Risk Factor For Preeclampsia Research Articles

Bayesian spatiotemporal modelling for disease mapping: an application to preeclampsia and gestational diabetes in Florida, United States.

Morbidities generally show patterns of concentration that vary by space and time. Disease mapping models are useful in estimating the spatiotemporal patterns of disease risks and are therefore pivotal for effective disease surveillance, resource allocation, and the development of prevention strategies. This study considers six spatiotemporal Bayesian hierarchical models based on two spatial conditional autoregressive priors. It could serve as a guideline on the development and application of Bayesian hierarchical models to assess the emerging risk trends, risk clustering, and spatial inequality trends, with estimation of covariables' effects on the interested disease risk. The method is applied to the Florida Birth Record data between 2006 and 2015 to study two cardiovascular risk factors: preeclampsia and gestational diabetes. High-risk clusters were detected in North Central Florida for preeclampsia and in Central Florida for gestational diabetes. While the adjusted disease trend was stable, spatial inequality peaked in 2011-2012 for both diseases. Exposure to PM2.5 at first or/and second trimester increased the risk of preeclampsia and gestational diabetes, but the magnitude is less severe compared to previous studies. In conclusion, this study underscores the significance of selecting appropriate disease mapping models in estimating the intricate spatiotemporal patterns of disease risk and suggests the importance of localized interventions to reduce health disparities. The result also identified an opportunity to study potential risk factors of preeclampsia, as the spike of risk in North Central Florida cannot be explained by current covariables.

ANALISIS FAKTOR RESIKO PRE EKLAMPSIA BERAT PADA IBU HAMIL DI BLUD RSU KOTA BANJAR

Maternal and child health services are a major priority in Indonesia's health development because there is still a significant problem with maternal mortality and morbidity. A measure of health is the Maternal Mortality Rate (MMR). 2015 saw an MMR of 305 per 100,000 live births in Indonesia. MMR reduction to 183 per 100,000 live births by 2024 and to less than 70 fatalities per 100,000 live births by 2030 is a global SDG target. Pregnancy-related hypertension is currently the leading cause of death in Indonesia. When proteinuria is absent and other organs are also affected by severe preeclampsia, blood pressure is >160/110 mmHg at >20 weeks of gestation. Preeclampsia's specific etiology is unknown as of right now. Preeclampsia in pregnant women can be caused by a number of variables, including low education levels, overworked mothers, primiparity or grande multiparity, and birth spacing that is either too near or too far apart. This study was conducted at BLUD RSU Banjar City with the aim of identifying the risk factors for severe pre-eclampsia in pregnant women. Correlational or association research, a retrospective study with a cross sectional design, is this kind of investigation. 614 pregnant women make up the study's population, which was chosen at random to create a sample size of 61. The findings revealed no relationship between educational factors (p-value: 0.394), employment (p-value: 0.664), parity (p-value: 1.000), and the time between pregnancies (p-value: 0.835; greater than 0.05) and the incidence of severe pre-eclampsia in pregnant women at BLUD RSU Banjar City. The frequency of severe pre-eclampsia in pregnant women at BLUD RSU Banjar City is not significantly correlated with education, occupation, parity, or pregnancy spacing.

Association between estradiol levels in early pregnancy and risk of preeclampsia after frozen embryo transfer.

