Mean arterial blood pressure: potential predictive tool for preeclampsia in a cohort of healthy nulliparous pregnant women

Mayrink, Jussara; Souza, Renato T.; Feitosa, Francisco Edson de Lucena; Filho, Edilberto A. Rocha; Leite, Débora Farias Batista; Vettorazzi, Janete; Calderon, Iracema de Mattos Paranhos; Costa, Maria Laura; Kenny, Louise C.; Baker, Philip N.; Cecatti, José Guilherme

doi:10.1186/s12884-019-2580-4

Cited by 21 publications

(21 citation statements)

References 28 publications

(29 reference statements)

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“…In agreement with our study, study conducted by Al-Amin et al 8 Along Similarity, to our study, in the normal blood pressure group, an increase of 5.2% was observed, compared to 13.3% in the preeclampsia late-onset group. 17 In the present work, there was a statistical significant increase in patient weight, height and BMI in patients who developed PE. Studies conducted in Canada, and China found that high weight gain was more strongly associated with later-onset preeclampsia.…”

Section: Resultssupporting

confidence: 55%

Accuracy of Second Trimester Prediction of Preterm Preeclampsia by Three Different Screening Algorithms

Hegab

Ali

Amin

2021

Al-Azhar International Medical Journal

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Background: Preeclampsia is a condition unique to pregnancy, which can lead to significant maternal and fetal morbidity and death. Early detection of women at greater risk of preeclampsia helps avoid and treat early illness. Aim of the work: current study aimed to compare the performance of the NICE guidelines, the ACOG recommendations and (FMF) algorithm for the early detection of preeclampsia. Patients and Methods: Current study was a cohort prospective study included 400 women who attended for their routine antenatal care during the second trimester. All demographic and clinical data and follow up cases collected. Results: The incidence of preeclampsia was 9.3%. There was a significant older age (28.89±2.74 vs 27.55±2.88) and increase in patient weight, height and BMI among PE cases. Also, there was a statistical significant raising in the cesarean section mode of delivery (45.9% vs 26.4%), ovulation induction (24.3% vs 6.1%) and high mean of arterial pressure (113.46±2.34 vs 92.09±2.98 mmHg), and Doppler ultrasound, the uterine artery pulsatility index (PI) (1.05±0.30 vs 0.55±0.14) among PE cases. On the other hand, there was a statistical significant decrease in fetal GA at delivery (37.0±1.49 vs 38.19±1.10 weeks), decrease of fetal birth weight, Apgar score at first and fifth minutes among females developed PE. Conclusion: Screening for early preeclampsia in second trimester using maternal history, mean arterial pressure and mean uterine artery Doppler pulsatility index (FMF algorithm) was better than screening by maternal characteristics alone (NICE and ACOG guidelines).

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Section: Resultssupporting

confidence: 55%

Accuracy of Second Trimester Prediction of Preterm Preeclampsia by Three Different Screening Algorithms

Hegab

Ali

Amin

2021

Al-Azhar International Medical Journal

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“…Moreover, some studies found that MAP and PP have a better predicting value for hypertensive disorders of pregnancy than SBP and DBP. 29,31 We are the first to examine the association between trajectories of MAP and PP during pregnancy and the risk of ABO. Our study enriches the literature on blood pressure during pregnancy and adverse fetal outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…26,28 However, the associations of trajectories of other blood pressure components such as mean arterial pressure (MAP) and pulse pressure (PP) with ABO have been scarcely studied. Further, MAP 29,30 and PP 31,32 showed a somewhat better prediction of hypertensive disorders of pregnancy than SBP and DBP. Therefore, we aimed to examine the association of trajectories of different blood pressure components (SBP, DBP, MAP, and PP) with ABO in a large cohort including 28,679 Chinese pregnant women with serial blood pressure assessments registered in the perinatal health registration system of Suzhou Industrial Park.…”

Section: Introductionmentioning

confidence: 88%

Associations Between Trajectory of Different Blood Pressure Components in Pregnancy and Risk of Adverse Birth Outcomes – A Real World Study

