Risk Of Pregnancy-induced Hypertension Research Articles

Association between Pre-pregnancy BMI and Pregnancy Outcomes in Women with Gestational Diabetes: A Retrospective Cohort Study.

The specific influence of the pre-pregnancy body mass index (PPBMI) on women with gestational diabetes mellitus (GDM) is unclear. Our objective was to investigate how PPBMI categories affect pregnancy and neonatal outcomes in women with GDM. A retrospective cohort study was conducted using data from patients attending the Fujian Maternity and Child Health Hospital (Fuzhou, China) from 2021 to 2023. The participant records were stratified into four groups according to their BMI values: underweight, normal-weight, overweight, and obese. The pregnancy and neonatal outcomes for these BMI categories were analyzed using multivariable logistic regression. The study included data from 2,909 pregnant women diagnosed with GDM. Underweight women with GDM showed significantly lower risks of pregnancy-induced hypertension (PIH) (adjusted OR, 0.26) and cesarean sections (adjusted OR, 0.55) but higher risks of low body weight (LBW) infants (adjusted OR, 3.40). Overweight and obese women experienced higher risks of PIH (adjusted OR, 2.96), cesarean sections (adjusted OR, 1.62), and macrosomia (adjusted OR, 1.43). PPBMIs significantly impact pregnancy outcomes in women with GDM. Both underweight and overweight/obese categories are associated with adverse outcomes, highlighting the need for pre-pregnancy counseling and interventions to achieve and maintain a healthy BMI.

Adolescent menstrual cycle pattern, body mass index, endocrine and ovarian ultrasound characteristics of PCOS and future fertility, cardiovascular-, and metabolic health: a 25-year longitudinal follow-up study.

What is the predictive value of oligomenorrhea and other PCOS diagnostic characteristics in adolescence (age 15-18 years) for future fertility and cardiovascular and metabolic health at adult age? Adolescents with oligomenorrhea are more often treated to conceive but are as likely to have as much children as those with regular periods, while persisting oligomenorrhea may associate more often with cardiovascular or metabolic problems. Adolescents with oligomenorrhea have a high risk for adult PCOS associated with subfertility due to ovulatory disorders and long-term health risks. Longitudinal studies to estimate the extent of these risks with input starting at adolescence and covering the complete reproductive lifespan are lacking. A 25-year prospective follow-up study based on a unique population-based adolescent study on menstrual irregularities performed between 1990 and 1997, the Pubertal Onset of Menstrual Cycle abnormalities, a Prospective study (POMP study). Of the 271 invited adults, 160 (59%) participated. We contacted stratified samples of the POMP study cohort two decades after the initial study for a questionnaire assessing PCOS features, fertility history, pregnancy outcome, metabolic, and cardiovascular health. One hundred and sixty subjects completed the questionnaire. The mean adolescent age was 15.3 years, and the women were 39.6 years at the time of follow-up. One hundred and eight subjects had a regular menstrual cycle as adolescents and 52 were oligomenorrheic. Of those with adolescent regular menstrual cycles 12 never tried to conceive, 4 tried but never conceived and 92 of 96 (96%) conceived, 89 of 96 (93%) delivering at least one living child. The median number of children was two. The mean time to pregnancy (TTP) was 8.4 months in the women with regular periods as adolescents and 13.2 months in case of oligomenorrhea (P = 0.08) and subfertility was present in respectively 18% and 26%. 47 of 52 adolescents with oligomenorrhea tried to conceive and 45 succeeded to have at least one live birth. Twenty-eight per cent of the subjects reported a change over time of their menstruation pattern. Fifty per cent of the girls with adolescent oligomenorrhea developed a regular cycle and 16% of those with regular periods changed to oligomenorrhea with significantly more reported subfertility (40%, P = 0.04). In case of persistent oligomenorrhea, a significant proportion (40%) underwent fertility treatment (P = 0.04). Adult BMI did not differ between groups. The risk for pregnancy-induced hypertension or pre-eclampsia was comparable between the groups. Gestational diabetes developed in three subjects each with persistent oligo amenorrhea. Adult diabetes, hypertension, and hypercholesterolemia were also mostly reported in case of persistent oligomenorrhea. In this group, the prevalence of combined cardiovascular and metabolic problems was 14% compared to 7% in the case of regular menstrual cycles as adolescent. The numbers in the study are small. However, the small difference between the percentage with a least one living child of those with adolescent oligomenorrhea versus those with adolescent regular menstrual cycles is reassuring. Time to pregnancy data may have been biased by early treatment of oligomenorrheic adults. Oligomenorrheic adolescents may be reassured that their chance to have a live birth is comparable with those with a regular menstrual cycle. This research received no external funding, J.S.E.L. received unrestricted research grants from the following companies (in alphabetical order): Ansh Labs, Ferring, Merck, and Roche Diagnostics. He received consultancy fees or royalties from Ansh Labs, Art pred, Ferring, Gedeon Richter, and Roche Diagnostics. He received presentation fees from Ferring and Roche Diagnostics as well as support for attending meetings and/or travel from Ferring and Roche Diagnostics and he participated in the advisory board of the LOCI Trial UK. Dutch Trial Registry, NTR5871.

