERS OF PREECLAMPSIA &amp; PREGNANCY INDUCED HYPERTENSION

Objective: The objective of this study was to compare the levels of Serum Activin A and Inhibin A in Pregnancy induced hypertension, Preeclampsia &amp; Normal Pregnancy Material and Methods: An analytical, cross-sectional study conducted at Chemical Pathology Laboratory Collaborating with Gynae/Obstetric Department of Pakistan Railway Teaching Hospital, Rawalpindi over the period of one year (18 Sep 2019 to 18 March 2020). The study started after the approval of Ethical Review Committee, Riphah International University Islamabad. The sample size was calculated using WHO sample size calculator. Taking Prevalence of PIH and PE is 8%.3 Non probability convenient sampling technique was used. An overall 100 pregnant women with gestation of 20 – 25 weeks, were included. Patients of UTI, Carcinomas, Diabetes Mellitus and other chronic disorders were not included. The subjects were divided into three groups. Group I PIH: This group included 30 pregnant women of PIH; 20 - 25 weeks of gestation, BP: ≥140/90 mmHg on two separate occasions without proteinuria. Group II PE: This group included 20 pregnant women of preeclampsia; 20 - 25 weeks of gestation, BP: ≥140/90 mmHg on two separate occasions with proteinuria (&gt;0.3 g protein/24 hours Urine). Group III Control Group: This group included 50 pregnant women with gestational age of 20 – 25 weeks without any complication as healthy controls. Results: It was determined that Serum Activin A and Serum Inhibin A levels were significantly increased in PIH and PE groups as compared to healthy group. Mean of Serum Activin A in PIH, PE and Control group was (251.53+200.23 pg/ml), (466.95 + 237.40 pg/ml) and (43.35 + 85.22 pg/ml) respectively. Similarly Mean and Standard Deviation of Serum Inhibin A levels in PIH, PE and Control group was (194.78 + 173.00 pg/ml), (349.20 + 190.30 pg/ml) and (17.27 + 44.33 pg/ml) respectively. One-way ANOVA and post-hoc Tukey analysis was conducted to compare the mean of Serum Activin A and Serum Inhibin A levels among three different groups i.e Group 1(PIH and PE), Group 2(PIH and Control) and Group 3 (PE and Control). p-value&lt; 0.05 was considered as statistically significant. Conclusion: It can be concluded that Serum Activin A and Serum Inhibin A can be used as biochemical markers of PIH and PE. Estimation of Serum Activin A and Inhibin A at an early stage can detect PIH and PE early and further prevents their complications such as Eclampsia and HELLP syndrome. Keywords: Pregnancy induced hypertension (PIH), Pre-eclampsia (PE), HELLP syndrome (H – Hemolysis, EL- Elevated Liver Enzymes, LP – Low platelets count), Serum activin A, Serum inhibin A.

P-778 Same mother-different Oocyte: Comparison of obstetric and perinatal outcomes between pregnancies achieved through oocyte donation versus those achieved through spontaneous conception for the same mother