The failure of remodeling the spiral arteries is associated with the pathogenesis of preeclampsia. Estradiol (E2) plays a crucial role in placentation and may be involved in the development of preeclampsia. However, there is a lack of data in this area. This study aims to assess the association between serum estradiol levels in early pregnancy and the risk of preeclampsia. We conducted a retrospective cohort study on patients who conceived after frozen embryo transfer (FET) using data from a database at a university-affiliated in vitro fertilization center. The study period spanned from January 1, 2010, to December 31, 2020. Multivariable logistic regression analyses were performed to determine the adjusted effect of E2 levels on the risk of preeclampsia. We compared the odds ratios of preeclampsia across quartiles of E2 levels and assessed their significance. Serum E2 levels at the fifth gestational week were significantly different between women with and without preeclampsia after FET programmed cycles (607.5 ± 245.4 vs. 545.6 ± 294.4 pg/ml, p=0.009). A multivariable logistic regression model demonstrated that E2 levels in early pregnancy were independent risk factors for preeclampsia. We observed an increased odds ratio of preeclampsia with increasing quartiles of estradiol levels after adjusting for potential confounders in FET programmed cycles. When comparing quartiles 3 and 4 (E2 > 493 pg/ml at the fifth gestational week) to quartiles 1 and 2, the odds ratios of preeclampsia were significantly higher. We found that serum E2 levels in early pregnancy may impact the risk of preeclampsia, particularly following FET programmed cycles. The association between E2 levels in early pregnancy and preeclampsia deserves further investigation.

Factors associated with preeclampsia among pregnant women in Gojjam zones, Amhara region, Ethiopia: a case-control study

Purpose Little is known about the factors contributing to preeclampsia in Ethiopia. Therefore, this study was conducted to determine factors associated with preeclampsia among pregnant women in public hospitals. Methods and materials An institution based unmatched case-control study was conducted. Women with preeclampsia were cases, and those without preeclampsia were controls. The study participants were selected using the consecutive sampling method with a case-to-control ratio of 1:2. The data were collected through measurements and a face-to-face interview. Then the data were entered using Epi Info and exported to STATA 14 for analysis. The findings were presented in text, tables, and figures. Results About 51 (46.4%) of cases and 81 (36.8%) of controls had no formal education. Multiple gestational pregnancies (AOR = 2.75; 95% CI: 1.20–6.28); history of abortion (AOR = 3.17, 95% CI: 1.31–7.70); change of paternity (AOR = 3.16, 95% CI: 1.47–6.83); previous use of implants (AOR = 0.41; 95% CI: 0.13–0.96); and fruit intake during pregnancy (AOR = 0.36, 95% CI: 0.18–0.72) were associated factors of preeclampsia. Conclusion History of abortion, change of paternity, and multiple gestational pregnancies were risk factors for preeclampsia. Fruit intake during pregnancy and previous use of implant contraceptives were negatively associated with preeclampsia. Further studies should be conducted regarding the effect of prior implant use on preeclampsia. Healthcare providers should give special attention to women with a history of abortion and multiple gestational pregnancies during the ANC follow-up period.

OP02_5. The social determinants of health as risk factors for pre-eclampsia: evidence from a pre-eclampsia conceptual framework

OP02_5. The social determinants of health as risk factors for pre-eclampsia: evidence from a pre-eclampsia conceptual framework

Low-Dose Aspirin Use in Pregnancy and the Risk of Preterm Birth: A Swedish Register-Based Cohort Study

