Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Ying, Wendy; Catov, Janet M.; Ouyang, Pamela

doi:10.1161/jaha.118.009382

Cited by 166 publications

(128 citation statements)

References 83 publications

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“…The current data confirm that routinely collected information on maternal, fetal, and delivery characteristics may be associated with postpartum cardiovascular outcomes, but do not appear to be useful in determining a high‐risk sub‐population for targeted follow‐up. As cardiovascular diseases and pre‐eclampsia share common pathophysiologic/risk factors, the role of maternal biomarkers for dyslipidemia, insulin resistance, hypercoagulability, and inflammation may help in the prediction of hypertension 23,24 . Maladaptation to the cardiovascular load and changes in pregnancy as noted in echocardiographic evaluation is observed as one of the pathophysiological processes in pre‐eclampsia 13 .…”

Section: Discussionmentioning

confidence: 99%

Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre‐eclampsia

Keepanasseril

Thilaganathan

Velmurugan

et al. 2020

Intl J Gynecology & Obste

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Objective To assess the prevalence of new‐onset postpartum chronic hypertension (PPCH) after pre‐eclampsia and to determine the factors are associated with it. Methods This study was conducted in a tertiary center in south India, between June 2018 and February 2019, consisting of pre‐eclamptic women who were recruited as part of an ongoing cohort and had completed at least 3 months of postpartum follow‐up. Demographic, medical, and laboratory details were collected. Primary outcome was a diagnosis of new‐onset PPCH at 3 months. Results PPCH at 3 months was noted in 32 (18.1%) women. During postnatal follow‐up, 2 (1.1%) women experienced hemiplegia from stroke and 19 (10.7%) had elevated serum creatinine levels (>1.1 mg/dL). On multivariate analysis, advancing maternal age (adjusted odds ratio [aOR] 1.10, 95% confidence interval [CI] 1.01–1.21), multiparity (aOR 2.79, 95% CI 1.07–7.24), and eclampsia (aOR 3.07, 95% CI 1.03–9.13) increased the risk of PPCH at 3 months postpartum. Conclusion One in five women present with a diagnosis of new‐onset PPCH within 3 months postpartum in a cohort of predominantly preterm and/or severe pre‐eclampsia. A significant but weak association of PPCH with peripartum clinical characteristics was noted. The role of biochemical, hemodynamic, and echocardiographic biomarkers should be evaluated for prediction of PPCH after pre‐eclampsia in future studies.

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Section: Discussionmentioning

confidence: 99%

Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre‐eclampsia

Keepanasseril

Thilaganathan

Velmurugan

et al. 2020

Intl J Gynecology & Obste

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“…[3][4][5][6] The mechanism underlying this association remains unclear. [7] There are two competing hypotheses. Firstly, HDP reflects an underlying genetic/environmental predisposition to hypertension that is uncovered during pregnancy and predicts future risk.…”

Section: Researchmentioning

confidence: 99%

Hypertension in pregnancy: A future risk for chronic kidney disease in South Africa

Jones

Rayner

2019

S Afr Med J

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“…It is said to complicate an estimated 2-10% of all pregnancies resulting in five-fold increase in perinatal morbidity and mortality. [1,2] The pathophysiology of PE/ E entails generalized endothelial dysfunction initiated by abnormal placentation. This endothelial dysfunction is associated with different degrees of fetal injury even though perinatal outcome is also influenced by gestational age and severity of the hypertension.…”

Section: Introductionmentioning

confidence: 99%

Profile of congenital heart disease in infants born following exposure to preeclampsia

et al. 2020

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BackgroundEvents in pregnancy play an important role in predisposing the newborn to the risk of developing CHD. This study evaluated the association between maternal preeclampsia and her offspring risk of CHD. MethodsThis is a cohort study of 90 sex-matched neonates (45 each born to women with preeclampsia and normal pregnancy) in Jos, Nigeria. Anthropometry was taken shortly after delivery using standard protocols. Echocardiography was performed within 24 hours of life and repeated 7 and 28 days later. SPSS version 25 was used in all analyses. Statistical significance was set at p<0.05. ResultsCongenital heart disease (CHD) was observed in 27 (30.0%) of newborns of women with preeclampsia compared with 11 (12.1%) of newborns without preeclampsia (p<0.001) at the end of 7 days and in 19 (21.1%) of newborns of women with preeclampsia and 3 (3.3%) of newborns of women without preeclampsia by the end of the 4 th week of life (p<0.001). Overall, ASD (4 newborns), PDA (21 newborns), patent foramen ovale (14 newborns) and VSD (2 newborns) were the prevalent lesions found among all the newborns studied in the first week of life. Isolated atrial and ventricular septal defects were seen in 4 (4.4%) of the newborns of women with preeclampsia. Being the infant of a woman with preeclampsia was associated with about 8-fold increased risk of having CHD (OR = 7.9, 95% CI = 2.5-24.9, p<0.001).

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Hypertensive Disorders of Pregnancy and Future Maternal Cardiovascular Risk

Cited by 166 publications

References 83 publications

Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre‐eclampsia

Influence of maternal and perinatal characteristics on risk of postpartum chronic hypertension after pre‐eclampsia

Hypertension in pregnancy: A future risk for chronic kidney disease in South Africa

Profile of congenital heart disease in infants born following exposure to preeclampsia

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