Vitamin D May not be Crucial: Association between Serum Vitamin D Level and Pregnancy-Induced Hypertension-A Meta-Analysis

Background: The association between vitamin D and pregnancy-induced hypertension (PIH) remains contentious. The aim of our study was to evaluate the existence of an association between serum vitamin D levels and the incidence of PIH. Methods: We conducted a literature search in PubMed, the Cochrane Library, and Embase databases in June 2024 using the following search terms: 25-hydroxyvitamin D (25(OH)D), Vitamin D, 1,25(OH)2D, VD, 1,25-dihydroxyvitamin D or 25(OH)D, combined with PIH. Two reviewers independently screened the literature based on inclusion and exclusion criteria. Data were then extracted and assessed for quality. Comparisons were made between the highest and lowest categories of serum vitamin D levels. Relative risks (RRs) and 95% confidence intervals (CIs), adjusted for multivariable effects, were pooled using a random-effects model. A two-stage dose-response meta-analysis was used to evaluate the trends. Results: 17 studies met the inclusion criteria. Of these, 11 prospective studies investigated the relationship between vitamin D levels and gestational hypertension, involving 8834 events and 17,104 participants. The results showed that vitamin D was only marginally associated with hypertensive disorders in pregnancy (summary RR = 0.99; 95% CI: 0.97–1.02; I2 = 67.5%; p = 0.001). However, 6 case-control studies investigated the relationship between vitamin D levels and gestational hypertension, involving 80,814 events and 330,254 participants. The results showed that vitamin D is not associated with pregnancy hypertensive disorders (summary RR = 1.09; 95% CI: 0.84–1.41; I2 = 75.4%; p = 0.001). In the subgroup analysis, the pooled effect of 25-hydroxyvitamin D (25(OH)D) showed a slight association with gestational hypertension (pooled RR = 0.99; 95% CI: 0.96–1.02; I2 = 72.6%; p = 0.000). The dose-response analysis showed that increasing vitamin D doses are marginally associated with a decrease in the incidence rate. Conclusions: Our research suggests that the risk of PIH may not be related to the vitamin D levels. Our research supports the hypothesis that gestational hypertension may not be associated with low levels of vitamin D, indicating that the role of vitamin D may not be significant.

ASHA-led community-managed intervention programme to improve maternal and neonatal outcomes in pregnant women with pregnancy hypertension: A study protocol.

The objective is to use the available technology in conjunction with the peripheral health workers to identify the early warning signs of pregnancy-induced hypertension (PIH), provide appropriate referral services and closely monitor the patient thereafter with the aim of improving the prognosis of the condition. Quasi-experimental design. The research will be carried out in Udupi District Karnataka, India. The study will involve 250 pregnant women in total as well as 50 ASHA workers. All the participants will undergo a PIH knowledge assessment, which will be followed by a PIH risk assessment for expectant mothers. There will be an implementation of the community-managed intervention programme (CMIP). The creation of a mobile application, ongoing prenatal follow-up and training for ASHAs on mobile app usage are all part of the CMIP. The results for mothers and newborns will be monitored and to learn more about the efficacy of CMIP and the difficulties ASHA workers and expectant mothers encounter in identifying the early warning signals of PIH a focused group discussion will be held. A number of research on pregnancy-induced hypertension have demonstrated the necessity for community-based treatments to be developed in order to improve the outcomes for expectant mothers and newborns. These programmes assist in managing hypertension throughout pregnancy. Conversely, ASHA employees have had a favourable influence on community-level health outcome management. Currently, technology is being used extensively in healthcare and is receiving favourable reception. Thus, in an effort to improve maternal and newborn outcomes, this study attempts to incorporate mobile technologies in addition to ASHA workers and pregnant women. If the CMIP proves to be beneficial, it might be implemented nationwide, particularly in isolated regions, to monitor expectant mothers and avoid PIH-related concerns.