ABSTRACT Evidence has shown that low-dose aspirin can reduce the risk of preeclampsia in women with risk factors; more recent evidence has shown that aspirin may also be useful for the prevention of spontaneous preterm birth, even among women without risk factors for preeclampsia. However, there are fewer studies examining the effectiveness of low-dose aspirin in this population, and the studies that have been done have generally been statistically underpowered. This study was meant to address this limitation in a large population of women who had previously experienced preterm birth, assessing whether low-dose aspirin treatment was associated with a lower risk for preterm birth. This study was a register-based cohort study performed using several different Swedish registries. The sample included all women with a first and second singleton birth between 2006 and 2019 and with a preterm birth in the first pregnancy. The primary outcome assessed was preterm birth during the second pregnancy, and secondary outcomes included assessment of preterm birth by severity (moderate preterm was between 32 and 36 weeks' gestation, and severe preterm was less than 32 weeks' gestation) and onset (spontaneous or medically indicated). The variable of interest was low-dose aspirin exposure or at least 1 dispensed prescription of 75 to 160 mg aspirin. The analysis included 22,127 women with a preterm birth in their first pregnancy followed by a second recorded pregnancy. Of this sample, 3057 (14%) were prescribed low-dose aspirin during their second pregnancy. Recurrent preterm birth occurred in 3703 individuals, of whom 547 (15%) had used low-dose aspirin. After adjusting for confounding variables, the incidence of preterm birth was lower in those using low-dose aspirin, with a marginal relative risk (mRR) of 0.87 (95% confidence interval [CI], 0.77–0.99). However, there was no difference in risk for moderate or severe preterm birth (moderate group: mRR, 0.90 [95% CI, 0.78–1.03]; severe group: mRR, 0.75 [95% CI, 0.54–1.04]). In adjusted analyses, there were no statistically significant differences for either medically indicated or spontaneous preterm birth between individuals who used low-dose aspirin and those who did not. The study was limited by its retrospective nature. In addition, the authors acknowledge that a dispensed prescription for aspirin does not necessarily equate to consistent intake of low-dose aspirin throughout a pregnancy. In addition, the population for this study was limited to those who had already experienced a preterm birth, which could affect the generalizability of the results. Although limited differences were found, a small protective effect could not be ruled out, and randomized controlled trials to understand more fully the effect low-dose aspirin might have on preterm birth would be helpful. Further research should also focus on whether the benefits of aspirin use during pregnancy outweigh the potential risks, as well as what the lowest effective dose might be.

SC4_4. Pathways to pre-eclampsia: learning from lived experience about the risk factors for pre-eclampsia

SC4_4. Pathways to pre-eclampsia: learning from lived experience about the risk factors for pre-eclampsia

OP19_3. The role of shared risk factors for COVID-19 and preeclampsia: an observational study

OP19_3. The role of shared risk factors for COVID-19 and preeclampsia: an observational study

The impact of risk factors on aspirin's efficacy for the prevention of preterm birth

The Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas trial was a landmark study that demonstrated a reduction in preterm birth and hypertensive disorders of pregnancy in nulliparous women who received low-dose aspirin. All women in the study had at least 1 moderate-risk factor for preeclampsia (nulliparity). Unlike current US Preventative Service Task Force guidelines, which recommend low-dose aspirin for ≥2 moderate-risk factors, women in this study were randomized to receive low-dose aspirin regardless of the presence or absence of an additional risk factor. This study aimed to compare how low-dose aspirin differentially benefits nulliparous women with and without additional preeclampsia risk factors for the prevention of preterm birth and hypertensive disorders of pregnancy. This was a non-prespecified secondary analysis of the Aspirin Supplementation for Pregnancy Indicated Risk Reduction In Nulliparas trial that randomized nulliparous women with singleton pregnancies from 6 low-middle-income countries to receive low-dose aspirin or placebo. Our primary exposure was having an additional preeclampsia risk factor beyond nulliparity. Our primary outcome was preterm birth before 37 weeks of gestation, and our secondary outcomes included preterm birth before 34 weeks of gestation, preterm birth before 28 weeks of gestation, hypertensive disorders of pregnancy, and perinatal mortality. Among 11,558 nulliparous women who met the inclusion criteria, 66.8% had no additional risk factors. Low-dose aspirin similarly reduced the risk of preterm birth at <37 weeks of gestation in women with and without additional risk factors (relative risk: 0.75 vs 0.85; P=.35). Additionally for our secondary outcomes, low-dose aspirin similarly reduced the risk of preterm birth at <28 weeks of gestation, hypertensive disorders of pregnancy, and perinatal mortality in women with and without additional risk factors. The reduction of preterm birth at <34 weeks of gestation with low-dose aspirin was significantly greater in women without additional risk factors than those with an additional risk factor (relative risk: 0.69 vs 1.04; P=.04). Low-dose aspirin's ability to prevent preterm birth, hypertensive disorders of pregnancy, and perinatal mortality was similar in nulliparous women with and without additional risk factors. Professional societies should consider recommending low-dose aspirin to all nulliparous women.