Abstract Study question Is there a difference in obstetrical and perinatal outcomes between pregnancies achieved through oocyte donation versus those achieved through spontaneous conception for the same mother Summary answer OD pregnancies show higher incidences of preterm labor and pregnancy-induced hypertension, and lower incidences of small for gestational age, compared to spontaneous pregnancies What is known already Oocyte donation (OD) is an integral part of modern assisted reproductive care and has been used for over three decades. OD pregnancies have an increased rate of hypertension, cesarean section, and preterm labor. Yet most of these complications are attributed to the mothers going through OD, not to the biological effect of different oocyte sources (autologous Vs. donation). Study design, size, duration This study is a retrospective cohort study that utilizes electronic data from Maccabi Healthcare Services. This 2.5-million-patient integrated care organization represents 25% of the pregnant population in the country. The data used in this study were collected from 2000 through 2018. Participants/materials, setting, methods The study included mothers who experienced both a spontaneous conception (SP) pregnancy and later an oocyte donation (OD) pregnancy. The study compared obstetric and perinatal outcomes, including the incidence of preterm labor (PTL) and small for gestational age (SGA). Mother's obstetric outcomes such as pregnancy induced hypertension (PIH), gestational diabetes, malpresentation, and postpartum hemorrhage were also analyzed. A paired t-test was performed to compare each outcome for the same mother Main results and the role of chance The cohort included 194 mothers who had a first spontaneous pregnancy and a second pregnancy with oocyte donation. The mean age of the mother during her OD pregnancy was statistically older than the OD pregnancy (mean difference 2.2 years, p = 0.0028). No difference was found between pregnancies regarding the BMI (p = 0.216). A trend toward a higher prevalence of PIH was found in the OD pregnancy compared to the SP (mean difference 2.5, p = 0.058). No difference was found between pregnancies regarding gestational diabetes (p = 0.7), malpresentation (p = 1), retained placenta (p = 0.318), and Cesarean section (p = 0.565). Perinatal outcomes show a higher prevalence of premature labor before the 34th week and 32nd week in the OD pregnancies compared to SC pregnancies (mean difference 3.6, p = 0.034 and mean difference 3, p = 0.33 respectively). No difference was found between pregnancies regarding labor before the 37th week (p = 1). A statistically lower prevalence of SGA was found in the OD pregnancy compared to the SP (p = 0.0057). Limitations, reasons for caution Due to its retrospective character, some information is lacking. Information regarding indications leading to OD/AO are missing which might have elaborated our findings Wider implications of the findings OD pregnancies should be considered high-risk, primarily due to the increased risk of PTL and PIH. Adequate recommendations should be considered, including cervical length surveillance, frequent blood pressure measurements, and perhaps prophylactic low-dose aspirin to reduce the risk of preeclampsia. Trial registration number 0046-18-BBL

Prevalence of Pregnancy-Induced Hypertension and Pregnancy Outcomes

Background: The most frequent medical comorbidity during pregnancy is hypertension, rendering an elevated menace of unfavorable outcomes for equally mother and infant. It is a substantial public health concern, characterized by eclampsia, chronic hypertension, and preeclampsia. Objectives: The study determined occurrence of pregnancy-induced hypertension (PIH) and pregnancy outcomes, in the locality of Pakistan. Methods: The cross-sectional research appraised 05 districts of Pakistan in 2021-22. The study comprised 1920 patients affected with PIH. The demographic characteristics, laboratory and clinical values and pregnancy outcomes were recorded on the approved questionnaire. Results: Prevalence of PIH in pregnant females in study area was recorded as 13.70%. A significant proportion of PIH-affected females had genetic predisposition (51.14%), followed by abortion history (15.52%), history of hormonal imbalance (9.94%), history of Cesarean section (7.50%) and history of stillbirth (0.88%). Pregnancy outcome revealed that 16 (0.833%) women died of the PIH, 31 suffered from renal failure, 36 from pulmonary edema, 4.06% were affected with abruptio placentae and 103 suffered from HELLP syndrome. Similarly, the neonatal complications revealed that 27 fetuses died to mothers’ PIH, 111 suffered from asphyxia (5.78%) at the time of birth and 13 infants were abnormal and had different congenital anomalies. Practical implication: It emphasized the need for improved prenatal care, early detection of pregnancy-induced hypertension, and meticulous management of the condition in order to improve maternal and neonatal outcomes, especially in high prevalence regions such as Pakistan. Conclusion: The frequency of PIH in Pakistan was high (13.70%) and women had a greater risk of adverse pregnancy outcomes. With good prenatal care and continuous monitoring of the mother and fetus, perinatal outcomes including maternal morbidity and infant mortality can be avoided. Keywords: Asphyxia; Hypertension; Neonatal mortality; Perinatal outcomes.

Safety of pregnancy in acromegaly patients and maternal and infant outcomes after pregnancy: single-center experience from China and review of the literature

