Long-Term Prognosis of Hypertension in Pregnancy

Marín, Rafael; Gorostidi, Manuel; Portal, C; Sánchez, Marisa; Sánchez, E. Martínez; Alvarez, Jaime A.

doi:10.1081/prg-100100136

Cited by 114 publications

(46 citation statements)

References 22 publications

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“…Both PC and TGH have been related to a higher risk of hypertension in the later years of life, 5,16 but data regarding which of these groups has a higher risk are debatable and controversial. 6,11,12 Various metabolic changes are normally observed in a routine pregnancy, including hyperlipidemia (for example, increased triglycerides or small-density LDL particles and decreased HDL), or a hypercoagulability and proinflammatory state. Similarly, there is a progressive increase in insulin resistance and hyperinsulinism until the third trimester (to facilitate the transfer of glucose to the fetus), which returns to normal values postpartum.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Thus, different reports have related the preexisting hypertension in pregnancy to a higher risk of hypertension, coronary heart disease and cerebrovascular disease later in life, as well as an earlier onset of these diseases. [5][6][7][8][9][10][11][12][13][14][15] Similarly, a higher prevalence of metabolic syndrome (MS) has been described to occur several years after gestation in women with prior preeclampsia (PC) or gestational hypertension in comparison with those with nonhypertensive pregnancies. 16 This syndrome is considered to be an independent risk factor for future CVD.…”

Section: Introductionmentioning

confidence: 99%

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Differences in the prevalence of metabolic syndrome and levels of C-reactive protein after puerperium in women with hypertensive disorders during pregnancy

et al. 2010

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To measure high-sensitivity C-reactive protein (hsCRP) levels and to assess the presence of metabolic syndrome (MS) after puerperium in women diagnosed with various hypertensive disorders during pregnancy (HDP), a consecutive, cross-sectional case study at the 15th week after gestation. The sample consisted of 264 women who were admitted to a women's hospital. The diagnoses consisted of transient gestational hypertension (TGH¼43.2%), preeclampsia (PC¼29.5%), chronic hypertension (CH¼20.1%) and PC superimposed on CH (7.2%). A diagnosis of previous hypertension was present in 45.8% of the CH group. The prevalence of MS was 16.7% (CH¼42.1%, TGH¼13.9%, PC¼4.1%, Po0.001). The average hsCRP levels for the CH, TGH and PC groups were 3.79±2.76, 3.55±3.15 and 2.89±3.02, respectively (P¼0.040). The levels of hsCRP were higher in women with MS (4.71±3.15 vs. 3.01±2.88 mg l À1 in those without MS, Po0.001), and they increased when a higher number of MS criteria was fulfilled (Po0.001). The results demonstrated a positive correlation between hsCRP levels and body mass index (BMI) (r¼0.46), waist circumference (r¼0.50) or the number of fulfilled MS criteria (r¼0.56). The results suggest differences in vascular risk that depend on the type of HDP and on the prevalence of MS. The prevalence of MS was notably higher in the CH group, intermediate among the TGH group and much lower in the PC group. Differences in hsCRP levels also depended on the type of HDP (higher levels in CH and TGH patients in comparison with PC patients). Women with MS had higher hsCRP levels compared with women without MS, and the levels correlated with the number of MS criteria fulfilled. This result suggests that subclinical inflammatory status is correlated with the number of MS components present. Furthermore, hsCRP levels increased with increasing BMIs and waist circumferences.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Differences in the prevalence of metabolic syndrome and levels of C-reactive protein after puerperium in women with hypertensive disorders during pregnancy

et al. 2010

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“…Placental growth results from the proliferation of stem cell-like villous cytotrophoblasts and their morphological differentiation and recruitment into the syncytiotrophoblast [1]. The syncytiotrophoblast is the epithelial covering of the highly vascular embryonic placental villi, which invades the wall of the uterus to establish nutrient circulation between the embryo and the mother.…”