OBESITY-RELATED PRE-ECLAMPSIA - FETUS AND NEWBORN OUTCOMES (literature review)

The paperdeals with the studying the epidemiology of risk factors of preeclampsia, including the delayed risk of preeclampsia associated with obesity. Obesity-is a serious risk factor for preeclampsia. Throughout the world, hypertensive disorders in pregnancy and related complications are among the main causes of maternal and their fetuses/newbornsmorbidity and mortality. Fetal and neonatal outcomes associated with eclampsia and its complications are significant, including neonatal mortality and serious long-term neonatal morbidity.

Risk Factors of Body Mass Index and Hypertension on Preeclampsia during the Covid-19 Pandemic

Preeclampsia, known as the "new onset of persistent hypertension," can increase the morbidity and mortality of mothers and fetus. The Indonesian Health Profile shows that the maternal mortality rate (MMR) due to preeclampsia in Indonesia reaches 25%. The Corona Virus Disease 2019 impacted the access to, and quality health services, including for maternal and neonatal. This study aim to determine the risk factors for preeclampsia at Budhi Asih Hospital during the Covid-19 pandemic. This was a retrospective, observational case-controlled study, using medical records of woman on antenatal care from March 2020 – March 2022. Samples size was 128 participants (64 cases and 64 controls) using a simple random technique. Data analysis used the Chi-square test and logistic regression. The results showed that the variables associated with the incidence of preeclampsia were maternal age (p=0.049), parity status (p=0.041), chronic hypertension (p=0.000), and BMI (p=0.003). Variables that were not related to the incidence of preeclampsia were previous history of preeclampsia (p=0.094), pregnancy interval (p=0.367), and family history of preeclampsia (p=0.154). The most dominant variable was chronic hypertension (OR 36.162; 95% CI 4.453-293.655). This study concludes that chronic hypertension, obesity, age at risk (&lt;20 years or &gt;35 years), and nullipara or primipara are risk factors for preeclampsia at Budhi Asih Hospital during the Covid-19 pandemic.

Demographic and Clinical Profile of Hypertensive Pregnant Women

Background: Preeclampsia, which complicates 2 to 4% of pregnancies globally, is progressive, unpredictable, and serious. It is a relatively common pregnancy disorder that originates in the placenta and causes variable maternal and fetal problems. In the worst cases, it may threaten the survival of both mother and baby. There are several risk factors of preeclampsia and the severity of mortality or morbidity can be minimized by identifying the risk factors. So, this study aimed to assess the risk factors of preeclampsia. Material &amp; Methods: It is a cross-sectional study carried out in the Department of Obs &amp; Gynae in DMCH from July 2017 to December 2018. The study included 50 cases. The selection criteria were 28 to 42 weeks of pregnancy with hypertension with proteinuria. Data was collected by history taking, clinical examination, and relevant biochemical tests. A purposive sampling technique was used in this study. Data was collected by a pre-designed questionnaire. Quantitative data were expressed as mean. Data were processed and analyzed by SPSS version 22.0. Informed written consent was taken from all participants. Ethical clearance was obtained by the ethical committee of DMCH. Results: In this study, most of the patients (16, 32%) were in the 16-20 years age group, followed by (13, 26%) 21-25 years age group and the mean age was (SD±) 24.5±6.3 years. Most of the patients (35,70%) were primigravida, and the rest (15, 30%) were multigravida. In the present study, most of the patient’s (20, 40%) gestational age at delivery was 33-38 weeks, followed by (18, 36%) 38-40 weeks. 64% of patients did not have a positive family history. Out of 50 patients, only a few (4, 8%) underwent regular antenatal care, and 72% had no antenatal care. Regarding systolic blood pressure, the range was 140.0-200.0 mmHg and mean±SD 159.0-9.08, and diastolic blood pressure was 90.0-120.0 mmHg and mean±SD 103.80-7.39. Conclusion: This study concluded that, most of the hypertensive pregnant women belonged to 16-20 years of age and most of them were primigravida. A greater part of the patients presented with hypertension at 33-38 weeks of pregnancy and only a few of them had a positive family history of hypertension. Considering antenatal care, they were unaware of it showing that, the most of the patient did not get proper antenatal care.