BackgroundPregnancy in acromegaly is uncommon and still in debate for fear of tumor progression or potential threat to both mother and fetus’s health. Besides, the data for pregnancy complications in uncontrolled acromegaly is limited. Thus, the objective of this study was to summarize pregnancy safety and disease courses after pregnancy in acromegalic patients and review their clinical characteristics based on disease activity in the literature.MethodsAn evaluation of eight acromegalic women from Peking Union Medical College Hospital (PUMCH) with 11 pregnancies was conducted. We also summarized a literature review of 82 disease-active pregnancies and 63 disease-controlled pregnancies with acromegaly. A second analysis was conducted to compare pregnancy courses and outcomes in different disease activities.ResultsBefore pregnancy, all patients had macroadenomas and underwent pituitary surgery. Pregnancy occurred at a median of 6 years (4–10) after the diagnosis of acromegaly. Assisted reproductive therapy was needed in 42.9% of participants. No cases had a premature birth or congenital malformations. Biochemical control was achieved in 50% of females before pregnancy and 75% at the last follow-up after delivery. Data analysis showed no differences in the prevalence of gestational diabetes mellitus (GDM) or pregnancy-induced hypertension (PIH) between acromegaly-active or acromegaly-controlled groups. The GDM prevalence in patients diagnosed during pregnancy (33.3%) was higher than that in patients diagnosed before pregnancy (4.8%) (p = 0.001).ConclusionPregnancy without biochemical control in acromegaly and receiving medical treatment during pregnancy are not rare and generally safe for the fetus. There could be a higher prevalence of PIH in acromegalic pregnancies. The treatment of acromegaly and related complications can be managed with regular follow-up after pregnancy.

A Narrative Review on Garbhajanya Vishamayata: The Pregnancy Induced Hypertension

Gestation, also known as Pregnancy, is the period during which one or more progeny develops inside a woman's womb. It is a crucial stage for a woman as several physiological changes occur during this period in her body. Now a day's, Pregnancy induced hypertension (PIH) is becoming the primary cause of maternal and prenatal mortality and morbidity. The prevalence of PIH is 2-8% of all pregnancies. In India, PIH incidence is higher in primiparae than in multipara. Therefore, finding all possible measures to prevent this disease is essential. In Ayurveda, Acharya Harit explains these conditions under Garbhinivyadhi. Garbhajanya Vishamayata is a condition in which hypertension develops after 20 weeks of gestation. Therefore, it is a primary concern during Pregnancy and can be prevented by early detection and appropriate treatment. Our Objective isto gain knowledge of ayurvedic aspects of Pregnancy induced hypertension, its prevention and treatment. This review is emphasized the ayurvedic aspects of Pregnancy induced hypertension. Detailed information was gathered by studying related classical texts of Ayurveda, research articles and websites. Collected data was later compiled, analyzed and discussed. This review concluded that by following Antenatal care(manumatic paricharya), Dos and don'ts (Pathyapathya), this disease can be prevented and treated effectively with safe motherhood and a healthy child. Keywords: , ,, ,

Pregnancy outcomes among women affected with thalassemia traits

ObjectiveTo compare the maternal and perinatal outcomes between a group of pregnant women diagnosed with thalassemia traits and normal controls.Study designA retrospective cohort study was conducted on singleton pregnant women affected and unaffected by thalassemia traits who attended an antenatal care clinic and delivered in Siriraj Hospital. Thalassemia status for all subjects was diagnosed by hemoglobin typing and/or DNA analysis. Patient charts were reviewed from January 2007 to December 2018. The control participants were randomly selected from the same period, with a control–case ratio of around 1:1.ResultsOverall, 1288 women with thalassemia traits (348 with α thal-1 trait, 424 with β thal trait and 516 with HbE trait) and 1305 women in the control group were recruited. Baseline characteristics of both groups were similar, with the exception that the hematocrit level in the first trimester in the thalassemia trait group was significantly lower than that in the control group (34.8 ± 3.4% VS 36.9 ± 3.0%; p < 0.001). The prevalence of pregnancy-induced hypertension (PIH) was higher in the thalassemia trait group, at 6.9% VS 4.7% in the control group; p = 0.018. When subgroups were analyzed between each thalassemia trait, the number of maternal anemias in the first and third trimester was higher for all thalassemia traits compared to the normal group. The β thal and HbE traits increased the risk of PIH, with a relative risk (RR) = 1.67 and 1.66, respectively.ConclusionsThalassemia traits minimally but significantly increase the risk of hypertensive disorders and maternal anemia. In addition, physiological changes during pregnancy may worsen the severity of anemia in the pregnant women with thalassemia traits.