Evaluation of Antithrombin-III Activity and Platelet Count in Pregnancy-Induced Hypertension among Pregnant Women attending Antenatal care in a Tertiary Health Facility in Southeast, Nigeria

Background: Pregnancy-induced hypertension (PIH) is a significant health issue that affects maternal and fetal outcomes. Antithrombin-III (AT-III) and platelet count alterations could serve as pivotal indicators for the management and prognosis of PIH. Objective: This study aimed to assess AT-III activity and platelet counts in pregnant women with and without PIH at the Federal Medical Centre (FMC), Owerri, Imo State, Nigeria. Methods: A case-control cross-sectional analytical study design was employed, including 135 pregnant women with PIH and 135 age-matched normotensive pregnant women. Exclusion criteria comprised chronic hypertension, known thrombophilic disorders, or anticoagulant therapy before pregnancy. AT-III levels and platelet counts were compared between groups using SPSS version 20.0, with significance set at p ≤ 0.05. Results: AT-III activity was significantly lower in the PIH group (75.45±6.23%) compared to the normotensive group (96.84±9.64%, p=0.028). Similarly, platelet count was significantly reduced in the PIH group (170.90 ±8.78 x109/L) versus the normotensive group (191.56±6.54 x109/L, p=0.032). No significant differences were found in sociodemographic variables except for the trimester of antenatal care registration and history of preeclampsia in previous pregnancies. Conclusion: This study highlights significant reductions in AT-III activity and platelet count among pregnant women with PIH, suggesting these parameters' potential role in PIH management and prognosis. These findings emphasize the importance of monitoring AT-III levels and platelet count as part of the antenatal care protocol in pregnant women, particularly those with or at risk for PIH.

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.

Elevated serum uric acid to creatinine ratio is associated with adverse pregnancy outcomes: a prospective birth cohort study.

Purpose: This study evaluated the association between maternal serum uric acid-to-creatinine ratio (SUA/SCr) in the first trimester and adverse maternal and neonatal outcomes. Methods: A prospective birth cohort study was conducted between 2018 and 2021. Logistic regression models and restricted cubic splines were utilized to estimate the associations between the SUA/SCr ratio and feto-maternal pregnancy outcomes. Women were stratified according to maternal age and pre-pregnancy body mass index. Results: This study included 33,030 pregnant women with live singleton pregnancies. The overall prevalence of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), cesarean delivery, preterm birth, large-for-gestational age (LGA), small-for-gestational age, and low Apgar scores were 15.18%, 7.96%, 37.62%, 4.93%, 9.39%, 4.79% and 0.28%, respectively. The highest quartile of SUA/SCr was associated with the highest risk of GDM (odds ratio [OR] 2.14, 95% CI 1.93-2.36), PIH (OR 1.79, 95% CI 1.58-2.04), cesarean delivery (OR 1.24, 95% CI 1.16-1.33), and preterm birth (OR 1.30, 95% CI 1.12-1.51). The associations between SUA/SCr with adverse pregnancy outcomes showed linear relationships except for GDM (P < 0.001 for all, P < 0.001 for non-linearity). Subgroup analyses revealed that the associations between the SUA/SCr ratio and the risks of PIH and LGA were significantly stronger in younger pregnant women (P = 0.033 and 0.035, respectively). Conclusion: Maternal SUA/SCr levels were associated positively with the risk of adverse pregnancy outcomes. Timely monitoring of SUA and SCr levels during early pregnancy may help reduce the risk of adverse pregnancy outcomes and provide a basis for interventions.

