Preeclampsia Prevalence, Risk Factors, and Pregnancy Outcomes in Sweden and China

Yang, Yingying; Ray, Isabelle Le; Zhu, Jing; Zhang, Jun; Hua, Jing; Reilly, Marie

doi:10.1001/jamanetworkopen.2021.8401

Cited by 143 publications

(114 citation statements)

References 51 publications

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“…The proportion of women with recorded gestational hypertension (1.02%) was similar to the results of a Swedish nationwide registry-based study (2007-2012) including 555,446 deliveries (1.1%) [30].…”

Section: Discussionsupporting

confidence: 81%

Recording of Chronic Diseases and Adverse Obstetric Outcomes during Hospitalizations for a Delivery in the National Swiss Hospital Medical Statistics Dataset between 2012 and 2018: An Observational Cross-Sectional Study

Marxer

Rauch

Lang

et al. 2022

IJERPH

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The prevalence of chronic diseases during pregnancy and adverse maternal obstetric outcomes in Switzerland has been insufficiently studied. Data sources, which reliably capture these events, are scarce. We conducted a nationwide observational cross-sectional study (2012–2018) using data from the Swiss Hospital Medical Statistics (MS) dataset. To quantify the recording of chronic diseases and adverse maternal obstetric outcomes during delivery in hospitals or birthing centers (delivery hospitalization), we identified women who delivered a singleton live-born infant. We quantified the prevalence of 23 maternal chronic diseases (ICD-10-GM) and compared results to a nationwide Danish registry study. We further quantified the prevalence of adverse maternal obstetric outcomes (ICD-10-GM/CHOP) during the delivery hospitalization and compared the results to existing literature from Western Europe. We identified 577,220 delivery hospitalizations, of which 4.99% had a record for ≥1 diagnosis of a chronic disease (versus 15.49% in Denmark). Moreover, 13 of 23 chronic diseases seemed to be substantially under-recorded (8 of those were >10-fold more frequent in the Danish study). The prevalence of three of the chronic diseases was similar in the two studies. The prevalence of adverse maternal obstetric outcomes was comparable to other European countries. Our results suggest that chronic diseases are under-recorded during delivery hospitalizations in the MS dataset, which may be due to specific coding guidelines and aspects regarding whether a disease generates billable effort for a hospital. Adverse maternal obstetric outcomes seemed to be more completely captured.

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Section: Discussionsupporting

confidence: 81%

Recording of Chronic Diseases and Adverse Obstetric Outcomes during Hospitalizations for a Delivery in the National Swiss Hospital Medical Statistics Dataset between 2012 and 2018: An Observational Cross-Sectional Study

Marxer

Rauch

Lang

et al. 2022

IJERPH

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“…Based on a retrospective study over 5 years (2011–2016), 57.3% of pregnant women with preeclampsia had severe hypertension called severe preeclampsia [ 19 ]. Risk factors for severe preeclampsia include multiple pregnancies, overweight, obesity, nulliparity, and diabetes [ 20 ]. Multiple pregnancies (pregnant with twins or triplets) and obesity are the strongest risk factors for severe preeclampsia, whereby women with multiple pregnancies or obesity have a fourfold risk of developing severe preeclampsia [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Antihypertensive Medications for Severe Hypertension in Pregnancy: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Hypertension in pregnancy causes significant maternal and fetal mortality and morbidity. A comprehensive assessment of the effectiveness of antihypertensive drugs for severe hypertension during pregnancy is needed to make informed decisions in clinical practice. This systematic review aimed to assess the efficacy and safety of antihypertensive drugs in severe hypertension during pregnancy. Methods: A systematic review using the electronic databases MEDLINE (PubMed) and Cochrane Library was performed until August 2021. The risk-of-bias 2 tool was used to assess the risk-of-bias in each study included. Meta-analysis was conducted to assess heterogeneity and to estimate the pooled effects size. Results: Seventeen studies fulfilled the inclusion criteria and 11 were included in the meta-analysis. Nifedipine was estimated to have a low risk in persistent hypertension compared to hydralazine (RR 0.40, 95% CI 0.23–0.71) and labetalol (RR 0.71, 95% CI 0.52–0.97). Dihydralazine was associated with a lower risk of persistent hypertension than ketanserin (RR 5.26, 95% CI 2.01–13.76). No difference was found in the risk of maternal hypotension, maternal and fetal outcomes, and adverse effects between antihypertensive drugs, except for dihydralazine, which was associated with more adverse effects than ketanserin. Conclusions: Several drugs can be used to treat severe hypertension in pregnancy, including oral/sublingual nifedipine, IV/oral labetalol, oral methyldopa, IV hydralazine, IV dihydralazine, IV ketanserin, IV nicardipine, IV urapidil, and IV diazoxide. In addition, nifedipine may be preferred as the first-line agent. There was no difference in the risk of maternal hypotension, maternal and fetal outcomes, and adverse effects between the drugs, except for adverse effects in IV dihydralazine and IV ketanserin.