Correlation of Severity of Maternal Hypertension and Birth Weight of Neonates- A Longitudinal Study

Introduction: Pregnancy Induced Hypertension (PIH) can lead to intrauterine growth restriction resulting in Low Birth Weight (LBW) neonates. LBW remains a significant cause of under-five mortality in India and Asia. Aim: To calculate the prevalence of PIH and to study the correlation between Birth Weight (BW) of neonates and severity of maternal hypertension; and compare the incidence of neonatal morbidities across varying severity of maternal hypertension. Materials and Methods: A longitudinal study was conducted among 153 pregnant mothers, diagnosed with PIH. They were classified into mild {Systolic Blood Pressure (SBP) ≥140- 149 mmHg or Diastolic Blood Pressure (DBP) ≥90-99 mmHg}, moderate (SBP ≥150-159 mmHg or DBP ≥100-109 mmHg) and severe (SBP ≥160 mmHg or DBP ≥110 mmHg) hypertension. A total of 142 neonates, born to PIH mothers, were included. The neonates were followed-up for seven days to check for early neonatal outcomes and deaths. Correlation between maternal blood pressure (systolic and diastolic) and BW of the neonates was assessed using Pearson’s correlation coefficient (r). Binary Logistic Regression (BLR) was performed to analyse the impact of confounders on BW. Results: The prevalence of PIH was 7.76% (153/1972). The mean BW of neonates born to mothers with moderate (2.435 kg) and severe hypertension (2.342 kg) was significantly lower than that of neonates born to mothers with mild hypertension (2.828 kg) (p&lt;0.00001). 1SD increase in SBP resulted in 0.245 kg decrease in BW, while an 1SD increase in DBP resulted in 0.312 kg decrease in BW. After accounting for confounders using BLR, maternal DBP still had a significant negative correlation with BW (r=-0.663; p&lt;0.001). The incidence of prematurity (p&lt;0.0001), small for Gestational Age (GA) (p=0.0283), Respiratory Distress (RD) (p=0.002), Neonatal Hyperbilirubinemia (NNH) (p=0.033) and Neonatal Intensive Care Unit (NICU) admissions (p=0.003) were significantly higher among neonates born to mothers with moderate and severe hypertension than those born to mothers with mild hypertension. Three neonatal deaths (all due to perinatal asphyxia) were observed in this study and there was no statistical significance with respect to deaths across neonates of the three groups (p=0.219). Conclusion: Maternal DBP had a significant negative correlation with BW. The mean BW of neonates born to mothers with severe hypertension was significantly lower compared to those born to mild hypertension.

467Hypertension, Dyslipidaemia and Pregnancy Complications in Filipino Women

Abstract Background There is an increasing trend of pregnancy complications in the Philippines. However, these are not well documented due to the lack of a national database. This study describes the prevalence of hypertension and lipid abnormalities among Filipino pregnant women, which result to complications during pregnancy. Methods Multi-stage stratified random sampling was employed in the National Nutrition Survey and 6,166 pregnant women were included in the study. Demographic data was gathered through an interview questionnaire. Blood samples were drawn to determine fasting blood sugar (FBS), cholesterol, HDL and LDL, and triglycerides levels. Results One in ten pregnant women (n = 661) showed signs of pregnancy complications. High risk pregnancies were identified, ranging from heart disease (2.9%), gestational diabetes (3.2%), asthma (3.51%) and goiter (4.12%). Prevalence of pregnancy-induced hypertension is 18.26%. Dyslipidemia is high among sample population with a prevalence of 39.54% (n = 376). Results showed that patients with hypertension are twice more likely to have pregnancy complications than those with normal BP (OR:1.95, CI 0.47, 6.08). Conclusions Based on the data, there is a high prevalence of pregnancy complications in the Philippines which is associated with having hypertension and lipid abnormalities. Key messages Health policies should be made to cater to the early detection of disease in pregnant women and widespread campaign for affordable prenatal check-ups.

Hyperinsulinemia and Preeclampsia among Pregnant Women: A Quantitative Study

Hypertensive disorders in pregnancy complicate 1 in 10 pregnancies, often associated with maternal and neonatal mortality and morbidity. The study was done on 100 pregnant women’s attending antenatal clinic of SreeBalaji Medical College &amp; Hospital, Chromepet, Chennai, during the period from December 2013 - May 2015. All women who met the inclusion and exclusion criteria were taken intothe study. Fasting insulin was calculated at 18 -22weeks of gestation, and then follow up of caseswas donefor signs of development of Pregnancy-induced hypertension (PIH). In the hypertensive group, the bulk of the patients were between the ages of 25 and 30. As (P &gt; 0.05), there is no statistical Significance in correlation between age and (PIH) in our study. Out of 100 cases studied, 64 cases (64%) had hyperinsulinemia. The remaining 36 cases (36%) had normal insulin values. The prevalence of PIH associated with hyperinsulinemia was 58% in our study. This test showed sensitivity of 87%, specificity of 82%, positive predictive value of 90%, negative predictive value 77% and diagnostic accuracy was 92%.

