Risk Factor For 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.

Study of Cardiovascular Parameters and Heart Rate Variability (Frequency Domain Analysis) In 1St Trimester of Normal Pregnant Women and Pregnant Women with Risk Factors for Pih in Western Rajasthan

Background: The role of sympathovagal imbalance (SVI) and CV risk in pregnancy-induced hypertension(PIH) has been reported, and their association during early trimesters of gestation in PIH has not beenstudied. Therefore, in the present study, we have investigated the maternal cardiovascular parameters andfrequency domain indices of Heart rate variability (HRV) between normal pregnant women and women withrisk factors for PIH in their 1st trimester of gestation.Methods: Two hundred twenty subjects each (220 of normotensive pregnant women i.e., control group and220 of pregnant women with risk factor for PIH i.e., study group) of 1st trimester of gestation were recruitedfrom the obstetrics &amp; gynecology department of Umaid hospital, associated with Dr. S. N. Medical College,Jodhpur, Rajasthan. Physical examination was done and anthropometric measurement like height &amp; weightwere taken. The collected data was statistically analyzed using HRV analysis software.Results: Significant difference in body mass index was observed between the two groups. Systolic bloodpressure, Diastolic blood pressure, Pulse pressure, Rate pressure product and Mean arterial pressure of studygroup was significantly higher than control group. Values of LF and LF/HF ratio components of frequencydomain analysis of HRV were significantly increased but HF component is non significantly decrease in 1sttrimester of the pregnant women with risk factor for PIH than normal pregnant women.Conclusion: The present study indicates that the cardiovascular parameters in 1st trimester of pregnantwomen with risk factor for PIH were increased highly significantly than the normal pregnant women. Thehighly significant (HS) (p&lt;0.000) increase in the LF (nu) &amp; LF/HF ratio and non significant (NS) (p&lt;0.552)decrease in HF (nu) of pregnant women with risk factors for PIH was observed than normal pregnant womenthis indicate that sympathetic tone was increased in 1st trimester of pregnant women with risk factor for PIH.Vagal withdrawal and sympathetic exaggeration may be the possible cause of PIH in pregnant women withits risk factors.

Study of Cardiovascular Parameters and Heart Rate Variability (Frequency Domain Analysis) in 1St Trimester of Normal Pregnant Women and Pregnant Women with Risk Factors for PIH in Western Rajasthan

Background: The role of sympathovagal imbalance (SVI) and CV risk in pregnancy-inducedhypertension (PIH) has been reported, and their association during early trimesters of gestation in PIHhas not been studied. Therefore, in the present study, we have investigated the maternal cardiovascularparameters and frequency domain indices of Heart rate variability (HRV) between normal pregnantwomen and women with risk factors for PIH in their 1st trimester of gestation.Methods: Two hundred twenty subjects each (220 of normotensive pregnant women i.e., control groupand 220 of pregnant women with risk factor for PIH i.e., study group) of 1st trimester of gestation wererecruited from the obstetrics &amp; gynecology department of Umaid hospital, associated with Dr. S. N.Medical College, Jodhpur, Rajasthan. Physical examination was done and anthropometric measurementlike height &amp; weight were taken. The collected data was statistically analyzed using HRV analysissoftware.Results: Significant difference in body mass index was observed between the two groups. Systolic bloodpressure, Diastolic blood pressure, Pulse pressure, Rate pressure product and Mean arterial pressure ofstudy group was significantly higher than control group. Values of LF and LF/HF ratio components offrequency domain analysis of HRV were significantly increased but HF component is non significantlydecrease in 1st trimester of the pregnant women with risk factor for PIH than normal pregnant women.Conclusion: The present study indicates that the cardiovascular parameters in 1st trimester of pregnantwomen with risk factor for PIH were increased highly significantly than the normal pregnant women.The highly significant (HS) (p&lt;0.000) increase in the LF (nu) &amp; LF/HF ratio and non significant (NS)(p&lt;0.552) decrease in HF (nu) of pregnant women with risk factors for PIH was observed than normalpregnant women this indicate that sympathetic tone was increased in 1st trimester of pregnant womenwith risk factor for PIH. Vagal withdrawal and sympathetic exaggeration may be the possible cause ofPIH in pregnant women with its risk factors.