Hubungan Kehamilan Ganda dengan Kejadian Preeklampsia

Complications in pregnancy include the onset of hypertension accompanied by protein in the urine that appears when the pregnancy reaches 20 weeks is called preeclampsia. Appropriate management and early detection is needed in cases of preeclampsia, if treatment is late, the condition will deteriorate very quickly which can lead to eclampsia. Eclampsia eventually causes the condition of the fetus and mother to worsen and increases morbidity and mortality. There are many risk factors for preeclampsia including parity, age of the mother during pregnancy, multiple pregnancies, and previous history. The purpose of this study was to identify the relationship between multiple pregnancies and cases of preeclampsia. This study used the case control method and the retrospective time approach, taking samples with purposive sampling, and processing data using the Fisher's test with the strength of the relationship using the odds ratio (OR). The results of this study were p value 0.03 &lt;0.05, with an OR value of 1.607 meaning that pregnant women with multiple pregnancies 1.6 times will experience preeclampsia in pregnancy.&#x0D;

Risk Factors of Pre-eclampsia: A Hospital-Based Case-Control Study.

Introduction Pre-eclampsia is a pregnancy-specific hypertensive disorder and is one of the leading causes of maternal and infant morbidity and mortality in India and worldwide. Evidence of the association between various risk factorsand pre-eclampsia is scarce in developing countries. As pre-eclampsia remains a leading cause of maternal mortality and morbidity, focusing on the causes and risk factors of pre-eclampsia during antenatal surveillance would prevent maternal deaths and reduce the maternal mortality rate. Our study aimed to determine the risk factors of pre-eclampsia. Materials and methods An unmatched case-control study was conducted at Veer Surendra Sai Institute of Medical Sciences and Research (VIMSAR), Burla, Odisha, taking 100 cases of pre-eclampsia and 100 controls without pre-eclampsia from January 2021 to January 2023. The study population included patients admitted to the Obstetrics & Gynecology labor room. Study participants were selected randomly from the labor room thrice weekly. Data were collected using a predesigned pre-tested questionnaire and case report format. Data were analyzed using IBMSPSSStatistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).Appropriate statistical tests (Odds ratio, proportions, Chi-square test) were applied, and the final interpretation was made. Results Family history of hypertension (AOR = 4.2), history of chronic hypertension (AOR = 13.7), and AB blood group (AOR = 3.6) were found to be significant risk factors for pre-eclampsia. No significant association was found between pre-eclampsia and factors such as mother's age, caste, mother's education, type of family, socioeconomic status, education and occupation of husband, family history of diabetes mellitus, parity, history of abortion, and anemia. Conclusion Risk factors identified in the present study can be used to identify women at risk of pre-eclampsia during antenatal check-ups to minimize the complications of pre-eclampsia in both the mother and the fetus.

Preeclampsia and risk of maternal pulmonary hypertension at high altitude in Bolivia.

Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.

HIGH SERUM RATIO OF SOLUBLE FMS-LIKE TYROSINE KINASE 1 (sFlt-1) TO PLACENTAL GROWTH FACTOR (PIGF) AND HIGH LEVEL OF LOW-DENSITY LIPOPROTEIN (LDL) AS RISK FACTORS OF PREECLAMPSIA