Prevalence of Pregnancy-Induced Hypertension and Its High-Risk Factors among the Antenatal Women

Abstract Objective A hypertensive disorder during pregnancy seriously endangers the safety of the fetus and women during pregnancy. This study was conducted to estimate the prevalence of pregnancy-induced hypertension (PIH) and its risk factors among antenatal women. The aim of this study was to find the prevalence of PIH and risk factors for PIH among antenatal women in a selected hospital in Mangaluru. Methods A descriptive study was performed. The study used the total sample size of 400 pregnant women attending the obstetrics and gynecology outpatient department according to the inclusion and exclusion criteria in a tertiary care hospital in Karnataka. The data was collected with a self-reported checklist. Data were entered and analyzed by using SPSS 23. Results The prevalence of PIH was 10.75% that is 43 antenatal women out of 400. In this study, 34.88% had a family history of PIH, 23% had a previous history of PIH, 16% had a history of gestational diabetes, and 20.93% had a history of thyroid problems. The most important risk factors found for PIH in the present study are the previous history of PIH (adjusted odds ratio [OR] = 1.276, 95% confidence interval [CI: 0.125–11.836), family history of hypertension (adjusted OR=1.930, 95% CI: 1.130–3.296), and thyroid problems (adjusted OR=1.904, CI: 0.786–4.611). Conclusion PIH is a common medical disorder associated with pregnancy. We noted that PIH is more prevalent in those who had it in their previous pregnancy. PIH is associated with multiple complications in the mother and the baby and particularly preterm delivery. The timely intervention of regular antenatal checkups, nutrition, health education, etc., can reduce the severity of PIH.

Weight gain after diagnosis of gestational diabetes mellitus and its association with adverse pregnancy outcomes: a cohort study

BackgroundGestational diabetes mellitus (GDM) and excessive body weight are two key risk factors for adverse perinatal outcomes. However, it is not clear whether restricted gestational weight gain (GWG) is favorable to reduce the risk for adverse pregnancy and neonatal outcomes in women with GDM. Therefore, this study aimed to assess the association of GWG after an oral glucose tolerance test with maternal and neonatal outcomes.MethodsThis prospective cohort study assessed the association of GWG after an oral glucose tolerance test (OGTT) with pregnancy and neonatal outcomes in 3126 women with GDM, adjusted for age, pre-pregnancy body mass index, height, gravidity, parity, adverse history of pregnancy, GWG before OGTT, blood glucose level at OGTT and late pregnancy. The outcomes included the prevalence of pregnancy-induced hypertension (PIH) and preeclampsia, large for gestational age (LGA), small for gestational age, macrosomia, low birth weight, preterm birth, and birth by cesarean section. GDM was diagnosed according to the criteria established by the International Association of Diabetes and Pregnancy Study Groups.ResultsGWG after OGTT was positively associated with risk for overall adverse pregnancy outcomes (adjusted odds ratio [aOR] = 1.72, 95% confidence interval [CI] = 1.50–1.97), LGA (aOR = 1.29, 95%CI = 1.13–1.47), macrosomia (aOR = 1.24, 95%CI = 1.06–1.46) and birth by cesarean section (aOR = 1.91, 95%CI = 1.67–2.19) in women with GDM. Further analyses revealed that a combination of excessive GWG before OGTT and after OGTT increased the risk of PIH and preeclampsia, LGA, macrosomia, and birth by cesarean section compared with adequate GWG throughout pregnancy. In contrast, GWG below the Institute of Medicine guideline after OGTT did not increase the risk of adverse perinatal outcomes despite GWG before OGTT.ConclusionExcessive GWG after OGTT was associated with an elevated risk of adverse pregnancy outcomes, while insufficient GWG after OGTT did not increase the risk of LBW. Restricting GWG after diagnosis of GDM in women with excessive GWG in the first half of pregnancy may be beneficial to prevent PIH and preeclampsia, LGA, macrosomia, and birth by cesarean section.