Sympathovagal imbalance, cardiometabolic risks and hypertension status are linked to depression in women having risk factors for pregnancy-induced hypertension

Background and Aim: Pregnancy is a physiological state in which there are cardiovascular, autonomic, hemodynamic and psychological changes. Increase in incidence of stress and depression in antenatal period has been reported. Autonomic changes in pregnancy-induced hypertension (PIH) and its dysfunction in depression are well documented. However, there is no report of contribution of sympathovagal imbalance (SVI) and cardiometabolic alterations to stress and depression in PIH. Methods: In this case-control study, we assessed and analyzed cardiovascular autonomic functions including heart rate variability (HRV) and cardiometabolic risks (CMR) between pregnant women having risks of PIH (n=62) and normal healthy pregnant women (n=68). The perceived stress scale (PSS-10) and Quality of Life (QoL) were used to evaluate depressive symptoms and perceived stress. The HRV and CMR parameters were correlated with PSS. Multiple regression analysis was performed individually to study their association with PSS. Logistic regression was done to determine the prediction of hypertension/prehypertension status by PSS. Results: There was increase in heart rate and blood pressure, decreased HRV and increased markers of insulin resistance, atherogenic lipid profile, markers of inflammation, oxidative stress and vascular endothelial dysfunction in PIH risk subjects compared to control subjects. Parameters of SVI and decreased cardiovagal modulation and CMR were significantly correlated and associated with PSS. PSS had independent prediction of prehypertension/hypertension status in the study group. Conclusion: Findings of the present study indicate that there is considerable SVI and CMR in PIH. It appears that depression is the major cause of SVI and decreased cardiovagal modulation in PIH, and retrograde inflammation and vascular endothelial dysfunction could be the potential mechanisms of depression mediated SVI in PIH.

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.

Assess the Knowledge and Risk Factors among Pregnancy Induced Hypertension among Antenatal Mothers

Background of the Study: Hypertension, complicating 5-10% of all pregnancies worldwide, is a leadingcause of maternal and fetal morbidity. The control of pregnancy-induced hypertension (PIH) appears difficultto achieve. Part of the reason for poor control of hypertension in these women might be limited PIH self-careknowledge.Objective: to assess the knowledge and risk factors of PIH among antenatal mothers and to find out theassociation between knowledge and risk factors with selected demographic variables.Materials and Method: Study was conducted on 110 antenatal mothers attending in Gynecologic OPD,AIMS, Kochi, Kerala. The research design used was non experimental descriptive design.Result: The present study reveals that more than half of the mothers (63.6%) had average knowledgeregarding PIH. Half of the mothers had the risk factors of family history of hypertension (50%) and followedby 32.7% had the habit of high non vegetarian food intake. A statistically significant association was observedfor education and knowledge and comorbidities and knowledge of antenatal mothers. Significant associationwas found in risk factors and comorbidities of antenatal mothers.Conclusion: The finding of the study shows that antenatal mothers had average knowledge related to PIH.Health care providers should implement the focused health education programme during antenatal visit

Maternal and fetal outcomes of Asian pregnancies after bariatricsurgery.