Preeclampsia is an obstetric disease that is a health problem worldwide, including in Indonesia. Several studies have shown that changes in the maternal spiral arteries are thought to lead to preeclampsia. Preeclampsia in this decade has been associated with changes in angiogenesis regulatory proteins originating from the placenta and circulating in the mother's blood circulation, namely soluble FMS-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF). The author was interested in examining the ratio of sFlt-1/PIGF and low-density lipoprotein (LDL) to the incidence of preeclampsia in pregnant women. This study used a case control analytic observational design. The research sample was selected by consecutive sampling of 20 cases and 20 controls. Univariate analysis was used to describe patient characteristics descriptively, and bivariate analysis was used to determine the relationship between the 2 variables There is no significant difference in the characteristics of the research subjects. Low PIGF levels are a risk factor for preeclampsia (OR 4.33; p 0.0302) with a cut-off value of 24.5. High sFlt-1 levels are a risk factor for preeclampsia (OR 4.33; p 0.027) with a cut-off value of 869.5. A high sFlt-1/PIGF ratio is a risk factor for preeclampsia (OR 4.33 p 0.030) with a cut-off value of 38. High LDL levels are a risk factor for preeclampsia (OR 6.0; p 0.013) with a cut-off value of 150 ,2. Low placental growth factor (PIGF), high levels of soluble FMS-like tyrosine kinase 1 (sFlt-1), and high levels of LDL are risk factors of preeclampsia in pregnant women.

Pregestational maternal risk factors for preterm and term preeclampsia: A population-based cohort study.

Most studies on factors affecting the risk of preeclampsia have not separated preterm from term preeclampsia, and we still know little about whether the predisposing conditions have a differentiated effect on the risk of preterm and term preeclampsia. Our aim was to assess whether diabetes type 1 and 2, chronic kidney disease, asthma, epilepsy, rheumatoid arthritis and chronic hypertension were differentially associated with preterm and term preeclampsia. This is a nationwide, population-based cohort study containing all births registered in the Medical Birth Registry of Norway from 1999 to 2016. Multinomial logistic regression analysis was used to estimate relative risk ratios (RRRs) with 95% confidence intervals (95% CIs), adjusting for maternal age, parity, multiple gestation and all other studied maternal risk factors. We registered 1 044 860 deliveries, of which 9533 (0.9%) women had preterm preeclampsia (<37 weeks) and 26 504 (2.5%) women had term preeclampsia (>37 weeks). Most of the assessed maternal risk factors were associated with increased risk for both preterm and term preeclampsia, with adjusted RRRs ranging from 1.2 to 10.5 (preterm vs no preeclampsia) and 0.9-5.7 (term vs no preeclampsia). Diabetes type 1 and 2 (RRR preterm vs term preeclampsia 2.89, 95% CI 2.46-3.39 and RRR 1.68, 95% CI 1.25-2.25, respectively), chronic kidney disease (RRR 1.55, 95% CI 1.11-2.17) and chronic hypertension (RRR 1.85, 95% CI 1.63-2.10) were more strongly associated with preterm than term preeclampsia in adjusted analyses. For asthma, epilepsy and rheumatoid arthritis, RRRs were closer to one and not significant when comparing risk of preterm and term preeclampsia. Main results were similar when using a diagnosis at <34 weeks to define preterm preeclampsia. Diabetes type 1 and 2, chronic kidney disease and chronic hypertension were more strongly associated with preterm than term preeclampsia.

Pregnancy outcomes and disease phenotype of hypertensive disorders of pregnancy in singleton pregnancies after in vitro fertilization: a retrospective analysis of 1130 cases

BackgroundAlthough in vitro fertilization (IVF) can increase the incidence of hypertensive disorders of pregnancy (HDP), the pregnancy outcomes and disease phenotype of HDP in singleton pregnancies conceived via IVF remain unclear.MethodsThis retrospective cohort study enrolled 1130 singleton pregnancies with HDP from 2016 to 2020. According to the mode of conception, they were allocated into IVF (n = 102) and natural conception (NC) groups (n = 1028). All IVF pregnancies were subdivided into frozen embryo transfer (FET) group (n = 42) and fresh embryo transfer (ET) group (n = 60). Demographic data, pregnancy outcomes and disease phenotypes of HDP among the groups were compared. The risk factors for severe preeclampsia (PE) and early-onset PE were analyzed.ResultsThe incidences of early-onset PE (P<0.001), severe PE (P = 0.016), cesarean section (P<0.001) and preterm births (P = 0.003) in the IVF-HDP group were significantly higher than those in the NC-HDP group, and gestational age at diagnosis of HDP (P = 0.027) and gestational age at delivery (P = 0.004) were earlier and birthweight of the neonates (P = 0.033) were lower in the IVF group. In singleton pregnancies with HDP, IVF was associated with increased risks for both severe PE and early-onset PE (aOR 1.945, 95% CI 1.256, 3.014; and aOR 2.373, 95% CI 1.537, 3.663, respectively), as well as FET, family history of preeclampsia, intrahepatic cholestasis of pregnancy, gestational hypothyroidism and multiparity were associated with increased risks of severe PE and early-onset PE.ConclusionsIn singleton pregnancies with HDP, IVF was associated with an increased incidence of the disease phenotype (severe or early-onset PE), as well as an increased incidence of pregnancy outcomes related to severe PE and early-onset PE.