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“…Preeclampsia is a multisystemic pregnancy disease seen approximately in 4% of pregnancies and has adverse maternal-fetal and neonatal effects [ 3 ]. Although the definition of preeclampsia differs between countries and textbooks, many of them use the definition provided by the International Society for the Study of Hypertension in Pregnancy (ISSHP), which is used worldwide.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency and Its Clinical Results in Preeclamptic Mothers and Their Babies

Tammo¹,

Yıldız²

2022

Cureus

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Introduction: Vitamin D deficiency during pregnancy may lead to many health problems by negatively affecting the metabolism of the newborn and the mother, such as infantile rickets, poor fetal and neonatal growth and development, gestational diabetes, and preeclampsia. We aimed to investigate the levels and clinical results of vitamin D in preeclamptic mothers and their babies. Methods: The study group consisted of 42 preeclamptic mothers, and their babies diagnosed with preeclampsia according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria, while the control group consisted of 49 healthy mothers and babies with similar gestational age and birth weight. All pregnant women participating in the study were routinely taking 1200 IU of vitamin D3 daily supplements. The cord blood vitamin D level of both groups of newborns was measured and the results were statistically compared. Results: The birth week, weight, and height averages and APGAR score averages measured at the first minutes of the babies in the study group (preeclamptic mother babies) were statistically significantly lower than those of the babies in the control group (babies of healthy mothers) (p=0.001, p=0.001, p<0.001, p=0.004, respectively). Vitamin D and calcium levels of the mothers in the study group were lower than those of the mothers in the control group. When the infants were examined, only the level of vitamin D was statistically significantly lower in infants in the patient group (p<0.001, p<0.001, p=0.001, respectively). Conclusion: There is consistent evidence of an association between low vitamin D concentrations and adverse preeclampsia outcomes. Since vitamin D deficiency is more common in preeclamptic mothers and their infants, higher-dose vitamin D supplementation than routine may be recommended to the patients.

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Preeclampsia Prevalence, Risk Factors, and Pregnancy Outcomes in Sweden and China

Abstract: This cross-sectional study compared preeclampsia prevalence, risk factors, and pregnancy outcomes between the Swedish and Chinese populations.

Cited by 143 publications

References 51 publications

Recording of Chronic Diseases and Adverse Obstetric Outcomes during Hospitalizations for a Delivery in the National Swiss Hospital Medical Statistics Dataset between 2012 and 2018: An Observational Cross-Sectional Study

Recording of Chronic Diseases and Adverse Obstetric Outcomes during Hospitalizations for a Delivery in the National Swiss Hospital Medical Statistics Dataset between 2012 and 2018: An Observational Cross-Sectional Study

Antihypertensive Medications for Severe Hypertension in Pregnancy: A Systematic Review and Meta-Analysis

Vitamin D Deficiency and Its Clinical Results in Preeclamptic Mothers and Their Babies

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