Section: Introductionmentioning

confidence: 99%

Electron and Scanning Microscopic Observations on the Syncytiotrophoblast Microvillous Membrane Contribution to Preeclampsia in Early Placental Rats

Selim¹,

Elshmry²,

Rashed³

2013

J Blood Disord Transfus

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“…For example, pregnant women with gestational diabetes or high blood pressure are at risk of later developing diabetes mellitus or hypertension. [14][15][16][17][18] A similar phenomenon may happen with gallbladder sludge and stones. With careful interpretation, our results also may help clarify risk factors for development of gallbladder disease in the general population.…”

mentioning

confidence: 99%

Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy

et al. 2005

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Gallstones are strongly associated with higher parity in women. This study prospectively assessed the incidence, natural history, and risk factors for biliary sludge and stones during pregnancy and the postpartum in 3,254 women at an army medical center. Women with a prior cholecystectomy or with stones at their first study ultrasound were excluded. Gallbladder ultrasound and subject questionnaires were obtained in each trimester and at 4 to 6 weeks postpartum. Serum glucose, lipids, insulin, leptin, estradiol, and progesterone were measured at 26 to 28 weeks' gestation. A nested case-control study was done to examine the effects of serum leptin and insulin on incident gallbladder disease. At least two study ultrasounds were available for 3,254 women. Sludge or stones had been found on at least one study ultrasound in 5.1% by the second trimester, 7.9% by the third trimester, and 10.2% by 4 to 6 weeks postpartum. Regression of sludge and stones was common, such that overall 4.2% had new sludge or stones on the postpartum ultrasound. Twenty-eight women (0.8%) underwent cholecystectomy within the first year postpartum. Prepregnancy body mass index was a strong predictor of incident gallbladder disease (P < .001). Serum leptin was independently associated with gallbladder disease (odds ratio per 1 ng/dL increase, 1.05; 95% CI, 1.01, 1.11), even after adjusting for body mass index. In conclusion, incident gallbladder sludge and stones are common in pregnancy and the postpartum, and cholecystectomy is frequently done within the first year postpartum. Prepregnancy obesity and serum leptin are strong risk factors for pregnancy-associated gallbladder disease. (HEPATOLOGY 2005;41: 359-365.) I n the United States, gallstone disease is the most common and costly of all digestive diseases, requiring more than 700,000 cholecystectomies annually. [1][2][3][4] Both the frequency and number of pregnancies are major risk factors for cholesterol gallstones. 2,5-9 European studies have suggested that new biliary sludge (a precursor to gallstones) and gallstones may form in as many as 31% and 2% of pregnant women, respectively. 10-12 Gallbladder disease is the most common non-obstetrical cause of maternal hospitalization in the first year postpartum. 13 This study prospectively evaluated the incidence and natural history of pregnancy-related gallbladder sludge and stones in the United States and closely examined potential demographic, medical, and behavioral risk factors for their development. Pregnancy may constitute a defined period of metabolic stress in which subclinical tendencies are transiently revealed. For example, pregnant women with gestational diabetes or high blood pressure are at risk of later developing diabetes mellitus or hypertension. 14-18 A similar phenomenon may happen with gallbladder sludge and stones. With careful interpretation, our results also may help clarify risk factors for development of gallbladder disease in the general population. Patients and MethodsConsecutive women attending obstetrics orient...

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Long-Term Prognosis of Hypertension in Pregnancy

Cited by 114 publications

References 22 publications

Differences in the prevalence of metabolic syndrome and levels of C-reactive protein after puerperium in women with hypertensive disorders during pregnancy

Differences in the prevalence of metabolic syndrome and levels of C-reactive protein after puerperium in women with hypertensive disorders during pregnancy

Electron and Scanning Microscopic Observations on the Syncytiotrophoblast Microvillous Membrane Contribution to Preeclampsia in Early Placental Rats

Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy

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