Prevalence and Risk Factors of Pregnancy Induced Hypertension among Pregnant Mothers Attending Antenatal Care in Wachemo University, Nigist Eleni Mohammed Memorial Comprehensive and Specialized Hospital, Hadiya Zone, Southern Ethiopia: A Cross-Sectional Study

Introduction: The leading cause of maternal and perinatal morbidity and mortality is pregnancy-induced hypertension. In developed countries, it complicates 10% of all births. Pregnancy-induced hypertension kills half a million women per year, mainly in developing countries. The aim of this study was to determine whether antenatal care attendants in Nigist Eleni Mohammed Memorial Comprehensive and Specialized Hospital in Southern Ethiopia had pregnancy-induced hypertension. Methods: A hospital-based cross-sectional study was conducted in Wachemo University Nigist Eleni Mohammed Memorial comprehensive and specialized Hospital from December 30, 2020, to February 2021. Finally, via the systematic random sampling process, the study subjects were chosen from a chart review from June 2019 to May 2020. Bivariate and multivariate analyses were used to identify factors associated with pregnancy-induced hypertension. A P-value less than 0.05 were considered statistically significant. Results: The prevalence of Pregnancy-Induced Hypertension was 23.42% with 95% CI (21.8, 30.5). Age in years 25 to 35; (AOR=6.189; 95%CI; 2.232, 7.164), urban residence (AOR=2.103; 95%CI=1.046, 4.234), primigravida (AOR=2.6; 95%CI=1.642, 2.611), gestational age 20 to 37 weeks (AOR=5.278; 95%CI=1.852, 6.038) and past history of pregnancy induced hypertension (AOR=1.358; 95%CI; 1.756, 4.351) and past history of diabetes mellitus (AOR=7.344; 95%CI=1.344, 9.372)were statistically significant with Pregnancy-Induced Hypertension. Conclusion: In this study the prevalence of pregnancy-induced hypertension was high. Age, urban residence, primigravida, gestational age in weeks, history of pregnancy-induced hypertension, and history of Diabetes Mellitus were statistically significant with Pregnancy Induced Hypertension. To enhance maternal and child health, improving screening, treatment, and prevention strategies for PIH is necessary.

Association of Hemoglobin during First Trimester and its Relation to Pregnancy-Induced Hypertension in Indian Women

Background and Aim: Globally, prevalence of pregnancy-induced hypertension (PIH) is 3-5% and in India it is around 5-15%. PIH is one of the major factors responsible for abnormal pregnancy outcome along with high maternal and perinatal morbidity and mortality. Role of hemoglobin is the key factor for pregnancy outcome and development of hypertension during pregnancy. This study was done with aim to check the relation of maternal hemoglobin with blood pressure and development of PIH in Indian women of 20 to 30 years of age group. Methods: A cross sectional multicentric study was done after approval of Institutional Ethics Committee. A total 200 pregnant female visiting to antenatal clinics in age group of 20 to 30 years were enrolled after their written voluntary consent. Participant’s body weight, hemoglobin, along with pulse rate, systolic blood pressure and diastolic blood pressure were done during 1st antenatal visit at first trimester, during next visit at 2nd trimester between 20th to 24th weeks and between 25th to 28th weeks during third trimester. During 1st antenatal visit participants were categorized into two groups with hemoglobin less than 10 gm% and hemoglobin more than 10 gm% comprising 100 participants in each group. Progress of pregnancy was documented very well during subsequent next visit. All participants had visited antenatal clinic till delivery as per instructions given to them. Pregnancy outcomes were documented very well up to 6 week of delivery. Results: In participants of both groups, progressive increases in weight, hemoglobin, heart rate, systolic blood pressure, diastolic blood pressure were seen. A statistical significant difference in weight was seen in both groups during all trimester. A statistical significant difference in diastolic blood pressure was seen in both groups during 2nd trimester. Total 17 participants developed PIH, out of which 10 participants were from group 1, i.e. hemoglobin less than 10 gm% and 7 from group 2 with haemoglobin more than 10 gm%. Conclusion: In the present study, role of maternal hemoglobin in development of pregnancy induced hypertension is not seen.

Blood pressure and hypertension during pregnancy in women with polycystic ovary syndrome: Odense Child Cohort.