Obesity is a risk factor for pregnancy-induced hypertension, preeclampsia, gestational diabetes, and large gestational age pregnancy. Bariatric surgery is widely accepted to treat obesity but associated with small for gestational age fetuses. To report maternal and fetal outcomes after bariatric surgery in morbidly obese Asian females. University Hospital, Singapore. We maintain a prospective cohort of patients who underwent bariatric surgery in our institution. Maternal and fetal outcomes are compared with a control group of 31 pregnancies matched for age, parity, presurgery weight, and year of delivery. Twenty-four pregnancies occurred in 16 patients in our postoperative cohort. Morbidly obese women in the control group were more likely to develop gestational diabetes (19.3% versus 5.0%, P = .150) and pregnancy-induced hypertension/preeclampsia (32.2% versus 0%, P = .003) compared with the postoperative group. Of fetuses, 37.5% in the bariatric group had low birth weight compared with only 9.4% fetuses in the control group (P = .016). Preoperative body mass index, short interval between conception and surgery, and poor weight gain during pregnancy did not predict for small for gestational age fetuses. Subsequent weights were available for 37.5% of the children in the surgical cohort and none of these children exhibited growth retardation. Bariatric surgery lowers the risk of maternal co-morbidities and large gestational age fetus during pregnancy. Asians are at high risk of small for gestational age pregnancies after bariatric surgery and should undergo close monitoring for fetal growth throughout their pregnancy.

Practice of Alternate-nostril Breathing (Anuloma-Viloma Pranayama) Attenuates the Development of Hypertension and Cardiometabolic Dysfunctions During Pregnancy in Women Having Risk Factors for Pregnancy-Induced Hypertension

Background and Objective: The early prediction and prevention of Pregnancy-induced Hypertension (PIH), a common morbid disorder of pregnancy is unsatisfactory. Therefore, in the present study we have investigated the role of alternate-nostril breathing (anulomaviloma pranayama) on cardiometabolic risks and prevention of PIH in women having risks of PIIH. Methods: A total of 148 subjects consisting of study group (n=76): pregnant women having risk factors for PIH and practiced pranayama; and control group (n=72): pregnant women with risk factors for PIH, but did not practice pranayama were recruited from obstetric out-patient department. Spectral analysis of Heart Rate Variability (HRV), autonomic Function Tests (AFTs), lipid profile, markers of insulin resistance, inflammation and oxidative stress were assessed in both groups in all the three trimesters. Results: It was observed that LF-HF ratio, the most sensitive indicator of sympathovagal imbalance was significantly reduced (P<0.001) and was linked to reduction in cardiometabolic risks and prediction of hypertension status in study group subjects following pranayama practice from their 1st trimester compared to control group subjects who did not practice pranayama. Conclusion: Practice of anuloma-viloma pranayama from 1st trimester improves sympathovagal balance, reduces cardiometabolic risks and prevents the development of PIH in later part of pregnancy in women having risk factors for PIH.

Association of pregnancy-associated plasma protein A and vascular endothelial growth factor with pregnancy-induced hypertension.

The present study aimed to evaluate changes of pregnancy-associated plasma protein A (PAPP-A) and vascular endothelial growth factor (VEGF) in pregnancy-induced hypertension (PIH). A total of 105 cases (observation group) with complete data that underwent delivery and suffered from PIH in The Affiliated Hospital of Xuzhou Medical University from February 2015 to February 2017 were retrospectively analyzed. The observation group was further divided into the mild observation and severe observation groups according to severity degree of the disease. Another 65 asymptomatic pregnant women were recruited as the healthy control group. Basic data, obstetric data, PAPP-A and VEGF and data of perinatal infants were compared and analyzed. The Logistic regression model was adopted to screen out risk factors for PIH. In the observation group, the rate of periodic antenatal care was lower, and there were more primigravidas and housewives, with lower education level and economic income (P<0.05). In the observation group, the occurrence rates of placental abruption as well as turbid and bloody amniotic fluid were higher than those in the healthy control group (P<0.05). The neonatal birth weight was lower in the observation group than that in the healthy control group, while the occurrence rates of neonatal department transfer, small for gestational age (SGA), neonatal asphyxia and survival rates of perinatal infants were higher (P<0.05). PAPP-A levels at 34–40 gestational weeks in the observation group were significantly higher than those in the healthy control group (P<0.05). VEGF levels were lower than those in the healthy control group (P<0.05). Multivariate analysis revealed that high PAPP-A value [odds ratio (OR)=3.736] and identity of housewife (OR=2.514) were risk factors for PIH, while high VEGF value (OR=5.258), non-primigravid (OR=2.173), higher economic income (OR=4.162) and periodic antenatal care (OR=1.201) were regarded as protective factors. Therefore, enhancement of gestational management, early discovery and early treatment are critical for improving the prognosis of pregnant women and infants.