Ma¹,

Wu²,

Qi³

et al. 2021

RMHP

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Background: High blood pressure during pregnancy has been suggested to be associated with adverse birth outcomes (ABO), but it is unclear how different blood pressure changes and the extent of the effect. Therefore, we aimed to investigate the association between blood pressure trajectories (systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP)) of pregnant women and ABO in a real-world study. Material and Methods: Leveraging 28,679 pregnant women and their fetuses from a register-based cohort from January 1, 2010, to December 31, 2019. Blood pressure trajectories were estimated by package "traj" in R software using real-world blood pressure data of routine antenatal care examinations. Logistic regression models were applied to examine the association between trajectories of different blood pressure components (SBP, DBP, MAP, and PP) during pregnancy and the risk of ABO. Results: Trajectories of all blood pressure components were identically labeled as lowstable, moderate-increasing, moderate-decreasing and high-stable. After adjusting for confounding factors, compared with pregnant women with the low-stable pattern, pregnant women with a high-stable or moderate-increasing pattern had a significantly increased risk of developing adverse birth outcomes. Pregnant women with a moderate-decreasing pattern had no significant increased risk of ABO but had a lower risk of adverse birth outcomes than those with a moderate-increasing pattern. The trajectories crossed at 17-20 weeks of gestation for all blood pressure components. Conclusion:Our study results indicated that reduction and maintenance of blood pressure to a low level of less than 110 mmHg for SBP and 65 mmHg for DBP after 20 weeks of gestation would benefit prevention of adverse birth outcomes, regardless of the level of blood pressure at early pregnancy.

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“…Vascular endotheliosis, an increase in the inflammatory vasoconstrictors, and a decrease in the nitric oxide may have been responsible for an increase in the mean arterial pressure, as observed in the present study. A previous study 19 also revealed an increment of 13.3% in the mean arterial pressure in PE as against 5.2% in the normotensive group. But the decrease in serum NO was not statistically significant.…”

Section: Discussionmentioning

confidence: 66%

Interplay of Oxidative Stress and Nitric Oxide Synthase Gene Expression on Cardiovascular Responses in Preeclampsia

Herur

Aithala

Das

et al. 2022

Rev Bras Ginecol Obstet

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Objective To assess the influence of oxidative stress on the gene expression of nitric oxide synthases (NOS 3 and NOS 2) and, hence, the cardiovascular responses in preeclampsia. Methods This was a case control study in which patients with preeclampsia (PE group) and normal pregnancy controls (NP group) were included according to the guidelines of the American College of Obstetricians and Gynecologists (ACOG). The serum levels of malondialdehyde (MDA), total antioxidant capacity, and nitric oxide (NO) were estimated, and the heart rate and mean arterial pressure were recorded. The gene profiling of NOS3 and NOS2 was performed through real-time polymerase chain reaction (RT-PCR). The statistical analysis was performed using the Student t-test, and values of p < 0.05 were considered statistically significant. Results The serum levels of malondialdehyde were increased (p < 0.0001), and the total antioxidant capacity was reduced in the PE group (p = 0.034), indicating oxidative stress. In the PE group, the mean arterial pressure was significantly higher (p < 0.0001), but the serum levels of NO did not show a statistically significant reduction (p = 0.20). The gene expression profiling of NOS3 and NOS2 revealed a down regulation in the PE group by 8.49 and 51.05 times respectively. Conclusion Oxidative stress may lead to endothelial dysfunction, which could result in increased mean arterial pressure. Nitric oxide may play a role in this mechanism, but interactions with other vasoactive /biological substances cannot be overlooked, as the gene expression of NOS3 and NOS2 has been reduced.

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Mean arterial blood pressure: potential predictive tool for preeclampsia in a cohort of healthy nulliparous pregnant women

Cited by 21 publications

References 28 publications

Accuracy of Second Trimester Prediction of Preterm Preeclampsia by Three Different Screening Algorithms

Accuracy of Second Trimester Prediction of Preterm Preeclampsia by Three Different Screening Algorithms

Associations Between Trajectory of Different Blood Pressure Components in Pregnancy and Risk of Adverse Birth Outcomes – A Real World Study

Interplay of Oxidative Stress and Nitric Oxide Synthase Gene Expression on Cardiovascular Responses in Preeclampsia

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