The aim of this study was to compare blood pressure and prevalence of pregnancy-induced hypertension in women with polycystic ovary syndrome and the reference group throughout pregnancy. This retrospective study was part of the prospective study Odense Child Cohort. Pregnant women were recruited from January 2010 to December 2012. Blood pressure was measured in 200 women with polycystic ovary syndrome and in 2197 in the reference group. Main outcome measures were blood pressure and pregnancy-induced hypertension. Pregnancy-induced hypertension was defined as systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg occurring after gestational week 20 at two separate visits. Mann-Whitney U test and Chi-square test were used to test differences between women with polycystic ovary syndrome and the reference group. Associations between polycystic ovary syndrome status (PCOS; the reference group) and blood pressure were tested using random mixed-effect linear regression analyses with subjects as random effect to comply with repeated blood pressure measurements. Median blood pressure was comparable in women with polycystic ovary syndrome and the reference group throughout pregnancy: systolic blood pressure 116 (111-123) vs 119 (112-124) (P=.06), diastolic blood pressure 72 (69-77) vs 73 (69-78) (P=.23) and mean arterial pressure 87 (83-93) vs 88 (84-92) (P=.13). In first trimester where systolic blood pressure was lower in polycystic ovary syndrome, median systolic blood pressure was 116 (111-123) vs 119 (112-124) mmHg (P=.04). The prevalence of pregnancy-induced hypertension was similar in polycystic ovary syndrome and the reference group: 17/200 (8.5%) vs 178/1997 (8.9%) (P=.84). Regression analyses showed no significant associations between polycystic ovary syndrome and blood pressure. Blood pressure and prevalence of pregnancy-induced hypertension were comparable in pregnant women with polycystic ovary syndrome and the reference group.

The Association of Pregnancy-induced Hypertension with Bronchopulmonary Dysplasia \u2013 A Retrospective Study Based on the Korean Neonatal Network database

The prevalence of pregnancy-induced hypertension (PIH) and preeclampsia (PE) are 5–10% and 2–4%, respectively. PIH might affect angiogenesis in preterm neonates, but its association with bronchopulmonary dysplasia (BPD) remains controversial. This study evaluated the association between PIH and BPD in very low-birth weight infants. We retrospectively analysed the maternal, perinatal, and neonatal data of preterm infants born before 30 weeks of gestation, selected from the nationwide registry of very low-birth weight infants, between January 2013 and December 2014. As a result, 1,624 infants without maternal PIH (gestational age: 27.3 ± 1.8 weeks) and 203 infants with maternal PIH (28.0 ± 1.4 weeks, p < 0.001) were included. Birth weight was higher in the non-PIH group, compared with the PIH group (1027.4 ± 250.2 vs. 876.4 ± 261.5 g, p < 0.001). Multivariate logistic regression showed that PIH was associated with BPD (adjusted OR 1.474, 95% confidence interval 1.025–2.121), after adjusting for confounders, including small-for-gestation age (SGA). The result of present study is consistent with the current concept of BPD as an early form of pulmonary vascular disease, for both PIH and BPD are attributed by abnormal vascular formation.

Risk factors and potential protective factors of pregnancy-induced hypertension in China: A cross-sectional study.

A cross-sectional study was conducted to the reported factors and assesses possible protective factors for pregnancy-induced hypertension (PIH) in China. The data of pregnant women who delivered between October 2016 and September 2017 were collected from a birth registry. The primary outcome was the occurrence of PIH. Secondary outcomes were delivery before 34 gestational weeks and other adverse obstetric outcomes of PIH. Among the 99535 women enrolled, 5731 women (5.8%) developed PIH. BMI had a positive correlation with the primary and two secondary outcomes (adjusted OR=2.05, 2.56, 1.87, respectively, for overweight; adjusted OR=4.44, 3.90, and 2.63, respectively, for obesity). Otherwise, calcium supplementation during pregnancy was a potential protective factor for those outcomes (adjusted OR=0.87, 0.14, and 0.44, respectively). These results provide a basis for PIH prevention strategy in the Chinese public health sector. Calcium supplementation and lowering the BMI might have the potential benefit on reducing the prevalence of PIH in selected women.