Diabetes and Pregnancy

Diabetes and Pregnancy

Factors influencing pregnancy induced hypertension among women treated in Khulna Medical College Hospital

Pregnancy induced hypertension (PIH) complicates approximately 6% of pregnancies globally and it is the most important cause of maternal and neonatal morbidity and mortality. The purpose of the cross sectional descriptive type of study was to assess the socio-demographic/economic characteristics of women with PIH in a selected tertiary care hospital. Respondents were selected by purposive sampling technique and data were collected by face to face interview using a semistructured type of questionnaire. In this study, the number purposively selected respondents was 113 who came for treatment in gynecology and obstetrics related inpatient and outpatient departments of the hospital. It was found that the age of mothers was directly and significantly (p &lt; 0.01) associated with PIH. The development of PIH was higher in the educated mothers than illiterate or less educated mothers. The relationship between PIH and educational status was significant (p &lt; 0.01). The association between the proportion of mothers with PIH and family history of hypertension was also statistically significant (p &lt; 0.01). Awareness regarding the associated risk factors for PIH shall be helpful in reducing the PIH related morbidity and mortality.Mediscope Vol. 3, No. 2: July 2016, Pages 31-35

74 Association of sympathovagal imbalance with endothelial dysfunction in South Indian women with risk for pregnancy-induced hypertension – A follow-up study from a tertiary care hospital

Introduction Pregnancy-induced hypertension (PIH) is a serious medical complication with increasing incidence across the developing countries like India (5–15%). PIH is mainly characterised by widespread alteration and dysfunction in maternal vascular endothelium. But, whether the dysfunction is a cause or consequence of this multisystemic disorder has to be determined. Though the etiology of the disease is still indefinable, it is clear that it requires placenta to develop. Placental factors leads to extensive stimulation/dysfunction of the vascular endothelium, which in turn causes hypertension. The sympathetic activity is exaggerated in PIH even in the first trimester. Also sympathetic over activity plays a pathogenic role in stimulating hypertension and endothelial dysfunction. But so far no research have been conducted to explore the relationship between maternal endothelial factors and sympathovagal imbalance. Hence, in this study, we measured the degree of sympathetic activity and endothelial dysfunction in all the three trimesters to understand the causation of the disorder in pregnant women. Objective To study the association of sympathovagal imbalance (SVI) with endothelial dysfunction in pregnant women having a risk for PIH. Methods This is a prospective longitudinal study. Subjects were initially divided into 2 groups: Control group ( n = 50) and study group. Control group includes normotensive pregnant women and study group includes pregnant women with risk factors for PIH. Subjects were followed till term and incidence of PIH were noted. The study group was later sub-grouped into study group I (did not develop PIH, n = 45) and study group II (developed PIH, n = 40). Later retrospective analysis was done to understand the changes from early trimester. Cardiac autonomic function test which includes short-term heart rate variability, forced breathing test, orthostatic stress test and isometric handgrip test were performed. Arterial stiffness was measured using the non-invasive oscillometric device called PeriScope. Results LF–HF ratio of HRV, the sensitive indicator of SVI was significantly high ( p Conclusion Endothelial dysfunction are present in pregnant women having a risk factors for PIH even from the early trimester and SVI is linked to endothelial dysfunction in these subjects.