Impact of abnormal placentation on the risk of hypertensive disorders in pregnancy: A retrospective analysis

We aimed to investigate the impact of abnormal placental location and placenta accreta spectrum (PAS) disorders on the incidence of hypertensive disorders of pregnancy. This retrospective, single-center study was conducted at a tertiary maternity hospital between 2018 and 2022. The study population was classified according to abnormal placentation, including control (normal placentation), low-lying placenta (LP), placenta previa (PP), and PAS. The PAS group was further divided into subtypes: accreta, increta, percreta. Logistic regression analysis was performed to evaluate factors influencing the incidence of HDPs and pregnancy-induced hypertension (PIH) and their association with abnormal placentation and PAS subtypes. A total of 337 pregnant women were recruited into the study, with 222 abnormal placentations (85 were classified as LP, 72 as PP and 65 as PAS) and 155 controls. Among the participants, 37 women (9.81%) were diagnosed with HDPs. The incidence of HDPs was significantly lower in the PP (4.2%) and PAS (7.7%) groups compared to the control group (12.3%) (p&lt;0.001). The prevalence rates of HDPs were 10.3% in women without PAS, 11.1% with accreta, 8.7% with increta, and 4.1% with percreta (p&lt;0.001). For PIH, the prevalence rates were 7.4% without PAS, 5.6% with accreta, 4.3% with increta, and 0% with percreta (p&lt;0.001). After adjustment for confounders, including advanced maternal age, nulliparity, gestational diabetes mellitus (GDM), and elevated thyroid-stimulating hormone (TSH) levels, a significant negative association was observed between PP and the risk of PIH (OR=0.215, 95% CI: 0.128–1.243, p=0.001) and HDPs (OR=0.215, 95% CI: 0.128–1.243, p=0.001). Similarly, a negative association was observed between PAS and the risk of PIH (OR = 0.550, 95% CI: 0.295–1.120, p = 0.004) and HDPs (OR=0.610, 95% CI: 0.350–1.320, p=0.004). However, no association was found between HDPs and LP. Abnormal placentation, particularly PP and PAS, is associated with a reduced risk of HDPs, suggesting a potential protective effect. Additionally, the prevalence of HDPs decreases as the invasiveness of PAS increases.

Association of Gestational Anemia with Pregnancy-Induced Hypertension in a Private Hospital Maternity Care

Anemia, a prevalent global health concern affecting a quarter of the world's population, notably impacts pregnant women, with approximately 56 million affected globally. Its repercussions on maternal and neonatal health are extreme, leading to increased risks of low birth weight, fetal complications, and maternal morbidity and mortality. Concurrently, pregnancy-induced hypertension (PIH) poses significant risks to maternal and fetal well-being, yet the link between anemia and PIH remains an understudied area, particularly in Pakistan. Objective: To investigate the association between anemia and the heightened risk of PIH, offering critical insights into perinatal outcomes. Methods: A retrospective study was designed and the data was collected from Hijaz Hospital Gulberg III Lahore, Pakistan. Total 120 pregnant women were selected for the study and split into two groups. Group A consisted of 65 pregnant women with hypertension, whereas group B included 55 non-hypertensive pregnant women. Hemoglobin levels and Complete Blood Count were evaluated using standard protocols. The association of hemoglobin levels and PIH was investigated using independent-students test and one-way ANOVA by utilizing SPSS version-25. Results: Our findings showed that the hemoglobin levels were lowest (9.953846±1.924584 g/dl) in hypertensive women as compared to no-hypertensive women (11.52±1.584172) in their 3rd trimester. It coincided with the lowest number of red blood cells (4.1067±0.57816 million/mm3) in women with hypertension. Conclusions: Our finding demonstrated that the lower the levels of hemoglobin, the higher the risk of PIH.