Antenatal care and its effect on risk of pregnancy induced hypertension in Lao PDR: A case-control study

Background: Pregnancy induced hypertension (PIH) is a global public health concern as a leading cause of maternal mortality. Lao PDR has a high prevalence of PIH, but little is known about its risk factors. This study aimed to identify risk factors of PIH relating to antenatal care (ANC) in Lao PDR. Methods: This hospital-based age-matched case control study was carried out between July and December 2017 in tertiary and secondary hospitals in Lao PDR. A total of 258 pregnant women (86 hypertensive and 172 normotensive pregnant women) were recruited to join the study based specific inclusion criteria. For each case, two consecutive controls were included in the study with matched maternal age. Data was collected using a structured questionnaire interview to identify the risk factors of PIH relating to ANC. The association between the independent variables and PIH was assessed through bivariable and conditional multiple logistic regression analyses. Results: Mothers with PIH had inadequate ANC (defined as &lt;4 times) (adj. OR= 10.23 , 95%CI: 3.67 – 28.49, p&lt;0.001), excessive maternal weight gain during pregnancy (&gt;13kg) ( adj. OR=7.35, 95%CI: 3.06 -17.69, p&lt;0.001), had a history of abortion (adj. OR=3.54, 95%CI: 1.30-9.59, p=0.013), and had received inadequate information about PIH (adj OR= 2.58 , 95%CI: 1.03 – 6.46 , p=0.043). Conclusion: Inadequate ANC and maternal factors were major risk factors of PIH in Lao PR. National PIH guidelines for effective counseling, ANC and treatment should be promptly developed and implemented at all levels in order to improve pregnancy outcomes.

Pregnancy outcomes in women with polycystic ovary syndrome in two Latin American populations

Pregnancy complications and obstetric outcomes were compared in 80 Chilean (PPCOSCh) and 70 Argentinian (PPCOSAr) pregnant women. Reference groups of Chilean and Argentinian normal pregnant women from the same antenatal care units were also compared. PPCOSCh showed a higher prevalence of gestational diabetes mellitus (GDM) (OR, 2.28, 95% CI: 1.08–4.77, p = .030) and a lower prevalence of pregnancy-induced hypertension (PIH) (OR, 0.20, 95% CI: 0.07–0.54, p = .001) compared to PPCOSAr. In the normal pregnant groups, the prevalence of PIH was lower in Chilean women compared to Argentinian women (OR, 0.24, 95% CI: 0.10–0.62, p = .001). Similar to the pattern observed in the normal populations, newborns from PPCOSCh had higher birth weight and length compared with the newborns of PPCOSAr (p = .006 and .014, respectively). In conclusion, differences in pregnancy complications and obstetric outcomes between Chilean and Argentinian pregnant women with PCOS could be determined by ethnic diversity together with environmental factors of both populations.Impact StatementWhat is already known on this subject: The reproductive and metabolic phenotypes of women with polycystic ovary syndrome vary between different populations, which could significantly influence the obstetric and neonatal outcomes in this syndrome.What the results of this study add: Pregnant women with PCOS from two Latin American countries (Chile and Argentina) exhibit differences in the prevalence of gestational diabetes and pregnancy-induced hypertension, and in the birth weight of their newborns.What the implications are of these findings for clinical practice and/or further research: Ethnic diversity together with environmental factors are fundamental elements that must be considered in the management of pregnant women with PCOS.

Medication for management of pregnancy-induced hypertension

Hypertension refers to increased arterial blood pressure and can be divided into two categories: primary and secondary. Primary hypertension caused by angiogenic degenerative changes is a degenerative disease. With liberalization of China’s reproduction policy and increases in maternal age, the prevalence of pregnancy-induced hypertension (PIH) in China has increased gradually. PIH is not a type of primary hypertension, but there are differences in the treatment of these two types of hypertension. Here, we review the choice and use of drugs for PIH management using drugs for the management of primary hypertension as a reference. First-line drugs such as labetalol, nifedipine, or methyldopa should be taken via the oral route if blood pressure is ≥ 150/90 mmHg. For chronic hypertension, other drugs should be added after the first drug at the highest concentration has been revealed to be ineffective. If the blood pressure of patients with acute hypertension is ≥ 160/110 mmHg, maternal stroke or eclampsia can result. If PIH patients are about to deliver, they can be given labetalol (i.v.), hydralazine (i.v.) or nifedipine (p.o.). Moreover, all anti-hypertensive treatments should be based on considerations of maternal and fetal safety.