Hypertensive pathologies and egg donation pregnancies: Results of a large comparative cohort study

To determine whether egg donation (ED) pregnancies are at higher risk of pregnancy-induced hypertension (PIH) than those achieved by autologous assisted reproductive technology (ART; controls). Anonymous comparative observational matched cohort study. Assisted reproductive technology centers. Two hundred seventeen ED and 363 control singleton pregnancies matched at 7-8weeks (pregnancy date, parity, cycle type [fresh/frozen] and women's age). According to French practice, all women were under45. None. Percentage of PIH for ED versus controls. The groups were comparable (mean age, 34.5). PIH was more frequent during ED pregnancies (17.8% vs. 5.3%), as was preeclampsia (11.2% vs. 2.8%) and eclampsia (1.8% vs. 0.0%). In multivariate analyses, PIH risk increased with ED (odds ratio [OR], 3.92; 95% confidence interval [CI], 1.93-7.97) and women's age (OR, 1.08; 95% CI, 1.00-1.16). No significant effect of previous pregnancies or cycle rank/type was observed. This study had sufficient power to detect doubling of the PIH rate. It was demonstrated that the risk of PIH was tripled for ED versus controls. Even in young women, ED is a risk factor for PIH. An immunological explanation seems most likely, that is, the fetus is fully allogeneic to its mother. This risk must be acknowledged to inform couples and provide careful pregnancy monitoring.

Latent Toxoplasmosis is Not a Risk Factor for Pregnancy-induced Hypertension

Latent Toxoplasmosis is Not a Risk Factor for Pregnancy-induced Hypertension

Pregnancy-induced hypertension and associated factors among pregnant women attending public health facilities in Swaziland

Background/Aims: Pregnancy-induced hypertension is the main cause of morbidity and mortality among pregnant women in Swaziland. The main objectives of this study were to: i) identify the factors contributing to the development of pregnancy-induced hypertension among women attending public health facilities in Swaziland; ii) investigate the association between the development of pregnancy-induced hypertension sociodemographic variables, family history, obstetric history, lifestyle, and access to health care services. Methods: An exploratory, descriptive research design, using a quantitative research approach was used. Data were analysed using SPSS version 20, where a sample frame of 60 women diagnosed with pregnancy-induced hypertension, and a sample of 50 women was selected using simple random sampling. Results: The findings revealed a significant association between sociodemographic variables and obstetric history (p=0.001), marital status (p=0.025) and lifestyle, which in turn predisposes the woman to pregnancy-induced hypertension. Employment status (p=0.044) was significantly associated with access to health care services and level of education (p=0.027). Conclusions: Factors that are significantly associated with the development of pregnancy-induced hypertension include age, multiple pregnancy, a history of pregnancy-induced hypertension in previous pregnancies and limited use of antenatal care services. The authors recommend strengthening pre- and in-service midwifery education on the management of pregnancy-induced hypertension, as well as client education on the risk factors for pregnancy-induced hypertension.

Risk factors for pregnancy-induced hypertension

Objective. The aim of the research was to investigate if the two groups of patients, women with pregnancy-induced hypertension (PIH) and women with normal pregnancy differed in some studied risk factors. Methods. The study has been carried out in Health Centre 'Sid' in Sid, Serbia, at Department for Women Primary Health Care. In order to collect data necessary for the research the survey questionnaire was used that was created by the study authors. The study sample consisted of 200 pregnant women divided in two groups. The first one included 100 pregnant women with hypertension. The second group included 100 pregnant women with normal pregnancy. The study subjects of two groups were selected randomly from the larger pool of pregnant women, which were followed regularly at the Department. Results. PIH occurred between 26-30 years of age in total of 34% of pregnant women. The average age of pregnancy when the disorder was firstly observed was 29.7 gestational weeks. In the group of women with PIH, 37% of them had the body mass index (BMI) between 25 and 29.99 kg/ m2, and 38% of women had BMI over 30 kg/m2. The total of 35% of pregnant women with PIH frequently consumed salty and spicy foods, while 42% of pregnant women such food consumed only occasionally. Conclusion. There were no significant differences in age between the patients with PIH and pregnant women with normal course of pregnancy. PIH was more common in primiparous mothers, pregnant women with elevated body mass index, among pregnant women with reduced physical activity, pregnant women who smoked and in pregnant women who consumed salty and spicy foods.

Maternal obesity and energy intake as risk factors of pregnancy-induced hypertension among Iranian women.

