An analysis of the differences between early and late preeclampsia with severe hypertension

Li, X.L.; Guo, Pengge; Xue, Yan; Gou, Wei; Tong, Mancy; Chen, Q.

doi:10.1016/j.preghy.2015.12.003

Cited by 40 publications

(37 citation statements)

References 34 publications

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“…Therefore, the relationships between thyroid dysfunction and pregnancy outcomes in preeclampsia still needs to be clarified. It is known that the placental dysfunction is more likely to occur in the early onset preeclampsia at < 34 weeks of gestation [26,27] and early onset preeclampsia conferred a substantially higher risk of cardiovascular [28], respiratory, central nervous system, renal, hepatic, and other morbidity [29]. However, in most previous studies, thyroid hormones were measured before 20 weeks of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Association between thyroid dysfunction and perinatal outcomes in women with gestational hypertension: a retrospective study

Gui

Zhang

2020

BMC Pregnancy Childbirth

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Background: Previous studies showed that thyroid dysfunction in women with gestational hypertension could negatively affect maternal and fetal outcomes. In this study, we aimed to investigate whether thyroid dysfunction assessed in the second half trimester contributed to neonatal outcomes of pregnancy in different subtypes of gestational hypertension disease. Methods: We performed a retrospective case-control study and collected data from 135 singleton pregnant women with gestational hypertension disease and their offspring who delivered in Renmin Hospital of Wuhan University from January 2015 to June 2017. We classified the patients based on the severity of the preeclampsia into three groups: pregnant induced hypertension (PIH), mild preeclampsia (MPE) and severe preeclampsia (SPE). Based on the onset time of preeclampsia, we classified the patients into PIH, early onset preeclampsia (EPE) and late onset preeclampsia. Demographic data and levels of thyroid hormones, as well as the adverse maternal and neonatal outcomes were collected from Electronic Medical Records. Logistic regression was used to estimate the associations between thyroid dysfunction and neonatal outcomes in these patients. Results: Gestational weeks and neonatal birthweight were significantly lower, while incidence of preterm birth was significantly higher in the SPE and EPE groups than those in the PIH group (P < 0.001). Thyroid dysfunction was more frequent in the SPE group than in the MPE group (P = 0.01). Incidences of both preterm birth and low birth weight were significantly higher in patients with thyroid dysfunction (P = 0.008, P = 0.047 respectively). After adjustment, both severity of gestational hypertension (OR = 4.360, 95%CI [2.050, 9.271], P < 0.001; OR = 4.023, 95%CI [1.933, 8.372], P < 0.001) and thyroid dysfunction (OR = 3.011, 95%CI [1.248, 7.262], P = 0.014; OR = 11.306, 95%CI [1.040, 122.889], P = 0.046) were associated with higher risk of preterm birth and low birth weight, while the onset time of preeclampsia (OR = 0.031, 95%CI [0.009, 0.110], P < 0.001; OR = 0.097, 95%CI [0.033, 0.282], P < 0.001) was negatively associated with the risk of preterm birth and low birth weight. Conclusion: Severe and early onset preeclampsia, as well as thyroid dysfunction are associated with higher risk of preterm birth and low neonatal birth weight. Therefore, our data suggest that monitoring thyroid hormones in women with preeclampsia might help to predict adverse neonatal outcomes.

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Section: Introductionmentioning

confidence: 99%

Association between thyroid dysfunction and perinatal outcomes in women with gestational hypertension: a retrospective study

Gui

Zhang

2020

BMC Pregnancy Childbirth

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“…11] and, at that gestational age, treatment of at-risk women is instituted late, after irreversible lesions have already occurred [12][13][14].…”

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confidence: 99%

First-Trimester Combined Multimarker Prospective Study for the Detection of Pregnancies at a High Risk of Developing Preeclampsia Using the Fetal Medicine Foundation-Algorithm

Guizani¹,

Valsamis

Dütemeyer³

et al. 2017

Fetal Diagn Ther

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Objective: To evaluate the Fetal Medicine Foundation (FMF) algorithm prospectively at 11-13 weeks' gestation in the prediction of preeclampsia (PE). Methods: Single-center prospective screening study for PE of singleton pregnancies at 11-13 weeks. The FMF algorithm takes into account maternal characteristics and biomarkers. Detection rate (DR) for a 10% false-positive rate (FPR) for delivery with preterm and term PE was estimated. Results: Between January 2011 and December 2013, of 3,239 patients available for final analysis, 36 (1.1%) subsequently developed preterm and 44 (1.4%) term PE. In combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, the DR was 80.6% (95% CI 64.0-91.8) for PE at <37 weeks and 31.8% (95% CI 18.6-47.6) for PE at ≥37 weeks, at a 10% FPR. Conclusion: Our data suggest that the FMF algorithm provides effective first-trimester screening for preterm PE.

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“…Instead, the term “preeclampsia without severe features” should be used to distinguish from more severe forms of “preeclampsia with severe features.” Based on the gestational age at delivery, PE has been broadly classified into early-onset, with signs and symptoms developing at <34 weeks of gestation, and late-onset in patient new-onset hypertension and proteinuria at ≥34 weeks of gestation, and sometimes during labor ( Table 1 ). Although data is limited, it has been suggested that the maternal and perinatal mortalities varies in the subgroups of preeclampsia ( 3, 4 ). The early-onset PE consist of about 10% of total cases of PE and placental dysfunction is more likely to occur in this subgroup than in the more prevalent late-onset PE.…”

Section: Introductionmentioning

confidence: 99%

Use of Antihypertensive Drugs During Preeclampsia

Odigboegwu

Pan

Chatterjee

2018

Front. Cardiovasc. Med.

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Treatment of pregnancy-related hypertensive disorders, such as preeclampsia (PE), remain a challenging problem in obstetrics. Typically, aggressive antihypertensive drug treatment options are avoided to prevent pharmacological-induced hypotension. Another major concern of administering antihypertensive drugs during pregnancy is possible adverse fetal outcome. In addition, management of hypertension during pregnancy in chronic hypertensive patients or in patients with prior kidney problems are carefully considered. Recent studies suggest that PE patients are at increased cardiovascular risk postpartum. Therefore, these patients need to be monitored postpartum for the subsequent development of other cardiovascular diseases. In this review article, we review the antihypertensive drugs currently being used to treat patients with PE and the advantages or disadvantages of using these drugs during pregnancy.

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An analysis of the differences between early and late preeclampsia with severe hypertension

Cited by 40 publications

References 34 publications

Association between thyroid dysfunction and perinatal outcomes in women with gestational hypertension: a retrospective study

Association between thyroid dysfunction and perinatal outcomes in women with gestational hypertension: a retrospective study

First-Trimester Combined Multimarker Prospective Study for the Detection of Pregnancies at a High Risk of Developing Preeclampsia Using the Fetal Medicine Foundation-Algorithm

Use of Antihypertensive Drugs During Preeclampsia

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