Obstetrical Complications and Long-Term Cardiovascular Outcomes

Savage, Megan; Steitieh, Diala; Amin, Nivee; Malha, Line; Chasen, Stephen T.

doi:10.1007/s11906-020-01102-9

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…Since the first (2008) systematic review reporting on the link between HDP and CVD,34 actioning education and awareness among HCP and women about post-HDP health has been suggested by both local22 and international guidelines 13 35–37. Participants in this study suggested increased visibility of existing guidelines, with some not aware they covered post-HDP health risks and screening.…”

Section: Discussionmentioning

confidence: 94%

Preferences of Australian healthcare providers regarding education on long-term health after hypertensive disorders of pregnancy: a qualitative study

et al. 2022

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Objectives)To explore Australian healthcare providers’ (HCPs’) preferred content, format and access to education regarding long-term health after hypertensive disorder of pregnancy (HDP), in order to guide the development of education programmes.Design and settingA qualitative study using a framework analysis was undertaken. Registered HCP who were practising in Australia and previously completed a survey about long-term health after HDP were invited to participate.ParticipantsTwenty HCP were interviewed, including midwives, specialist obstetrician/gynaecologists, general practitioners with a diploma in obstetrics and gynaecology, and cardiologists.Primary and secondary outcome measuresExploration of preferred content, format and distribution of educational material post-HDP.ResultsTwenty HCP were interviewed in April to May 2020. Four main categories were identified. ‘Obtaining evidence-based information for own learning’ addressing own learning with preference for multi-disciplinary education, preferably endorsed or facilitated by professional organisations. ‘Optimising the referral process from hospital to community health services’ was about the need for structured long-term follow-up to transition from hospital to community health and align with HDP guidelines. ‘Facilitating women’s health literacy’ addressed the need for evidence-based, print or web-based material to assist risk discussions with women. ‘Seizing educational opportunities’ addressed the responsibility of all HCP to identify education opportunities to initiate key health discussions with women.Conclusion(sHCP provided ideas on content, format and access of education regarding long-term health post-HDP within the parameters of the Australian healthcare context. This evidence will guide educational developments for HCP on post-HDP health to ensure they can better care for women and families.

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Section: Discussionmentioning

confidence: 94%

Preferences of Australian healthcare providers regarding education on long-term health after hypertensive disorders of pregnancy: a qualitative study

et al. 2022

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“…GDM results in pregnancy complications and is known to adversely affect maternal and neonatal outcomes. While the females with GDM are at an increased risk of developing pre‐eclampsia, labor abnormalities, cardiovascular, and other metabolic disorders, the neonates may suffer from macrosomia, hyperbilirubinemia, low birth weight, and hypoglycemia (Koivunen et al., 2020; Murray & Reynolds, 2020; Savage et al., 2020; Wendland et al., 2012). The massive impact of both short‐term and long‐term effects of GDM on maternal and neonatal health necessitates the proper management of the disease during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Effect of magnesium supplementation on pregnancy outcome in gestational diabetes mellitus patients: A meta‐analysis of randomized controlled trials

Rong

2022

Food Science & Nutrition

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Conflicting evidence exists regarding the effectiveness of magnesium supplementation during pregnancy in gestational diabetes mellitus (GDM) patients. This meta‐analysis examines the effect of magnesium on glycemic indices and metabolic status in GDM. We searched databases for randomized controlled trials (RCTs) conducted, and after applying inclusion and exclusion criteria, a total of four RCTs were considered eligible for the analysis. Outcome parameters included markers for glycemic control and metabolic status. A total of four RCTs with 198 participants (control = 99; magnesium supplemented = 99) were selected for the analysis. Magnesium supplementation resulted in a significant reduction in markers of glycemic control—fasting plasma glucose (standard mean difference (trueμ^) = −0.83; 95% CI: [−1.13, –0.54]; p‐value <.0001), and insulin levels (trueμ^ = −0.95; 95% CI: [−1.38, −0.52]; p‐value <.0001). Also, Mg intake resulted in altered oxidative stress markers TAC (trueμ^ = 1.09; 95% CI: [0.10, 2.07]; p‐value = .03) of the pregnant women. No significant effect on GSH and CRP levels was observed. This study provides evidence of the positive effects of magnesium intervention on insulin sensitivity and oxidative stress in GDM patients.

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“…PE induces 70,000 maternal deaths and ~ 1,000,000 fetal deaths worldwide (1.5-10% of pregnancies according to the country, with a high prevalence in sub-Saharan Africa). IUGR, a failure of the fetus to reach its normal growth potential, affects up to 10% of the fetuses, and is a major cause of the birth of small babies, that are at risk for acute diseases of the retina (Gupta et al 2008), the lung (Arroyas et al 2020;Fandino et al 2019;Zana-Taieb et al 2015), the heart (Crispi et al 2008) (in the most severe cases) and long term increased risk of cardiovascular diseases (less severe cases) (Jansson and Powell 2007;Savage et al 2020). These two gestational pathologies are strongly connected since one third of the preeclampsia cases results in IUGR.…”

Section: Introductionmentioning

confidence: 99%

Alternative splicing in normal and pathological human placentas is correlated to genetic variants

et al. 2021

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Two major obstetric diseases, preeclampsia (PE), a pregnancy-induced endothelial dysfunction leading to hypertension and proteinuria, and intra-uterine growth-restriction (IUGR), a failure of the fetus to acquire its normal growth, are generally triggered by placental dysfunction. Many studies have evaluated gene expression deregulations in these diseases, but none has tackled systematically the role of alternative splicing. In the present study, we show that alternative splicing is an essential feature of placental diseases, affecting 1060 and 1409 genes in PE vs controls and IUGR vs controls, respectively, many of those involved in placental function. While in IUGR placentas, alternative splicing affects genes specifically related to pregnancy, in preeclamptic placentas, it impacts a mix of genes related to pregnancy and brain diseases. Also, alternative splicing variations can be detected at the individual level as sharp splicing differences between different placentas. We correlate these variations with genetic variants to define splicing Quantitative Trait Loci (sQTL) in the subset of the 48 genes the most strongly alternatively spliced in placental diseases. We show that alternative splicing is at least partly piloted by genetic variants located either in cis (52 QTL identified) or in trans (52 QTL identified). In particular, we found four chromosomal regions that impact the splicing of genes in the placenta. The present work provides a new vision of placental gene expression regulation that warrants further studies.

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Obstetrical Complications and Long-Term Cardiovascular Outcomes

Cited by 5 publications

References 11 publications

Preferences of Australian healthcare providers regarding education on long-term health after hypertensive disorders of pregnancy: a qualitative study

Preferences of Australian healthcare providers regarding education on long-term health after hypertensive disorders of pregnancy: a qualitative study

Effect of magnesium supplementation on pregnancy outcome in gestational diabetes mellitus patients: A meta‐analysis of randomized controlled trials

Alternative splicing in normal and pathological human placentas is correlated to genetic variants

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