Pregnancy-induced hypertension is causing striking maternal, foetal and neonatal mortality and morbidity in the world. A case-control study was conducted on 113 women with gestational hypertension and 150 healthy pregnant women at Shahid Akbarabadi Hospital of obstetrics and gynaecology in south of Tehran. Women who were obese (OR 4.44; 95% CI 1.84-10.72) before pregnancy were more likely to develop gestational hypertension. Proportion of having excessive gestational weight gain was positively and significantly associated with development of gestational hypertension (OR 2.70; 95% CI 1.19-6.13). Furthermore, findings revealed that women who were in the highest quartile of mid-arm-circumference had a 3-fold increased risk of gestational hypertension compared to women in the lowest quartile (OR 8.93; 95% CI 2.16-36.93). We found that having been in the highest quartile of energy intake positively correlated with increased risk of gestational hypertension (OR 9.66; 95% CI 3.30-28.21). The results suggest pre-pregnancy obesity, excessive gestational weight gain, and increased intake of energy as potential risk factors of developing gestational hypertension.

The relationship between neck circumference and pregnancy-induced hypertension in the third trimester pregnant women

Objective: The purpose of this study was to evaluate the relationship between neck circumference (NC) and pregnancy-induced hypertension (PIH) in the third trimester pregnant women. Methods: The study included 126 women who were in the third trimester pregnancy. All subjects completed a standard sleep questionnaire, anthropometric measurements and ultrasonic testing. Results: Pregnant women with NC ≥34.7 cm had significantly higher frequency of PIH than pregnant women with NC <34.7 cm (35.6% versus 2.5%, χ2 = 25.863, p = 0.000). Conclusions: The increase of NC was independent risk factor for PIH in the third trimester pregnant women.

Association of sympathovagal imbalance with arterial stiffness indices in women with risk factors for pregnancy-induced hypertension in first and third trimesters of gestation

Background and Aim: Though contribution of sympathovagal imbalance (SVI) to arterial stiffness indices (ASI), and markers of CV risk in pregnancy-induced hypertension (PIH) has been reported, their association during early trimesters of gestation in PIH has not been studied. Therefore, in the present study, we have investigated the association of SVI with ASI in pregnant women with risk factors for PIH during their first and third trimesters of gestation. Methods: Blood pressure (BP), rate-pressure product (RPP), spectral analysis of heart rate variability (HRV), and arterial stiffness indices (ASI) were assessed in subjects of control group (normal pregnant women without having risk for PIH, n = 50) and study group (pregnant women with risk factors for PIH, n = 50). Independent association of LF:HF ratio to the various parameters were determined using multiple regression analysis. Results: It was observed that the ratio of low-frequency to high-frequency power (LF-HF ratio) of HRV, the sensitive indicator of SVI was significantly high in study group subjects starting from first trimester of pregnancy. SVI could be due to both sympathetic activation and vagal withdrawal. ASI was found to be significantly high in study group subjects compared to that of controls. LF-HF ratio had significant correlation and independent association with RPP (the marker of CV risk) and ASI. Conclusion: SVI is associated with arterial stiffness in pregnant women having risk factors for PIH. SVI and increased arterial stiffness could contribute to CV risks in pregnant women with risk factors for PIH.

Emerging role of vitamin D in health

Vit. D is a steroid prohormone. It is synthesized in the skin under ultra –violet light exposure. Traditionally, Vit.D3, cholecalciferol and calcitriol were known to have a role only in calcium and bone mineral metabolism. This article takes an account of the current view on the impact of Vit D deficiency on human health. Research has now shown the indisputable role of Vit D in prevention/treatment of some cancers, osteoporosis, rheumatoid arthritis, multiple sclerosis, tuberculosis, hypertension, and diabetes mellitus. In addition lower maternal Vit. D levels are associated with Pregnancy Induced Hypertension (PIH), suggesting that Vit. D deficiency may be a modifiable risk factor for PIH. Greater awareness of the problem of a high prevalence of vitamin D inadequacy is required among researchers, clinicians, and patients. Special efforts on the medical and social fronts are necessary to combat this preventable epidemic of vitamin D deficiency.