Association between Parity and Blood Pressure in Korean Women: Korean National Health and Nutrition Examination Survey, 2010-2012

Jang, Mi-Ae; Lee, Yeonji; Choi, Jiho; Kim, Beomseok; Kang, Ja-Yeon; Kim, Yongchae; Cho, Se-Wook

doi:10.4082/kjfm.2015.36.6.341

Cited by 19 publications

(18 citation statements)

References 26 publications

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“…A general assumption for the generated trajectories of physiological changes was that the prepregnant levels are eventually attained which might not always be the case. For example, pregnancy is known to result in long-term vascular remodeling; specifically, in non-pregnant women without cardiovascular disease, parity has been found to be significantly associated with blood pressure [50,51], aortic root size [52] and carotid distensibility [53]. Yet, it is unknown whether this vascular remodeling affects relevant model parameters, such as organ blood flows.…”

Section: Discussionmentioning

confidence: 99%

Integration of physiological changes during the postpartum period into a PBPK framework and prediction of amoxicillin disposition before and shortly after delivery

Dallmann

Himstedt

Solodenko

et al. 2020

J Pharmacokinet Pharmacodyn

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The objective of this study was to develop a physiologically based pharmacokinetic (PBPK) model for amoxicillin for nonpregnant, pregnant and postpartum populations by compiling a database incorporating reported changes in the anatomy and physiology throughout the postpartum period. A systematic literature search was conducted to collect data on anatomical and physiological changes in postpartum women. Empirical functions were generated describing the observed changes providing the basis for a generic PBPK framework. The fraction unbound (f u) of predominantly albumin-bound drugs was predicted in postpartum women and compared with experimentally observed values. Finally, a specific amoxicillin PBPK model was newly developed, verified for non-pregnant populations and translated into the third trimester of pregnancy (29.4-36.9 gestational weeks) and early postpartum period (drug administration 1.5-3.8 h after delivery). Pharmacokinetic predictions were evaluated using published clinical data. The literature search yielded 105 studies with 1092 anatomical and physiological data values on 3742 postpartum women which were used to generate various functions describing the observed trends. The f u could be adequately scaled to postpartum women. The pregnancy PBPK model predicted amoxicillin disposition adequately as did the postpartum PBPK model, although clearance was somewhat underestimated. While more research is needed to establish fully verified postpartum PBPK models, this study provides a repository of anatomical and physiological changes in postpartum women that can be applied to future modeling efforts. Ultimately, structural refinement of the developed postpartum PBPK model could be used to investigate drug transfer to the neonate via breast-feeding in silico.

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Section: Discussionmentioning

confidence: 99%

Integration of physiological changes during the postpartum period into a PBPK framework and prediction of amoxicillin disposition before and shortly after delivery

Dallmann

Himstedt

Solodenko

et al. 2020

J Pharmacokinet Pharmacodyn

View full text Add to dashboard Cite

show abstract

“…Most researchers have studied postmenopausal women and reported an increased risk of CVD with parity or a J-shaped association with two births as the nadir of risk 5–11. Premenopausal risk of CVD and hypertension has only been examined in few studies that show inconclusive findings 12 13. None of these studies followed women through their reproductive period, considered the potential different risks during and between pregnancies or accounted for the mother’s history of pregnancy loss, even though the metabolic changes that resemble a cardiovascular risk profile occur in all pregnancies, also when the pregnancy does not result in a live birth.…”

Section: Introductionmentioning

confidence: 99%

Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease: a Danish cohort study

et al. 2019

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ObjectivesThe metabolic changes of pregnancy resemble a cardiovascular risk profile and may persist postpartum, with body mass index (BMI) as a potential modifier. We examined the association between the number of live-birth pregnancies and maternal premenopausal risks of hypertension and cardiovascular disease (CVD), accounting for pre-pregnancy BMI as well as abortions and stillbirths.DesignA prospective cohort study.SettingMothers from the Danish National Birth Cohort (1996 to 2002). For each of these women, registry data on all pregnancies from 1973 to 2011 were obtained, as were self-reported pre-pregnancy weight and height.ParticipantsA total of 44 552 first-time mothers in the Danish National Birth Cohort.Outcome measuresRisks of hypertension and CVD during and between live-birth pregnancies separately and combined as live-birth cycles.ResultsAfter adjustment for abortions, stillbirths, pre-pregnancy BMI and other covariates, a higher risk of hypertension was observed in the first (HR 1.53, 95% CI: 1.37 to 1.72) and fourth and subsequent live-birth cycles (HR 1.72, 95% CI: 1.15 to 2.58), compared with the second. However, as number of live-birth pregnancies increased, risk of hypertension decreased during live-birth pregnancies and increased between live-birth pregnancies (tests for trend, p<0.01). For CVD, we found an overall J-shaped but non-significant association with number of live-birth pregnancies. No interaction with pre-pregnancy BMI (<25 versus ≥25 kg/m2) was observed.ConclusionsPremenopausal women had the highest risk of hypertension and CVD during their first live-birth pregnancy and after their fourth live-birth pregnancy. All risks were independent of BMI before the first live-birth pregnancy and of number of abortions and stillbirths.

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“…In a Swiss cohort study [ 9 ], parity was associated with lower blood pressure before 60 years, but with a higher blood pressure after 60 years of age. Other cross-sectional studies examining blood pressure or risk of hypertension by parity status have reported either no significant association [ 13 – 15 ] or lower blood pressure among parous women [ 10 , 11 ], with stronger association seen in premenopausal women [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of parity on life course blood pressure trajectories: the HUNT study in Norway

et al. 2018

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The drop in blood pressure during pregnancy may persist postpartum, but the impact of pregnancy on blood pressure across the life course is not known. In this study we examined blood pressure trajectories for women in the years preceding and following pregnancy and compared life course trajectories of blood pressure for parous and nulliparous women. We linked information on all women who participated in the population-based, longitudinal HUNT Study, Norway with pregnancy information from the Medical Birth Registry of Norway. A total of 23,438 women were included with up to 3 blood pressure measurements per woman. Blood pressure trajectories were compared using a mixed effects linear spline model. Before first pregnancy, women who later gave birth had similar mean blood pressure to women who never gave birth. Women who delivered experienced a drop after their first birth of − 3.32 mmHg (95% CI, − 3.93, − 2.71) and − 1.98 mmHg (95% CI, − 2.43, − 1.53) in systolic and diastolic blood pressure, respectively. Subsequent pregnancies were associated with smaller reductions. These pregnancy-related reductions in blood pressure led to persistent differences in mean blood pressure, and at age 50, parous women still had lower systolic (− 1.93 mmHg; 95% CI, − 3.33, − 0.53) and diastolic (− 1.36 mmHg; 95% CI, − 2.26, − 0.46) blood pressure compared to nulliparous women. The findings suggest that the first pregnancy and, to a lesser extent, successive pregnancies are associated with lasting and clinically relevant reductions in systolic and diastolic blood pressure.Electronic supplementary materialThe online version of this article (10.1007/s10654-018-0358-z) contains supplementary material, which is available to authorized users.

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Association between Parity and Blood Pressure in Korean Women: Korean National Health and Nutrition Examination Survey, 2010-2012

Cited by 19 publications

References 26 publications

Integration of physiological changes during the postpartum period into a PBPK framework and prediction of amoxicillin disposition before and shortly after delivery

Integration of physiological changes during the postpartum period into a PBPK framework and prediction of amoxicillin disposition before and shortly after delivery

Maternal reproductive history and premenopausal risk of hypertension and cardiovascular disease: a Danish cohort study

The impact of parity on life course blood pressure trajectories: the HUNT study in Norway

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