The mediating role of pregnancy-induced hypertension on pre-pregnancy body mass index and adverse neonatal outcomes in women with assisted reproductive technology

ObjectiveTo explore whether pregnancy-induced hypertension (PIH) mediates the association between pre-pregnancy body mass index (BMI) and adverse neonatal outcomes in women undergoing assisted reproductive technology (ART) for singleton pregnancies.MethodsThis cohort study collected 79437 maternal data from the National Vital Statistics System (NVSS) between 2020 and 2021. Univariable and multivariable logistic regression models were applied to estimate the association between pre-pregnancy BMI and PIH in women receiving ART as well as the associations between pre-pregnancy BMI and PIH and adverse neonatal outcomes. The mediation effect of PIH on the association between pre-pregnancy BMI and adverse neonatal outcomes was estimated according to the total effect, natural direct effect, natural indirect effect, and percentage of mediation.ResultsThere were 25769 participants had adverse neonatal outcomes at the end of the follow-up. After adjusting for confounding factors, an increased risk of PIH in women receiving ART was identified in those with pre-pregnancy BMI ≥25 kg/m2 [odds ratio (OR)=1.92, 95% confidence interval (CI):1.84–2.01]. Pre-pregnancy BMI ≥25 kg/m2 was associated with an increased risk of adverse neonatal outcomes (OR = 1.26, 95%CI:1.22–1.30). Women with PIH had an increased risk of adverse neonatal outcomes (OR = 1.79, 95%CI:1.71–1.87). The percentage mediated by PIH in the association between pre-pregnancy BMI and adverse neonatal outcomes was 21.30%.ConclusionPIH partially mediated the association between pre-pregnancy BMI and adverse neonatal outcomes in women receiving ART, which recommends that women control weight before receiving ART.

Changes in Intrapersonal Factors of Participants in the Pregnancy Remote Monitoring Study Who Are at Risk for Pregnancy-Induced Hypertension: Descriptive Quantitative Study.

The peripartum period, defined as the period from the beginning of the gestation until 1 year after the delivery, has long been shown to be potentially associated with increased levels of stress and anxiety with regard to one's transition to the status of parent and the accompanying parental tasks. Yet, no research to date has investigated changes in intrapersonal factors during the peripartum period in women at risk for pregnancy-induced hypertension (PIH). The aim of this study is to explore and describe changes in intrapersonal factors in participants at risk for PIH. We used an explorative design in which 3 questionnaires were sent by email to 110 participants the day following enrollment in the Pregnancy Remote Monitoring program for pregnant women at risk for PIH. Women were invited to complete the questionnaires at the beginning of their participation in the Pregnancy Remote Monitoring project (mostly at 14 weeks of gestation) and after approaching 32 weeks of gestational age (GA). The Generalized Anxiety Disorder-7 Scale (GAD-7) and the Patient Health Questionnaire-9 were used to assess anxiety and depression, and adaptation of the Pain Catastrophizing Scale was used to measure trait pain catastrophizing. Scores were significantly higher at 32 weeks of GA than at the moment of enrollment (GAD-7 score=7, range 4-11 vs 5, range 3-8; P=.01; and Patient Health Questionnaire-9 score=6, range 4-10 vs 4, range 2-7; P<.001). The subscale scores of the Pain Catastrophizing Scale were all lower at 32 weeks of GA compared with 14 weeks of GA (rumination: 4, range 1-6 vs 5, range 2-9.5; P=.11; magnification: 3, range 1-5.5 vs 4, range 3-7; P=.04; and helplessness: 5, range 2-9 vs 6, range 3.5-12; P=.06). The proportion of women with a risk for depression (GAD-7 score >10) was 13.3% (10/75) at enrollment and had increased to 35.6% (26/75) at 32 weeks of GA. This study shows that pregnant women at risk for PIH have higher levels of stress and anxiety at 32 weeks of GA than at the moment of enrollment. Further research is recommended to investigate potential strategies to help pregnant women at risk for PIH manage feelings of stress and anxiety. ClinicalTrials.gov NCT03246737; https://clinicaltrials.gov/study/NCT03246737.

