Differences in epidemiology of patients with preeclampsia between China and the US (Review)

Shi, Ping; Zhao, Lei; Sha, Yu; Zhou, Jun; Li, Jing; Zhang, Ning; Xing, Baoxiang; Cui, Xuena; Yang, Shuai

doi:10.3892/etm.2021.10435

Cited by 10 publications

(10 citation statements)

References 79 publications

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“…Mothers from our socially distanced cohort were noted to be younger than controls with rates of primiparity well above normative rates in the USA. 12 Breastfeeding rates were, as expected, high in both cohorts. However, the rate in our COVID cohort also exceeded national rates for breastfeeding at birth (87.5 vs. 83.9%).…”

Section: Discussionsupporting

confidence: 78%

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Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

Mokha

Heintz

Agrawal

et al. 2022

J Paediatrics Child Health

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Aim Social distancing guidelines implemented with the COVID‐19 pandemic impacted health‐care utilisation and disrupted critical social supports. Resurgence of highly transmissible strains has resulted in revisiting restrictions with potential impacts on newborn health. With concerns for inadequate post‐partum support, we sought to determine if social distancing correlated with increased rates of readmission for hyperbilirubinaemia. Methods Retrospective chart review identified all readmissions for hyperbilirubinaemia between 1/18 and 4/20 in Western New York. Infant/maternal demographics and data on hospital course were collected on control (1/1/18–31/1/20) and social distancing (1/2/20‐30/4/20) cohorts. Nineteen outpatient clinics were surveyed regarding lactation support. Results Monthly readmissions for hyperbilirubinaemia nearly tripled during social distancing (0.90 ± 0.91 vs. 2.63 ± 2.29 per 1000 births during early COVID, P = 0.015). Comparable severity of disease at readmission was observed with no difference in the need for therapies (phototherapy, intravenous immunoglobulin or exchange transfusion) or length of hospital stay. Mothers were younger (25.8 ± 3.3 vs. 31.3 ± 4.7 years; P = 0.005) with higher rates of primiparity and exclusive breastfeeding than national norms, however not significantly higher than controls in our small cohort (62.5 vs. 37.0% for primiparity; 87.5 vs. 81.5% for breastfeeding). Of 19 clinics surveyed, only six confirmed a telemedicine option for lactation support. Conclusions Rates of readmission for hyperbilirubinaemia increased during social distancing. Younger maternal age with high rates of primiparity and exclusive breastfeeding raise concern for inadequate social and/or lactation support. Proactive identification of mothers at risk and expansion of remote lactation services may be indicated with recurrent waves of the pandemic.

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Section: Discussionsupporting

confidence: 78%

“…Mothers from our socially distanced cohort were noted to be younger than controls with rates of primiparity well above normative rates in the USA 12 . Breastfeeding rates were, as expected, high in both cohorts.…”

Section: Discussionsupporting

confidence: 72%

Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

Mokha

Heintz

Agrawal

et al. 2022

J Paediatrics Child Health

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“…First, the causality of the studied association remained uncertain due to the inherent limitation of the retrospective study design of case–control study. Second, according to the rare disease assumption in the case-control study, OR might not well estimate RR (relative ratio) for the low incidence (but not rare) disease of PE in China (about 3%) [ 59 ]. The First Affiliated Hospital of Zhengzhou University is the most authoritative comprehensive hospital in Henan Province and has treated enough PE patients in this area.…”

Section: Discussionmentioning

confidence: 99%

Dietary carotenoid intake and risk of developing preeclampsia: a hospital-based case–control study