Perbedaan Indeks Massa Tubuh pada Ibu Hamil dengan Preeklamsi Ringan, Berat, dan Eklamsi di Rumah Sakit Umum Daerah (RSUD) Ciawi

Background: Preclampsia is a one of complication in pregnancy characterised by systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and proteinuria (≥300mg/24hours in urine; protein/creatinine ≥0.3; dipstick protein +1; and/or with additional symptoms. Eclampsia is a severe form of preeclampsia where the mother experiences seizures and/or coma. There are various risk factors for preeclampsia and eclampsia, one of which is the mother's body mass index (BMI). Excessive maternal weight before pregnancy, as well as excessive weight gain during pregnancy are at risk for preeclampsia. Methods: This study used medical records from the Ciawi General Hospital in 2020, and cross-sectional observational study was carried out. Pregnant women with eclampsia and preeclampsia were the study's population. This study used total sampling as its sampling method, and body mass index measurements were made using information from medical records. The Kruskall Wallis alternative test was utilized in place of the One Way Anova as the hypothesis test in this investigation. In this investigation, a 5% level of significance is expected. Results: This study involved 190 respondents who met the inclusion criteria. The statistical test results showed no significant difference in mean body mass index between the eclampsia, severe preeclampsia, and mild preeclampsia groups (P-value: 0.688). This difference is expected due to the small number of samples and/or the high variability of the samples. Conclusion: Based on the results of the study, there was no significant association between body mass index and mild, severe, and eclampsia. Further research should be conducted and developed for prevention and lifestyle intervention in preeclampsia.

Decreased Risk of Preeclampsia in Women with Inflammatory Bowel Disease on Anti-Tumor Necrosis Factor Therapy.

Evidence suggests that upregulation of tumor necrosis factor-alpha (TNF-α) plays a role in immune dysregulation in both preeclampsia and inflammatory bowel disease (IBD). We aimed to investigate whether anti-TNF therapy during pregnancy decreases the risk of preeclampsia in women with IBD. The study population included women with IBD and pregnancies who were followed at a tertiary care center from 2007 to 2021. Cases of preeclampsia were compared with controls with a normotensive pregnancy. Data on patient demographics, disease type and activity, pregnancy complications, and additional risk factors for preeclampsia were collected. The association between anti-TNF therapy and preeclampsia was analyzed using univariate analysis and multivariate logistic regression. Women with preeclampsia were more likely to have a preterm delivery (44% vs. 12%, p < 0.001). More women without preeclampsia were exposed to anti-TNF therapy during pregnancy than women with preeclampsia (55% vs. 30%, p = 0.029). The majority of women (32/44) on anti-TNF therapy, either adalimumab or infliximab, continued to have some degree of exposure during the third trimester. Though not significant, multivariate analysis showed a trend towards a protective effect of anti-TNF therapy against developing preeclampsia if exposed during the third trimester (OR 0.39; 95% CI 0.14-1.12, p = 0.08). In this study, anti-TNF therapy exposure was higher in IBD patients who did not develop preeclampsia than in those who did. While not significant, there was a trend towards a protective effect of anti-TNF therapy against preeclampsia if exposed during the third trimester.