Fatty acids and pregnancy-induced hypertension: a Mendelian randomization study

BackgroundIt is well known that pregnancy-induced hypertension (PIH) contributes significantly to the mortality rates of both mothers and babies during pregnancy. The relationship between fatty acids (FAs) and PIH remains debatable, with the causality between the two yet to be definitively established.MethodsTwo-sample univariable and multivariable Mendelian Randomization (MR) analyses were executed, based on pooled data from Genome-Wide Association Studies (GWAS), to investigate any causal impact of FAs on PIH. A suite of methods was employed to assess causality, including inverse variance weighting (IVW), weighted median, MR Egger, simple mode, and weighted mode. Subsequently, the data underwent a sensitivity analysis (using Leave-One-Out analysis), a heterogeneity test (with MR-PRESSO and Cochran’s Q test), as well as a multiple validity test (using MR-Egger regression). In multivariable analyses, fatty acids were first grouped to observe the effect of individual FAs on PIH. Subsequently, factors such as diabetes, high blood pressure, and body mass index (BMI) were incorporated into a multivariable examination of the impact of each FA on PIH. During this process, the IVW, weighted median, MR-Lasso, and MR-Egger methods were employed.ResultsA systematic investigation was conducted into the causal impact of each FA on PIH. The findings indicated that Polyunsaturated Fatty Acids (PUFA), Omega3, the ratio of Omega6 to Omega3, and Docosahexaenoic Acid (DHA) have a causal relationship with PIH. Increases in PUFA, Omega3, and DHA could potentially reduce the risk of PIH, while an increase in the Omega6/Omega3 ratio could heighten the risk. The impacts of other FAs (including Total Fatty Acids, Monounsaturated Fatty Acids (MUFA), Saturated Fatty Acids (SFA), and Omega 6) on PIH were not substantiated by the MR analysis. In the univariate leave-one-out analysis, rs174564 was identified in PUFA, Omega3, and DHA as having a significant role. The tests with MR-Egger and MR-PRESSO found that the results were not influenced by pleiotropy and heterogeneity. After adjusting for BMI, Diabetes Mellitus, and pre-existing hypertension in the multivariable analysis, the results mirrored those obtained univariable.ConclusionThe research implies that elevated levels of circulating PUFA, DHA, and Omega3 may serve as a protective mechanism against PIH, while higher Omega6/Omega3 ratios could potentially increase the risk of PIH. These findings may inform clinical strategies for PIH prevention.

Influence of temperature on the risk of gestational diabetes mellitus and hypertension in different pregnancy trimesters

Previous studies have proved that exposure to extreme temperature in specific windows of pregnancy could cause some complications, such as pregnancy induced hypertension (PIH) and gestational diabetes mellitus (GDM), but differences in the effect of extreme temperature on the 2 complications are rarely studied. We carried a retrospective study on the impact of temperature on GDM/PIH in different trimesters based on data from a maternal and child health center in Beijing, China. Ambient temperatures (°C) were obtained from the China Meteorological Administration from January 1st, 2013 to May 15th, 2018. We use distributed lag non-linear models (DLNMs) combined with logistic regression to calculate the lag exposure-response relationships between the temperature and GDM/PIH from 1st to 24th/20th weeks of pregnancy. In both first and second trimesters, the risk of GDM was increased in summer with high temperatures; in second trimester, the risk of GDM increased in winter with low temperatures. In first half of pregnancy, risk of PIH was decreased in winter with low temperatures. These findings can provide the guideline for preventing the GDM and PIH induced by extreme temperature during pregnancy.

Reproductive and Obstetric Outcomes Following a Natural Cycle vs. Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer: A Retrospective Cohort Study.

Background: The proportion of frozen embryo transfer cycles has consistently grown in recent decades. Some adverse obstetric outcomes after frozen embryo transfer could possibly be explained by different approaches in endometrial preparation. The aim of the present study was to investigate reproductive and obstetric outcomes after frozen embryo transfer, comparing different endometrial preparation strategies. Methods: This retrospective study included 317 frozen embryo transfer cycles, of which 239 had a natural or modified natural cycle and 78 underwent artificial endometrial preparation. After excluding late abortion and twin pregnancies, the outcomes of 103 pregnancies were analyzed, 75 of which were achieved after a natural cycle/modified natural cycle, and 28 were achieved after an artificial cycle. Results: The overall clinical pregnancy rate/embryo transfer was 39.7%, the miscarriage rate was 10.1%, and the live birth rate/embryo transfer was 32.8%, without significant differences in reproductive outcomes between natural/modified cycle and artificial cycle groups. The risks of pregnancy-induced hypertension and abnormal placental insertion were significantly increased in pregnancies achieved after the artificial preparation of the endometrium (p = 0.0327 and =0.0191, respectively). Conclusions: Our study encourages the use of a natural cycle or modified natural cycle for endometrial preparation for frozen embryo transfer in order to ensure the presence of a corpus luteum able to orchestrate maternal adaptation to pregnancy.