Kang

Liu

Chen

et al. 2022

BMC Pregnancy Childbirth

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Background The effect of carotenoids on the risk of preeclampsia (PE) is uncertain. We aimed to examine the associations between the intake of dietary carotenoids and related compounds by pregnant women in China, and the risk of their developing PE. Methods Four hundred and forty PE cases and 440 age- (± 3 years), gestational age- (± 1 weeks) and gestational diabetes mellitus status- (yes/no) matched healthy controls were recruited from March 2016 to June 2019. Dietary intake of carotenoids was assessed using a 79-item validated food-frequency questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression. Results After adjusting for potential confounders, we found that the intake of total carotenoids, β-carotene, β-cryptoxanthin, lycopene, and lutein and zeaxanthin (lut-zea) were negatively associated with the odds of developing PE. Compared with the lowest quartile intake, the multivariate-adjusted OR (95% CI) of the highest quartile intake was 0.29 (0.16–0.54, Ptrend < 0.001) for total carotenoids, 0.31 (0.16–0.58, Ptrend < 0.001) for β-carotene, 0.50 (0.27–0.90, Ptrend = 0.007) for β-cryptoxanthin, 0.55 (0.30–0.99, Ptrend = 0.04) for lycopene and 0.32 (0.17–0.61, Ptrend = 0.001) for lut-zea. However, no significant associations were observed between the risk of developing PE and α-carotene intake (OR = 0.75, 95% CI: 0.41–1.36, Ptrend = 0.28). Moreover, similar negative associations were found for every one-standard-deviation increase in the intake of total carotenoids, β-carotene, β-cryptoxanthin, lycopene and lut-zea. Conclusion These results indicate that a high intake of total carotenoids, β-carotene, β-cryptoxanthin, lycopene and lut-zea may be associated with a low risk of developing PE.

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“…Chinese are reported to have low risk and morbidity due to PE, 56 while the morbidity has been found to be higher in US and majority of other developing countries, specifically Africa and Latin America.…”

Section: Ethnic Disparitymentioning

confidence: 98%

“…Multiple reports show a difference in the prevalence and morbidity of PE across countries and ethnicities. For instance, Asians and Chinese are reported to have low risk and morbidity due to PE, 56 while the morbidity has been found to be higher in US and majority of other developing countries, specifically Africa and Latin America. Besides genetic basis, lifestyles such as diet, body mass index, cultural practices, economic status and access to clinical care may be contributing to these ethnic variations.…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 and preeclampsia: The unique and the mutually nonexclusive clinical manifestations

Shetty

Kshirsagar

Bansal

et al. 2023

American J Rep Immunol

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Preeclampsia (PE) is a serious, unpredictable hypertensive disorder of pregnancy present in around 8–10% of all pregnancies resulting in high rate of maternal and fetal morbidity and mortality. With the pathophysiology partially known, delivery is the only cure for PE. The disease sets due to multiple pathologic processes involving endothelial cell activation, inflammation, multiorgan damage and syncytiotrophoblast stress. Though the primary target organ is lungs in COVID‐19, other systemic manifestations which include endothelial dysfunction, dysregulated angiogenesis, thrombosis, liver injury, thrombocytopenia, hypertension and kidney damage overlap with PE. COVID‐19 patients show a higher incidence of PE as compared to their noninfected counterparts and vice versa. Similar pathophysiology and clinical features make differential diagnosis challenging. For effective and specific management, it is important to differentiate actual PE from COVID‐19 with PE like features. There are contradictory reports about the accuracy of diagnostic tools in distinguishing PE from severe COVID‐19 with PE like features. With the available data, it can only be stated that PE is a common adverse pregnancy event, which may be exacerbated by, or may exacerbate, COVID‐19. Future research should focus on cohesive understanding of the pathophysiology of the clinical manifestations, and preventive strategies during pregnancy.

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Differences in epidemiology of patients with preeclampsia between China and the US (Review)

Cited by 10 publications

References 79 publications

Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

Increased prevalence of severe neonatal hyperbilirubinaemia during social distancing

Dietary carotenoid intake and risk of developing preeclampsia: a hospital-based case–control study

COVID‐19 and preeclampsia: The unique and the mutually nonexclusive clinical manifestations

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