The Relationship between Serum Calcium Level and Risk Factor of Pregnancy-Induced Hypertension: A Meta-Analysis

Background: The relationship between serum calcium levels and pregnancy-induced hypertension is controversial. This work aimed to evaluate the relationship between serum calcium levels and the risk of pregnancy-induced hypertension. Methods: The following database: Chinese National Knowledge Infrastructure and PubMed, were searched to identify articles on the relationship between serum calcium levels and pregnancy-induced hypertension. The meta-analysis was conducted by using Review Manager (RevMan) [Computer program]. Results: A total of twenty one articles included in the present study. The meta-analysis revealed that patients with pregnancy-induced hypertension (PIH) had lower calcium levels (standardized weighted mean difference (SMD) = –0.68; 95% (–0.79, –0.56); p &lt; 0.05). Conclusions: Our study suggests that serum calcium levels may be associated with the risk of pregnancy-induced hypertension.

Risk of Gestational Diabetes and Pregnancy-Induced Hypertension with a History of Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study

To evaluate the risks of developing gestational diabetes (GDM) and pregnancy-induced hypertension (PIH) in women with polycystic ovary syndrome (PCOS) using data from Korea's National Health Insurance Service. The PCOS group comprised women aged 20 to 49 years diagnosed with PCOS between 1 January 2012, and 31 December 2020. The control group comprised women aged 20 to 49 years who visited medical institutions for health checkups during the same period. Women with any cancer within 180 days of the inclusion day were excluded from both the PCOS and control groups, as were women without a delivery record within 180 days after the inclusion day, as well as women who visited a medical institution more than once before the inclusion day due to hypertension, diabetes mellitus (DM), hyperlipidemia, DM in pregnancy, or PIH. GDM and PIH were defined as cases with at least three visits to a medical institution with a GDM diagnostic code and a PIH diagnostic code, respectively. Overall, 27,687 and 45,594 women with and without a history of PCOS experienced childbirth during the study period. GDM and PIH cases were significantly higher in the PCOS group than in the control group. When adjusted for age, SES, region, CCI, parity, multiple pregnancies, adnexal surgery, uterine leiomyoma, endometriosis, PIH, and GDM, an increased risk of GDM (OR = 1.719, 95% CI = 1.616-1.828) was observed among women with a history of PCOS. There was no increase in the risk of PIH among women with a history of PCOS (OR = 1.243, 95% CI = 0.940-1.644). A history of PCOS itself might increase the risk of GDM, but its relationship with PIH remains unclear. These findings would be helpful in the prenatal counseling and management of patients with PCOS-related pregnancy outcomes.

Association between dietary patterns and pregnancy induced hypertension: a case control study from Sudan.

Dietary patterns and its associated factors and can play an essential role in development of preeclampsia and implication in pregnancy-induced hypertension (PIH). This study was performed to determine nutritional factors associated with PIH among pregnant women in Khartoum, Sudan. This study was a case-control involving 100 women with PIH and 200 normotensive pregnant women. The mean current weight in the control and PIH groups was 70.25 ± 12.35 and 72.42 ± 12.33 kg; whereas the mean energy intake in the control and PIH groups was 1991.58 ±140.72 and 2154.37 ± 130.85 kcal, respectively. The study results indicated a significantly lower risk of PIH among women ingesting fruits and legumes (odds ratio, 8.44 and 4.07, respectively; 95% confidence interval; P < 0.05). PIH was positively associated with higher energy, fat, and protein intake. A lower risk of PIH was calculated for women whose dietary habits included fruits and legumes. Measures with which to ensure proper nutrition education are needed to obtain good health and pregnancy outcomes. PIH is a multifactorial disease with an unclear etiology, and the findings of this study will serve as a baseline for future studies in this field.

The association between maternal tea consumption and the risk of pregnancy induced hypertension: A retrospective cohort study in Lanzhou, China.

Existing evidence on the relationship between maternal tea consumption and pregnancy induced hypertension (PIH) is inconclusive. This study aimed to evaluate the association between maternal tea consumption and the risk of PIH. This study analysed the data of women without chronic hypertension who participated in a retrospective birth cohort study conducted from 2010 to 2012 at the Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China. Multivariable logistic regression models were used to estimate the association between tea consumption and the risk of PIH and its clinical subtypes by different tea exposure time windows. Among the 10,452 women included in this study, tea consumption during pregnancy was significantly associated with an increased risk of PIH (odds ratio [OR]=1.44, 95% confidence interval [CI]: 1.01, 2.05), gestational hypertension (OR=1.86, 95% CI: 1.07, 3.21), and early-onset preeclampsia (OR=2.93, 95% CI: 1.21, 7.09). This was especially the case with black tea (OR=3.57, 95% CI: 1.67, 7.62). Tea consumption during pregnancy might be associated with an increased risk of PIH, gestational hypertension, and early-onset preeclampsia. These findings have important implications for public health in reducing the PIH.

Obstetric complications and outcomes of singleton pregnancy with previous caesarean section according to maternal age

IntroductionTo delineate obstetric complications and neonatal outcomes by maternal age in singleton pregnancies with previous caesarean section (CS). MethodsA retrospective study involved 7715 singleton gestations with previous CS was conducted in a single centre. Statistical methods were used to describe and analyse the incidence of various complications and adverse outcomes classified by maternal ages. After selecting the reference group (30–34 years), multivariate logistic-binomial regression model was used to investigate the outcomes using SPSS. ResultsFrom 2013 to 2017, the proportion of advanced maternal age (AMA, ≥35 years) women with a history of CS increased yearly, especially in the 35–39 years age group. AMA women accounted for 39.4% of all pregnancies and has a high incidence of in vitro fertilization(IVF), progesterone therapy in early pregnancy, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), placenta previa, premature rupture of membranes (PROM) and postpartum haemorrhage (PPH). Compared to the 30–34 years group, the risks of PIH, GDM, placenta previa, PROM and PPH increased in AMA pregnancies. Very advanced age (≥40 years) may be associated with placenta accreta while young mothers (20–24 years) have a higher prevalence of premature birth. Vaginal bleeding during pregnancy is a risk factor for maternal complications, maternal and neonatal morbidity. DiscussionAMA is associated with increased risk of PIH, GDM, placenta previa, PROM and PPH. Vaginal bleeding may be a predictor during pregnancy.

Calcium Supplementation For The Prevention Of Pregnancy Induced Hypertension/Preeclampsia

Background: Pregnancy induced hypertension (PIH) and preeclampsia (PE) contribute significantly to maternal and perinatal morbidity and mortality. The role of calcium supplementation towards preventing PIH/PE however remains unclear.Objective: To assess the efficacy of calcium supplementation in prevention of PIH and PE. Materials and methods: An open label, randomized controlled trial conducted at the antenatal clinic of University of Abuja Teaching Hospital between July 2014 and June 2015. A total of 484 nulliparous women 16 weeks or less gestation and with normal bloodpressures were randomly assigned to either receive 1200mg of calcium tablet daily (N=242) or not to receive calcium tablets (N=242) from 16weeks until delivery. Primary outcome measure was development of PIH or PE and secondary outcome measure was preterm birth.Results: The incidence of PIH was 7.7% among the intervention group compared to 13.7% in the control, p=0.039 and calcium supplementation reduced the risk of PIH (RR=0.56 (95% CI: 0.32-0.98)), but not PE. It also prolonged the duration of pregnancy in women who developed PIH (p=0.02). Incidence of preeclampsia was not significant, RR-0.56 (95% CI: 0.21-1.52) so also was the incidence of preterm delivery between the two groups (RR-0.65 (95% CI: 0.32-1.31)). No serious maternal side effects of treatment were recorded.Conclusion: Calcium supplementation during pregnancy reduced the risk of PIH and thus may have a role in the prevention of PIH amongst nulliparous women. Its role in the absolute prevention of PE was not demonstrated in this study.