The relationship between circadian blood pressure variability and maternal/perinatal outcomes in women with preeclampsia with severe features

Zhong, Liuying; Deng, Wenfeng; Zheng, Weihan; Yu, Shuting; Huang, Xiaosi; Wen, Yaohong; Chiu, Philip C.N.; Lee, Cheuk‐Lun

doi:10.1080/10641955.2020.1797777

Cited by 7 publications

(7 citation statements)

References 30 publications

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“…As described in the literature, gestational age at delivery was lower in pregnant women with GDM, probably due to the higher frequency of indications for induction in these patients compared to women with obesity without GDM. Most patients who had a preterm delivery showed a non-dipper pattern in ABPM, according to the data published by other authors, in pregnant women who develop gestational hypertension [ 16 ] and preeclampsia [ 38 ]. Furthermore, we observed significantly higher mean and nocturnal BP, both systolic and diastolic, and daytime SBP levels in these women compared to those with delivery at term, similar to that described previously in patients with preterm delivery associated with gestational hypertension [ 17 ].…”

Section: Discussionmentioning

confidence: 91%

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Lara-Barea

Sánchez-Lechuga

Vidal-Suárez

et al. 2022

JCM

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Alterations in ambulatory blood pressure detected by monitoring (ABPM) have been associated with perinatal complications in hypertensive pregnant women. Aim: To establish the relationships between the blood pressure (BP) profiles detected by ABPM and adverse perinatal outcomes in normotensive women with gestational diabetes mellitus (GDM). Methods: A prospective study of normotensive women in whom 24 h ABPM was performed at 28–32 weeks of pregnancy. The obstetric and perinatal outcomes were evaluated. Results: Two hundred patients were included. Thirty-seven women with GDM and obesity had significantly higher mean systolic BP (SBP) and nocturnal SBP and diastolic BP (DBP) compared to women with only GDM (n = 86). Nocturnal SBP (OR = 1.077; p = 0.015) and obesity (OR = 1.131; p = 0.035) were risk factors for the development of hypertensive disorders of pregnancy (HDPs). Mothers of newborns with neonatal complications (n = 27) had higher nocturnal SBP (103.8 vs. 100 mmHg; p = 0.047) and DBP (62.7 vs. 59.4; p = 0.016). Women who delivered preterm (n = 10) had higher BP and a non-dipper pattern (p = 0.005). Conclusions: Nocturnal SBP was a predictor of HDPs in normotensive women with obesity or GDM. Alterations in ABPM in these patients were associated with poor obstetric and perinatal outcomes.

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Section: Discussionmentioning

confidence: 91%

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Lara-Barea

Sánchez-Lechuga

Vidal-Suárez

et al. 2022

JCM

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“…Among the 50 maternities in the observation group, 48 cases of cesarean section, the composition ratio of 96.00%; 2 cases of induced labor, the composition ratio of 4.00%; no natural delivery. Early onset and rapid progression of HELLP syndrome can often lead to preterm delivery, and in more severe cases, it can lead to placental decline, inadequate placental blood and oxygen supply, fetal growth restriction and neonatal asphyxia, which can seriously affect fetal growth and development and increase fetal perinatal mortality ( 19 ). The mode of delivery is related to the severity of the disease and the gestational age of onset.…”

Section: Discussionmentioning

confidence: 99%

Clinical Classification, Pregnancy Outcomes and Risk Factors Analysis of Severe Preeclampsia Complicated With HELLP Syndrome

et al. 2022

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PurposeTo investigate the clinical classification, pregnancy outcomes and risk factors of pregnant women with severe preeclampsia (SPE) complicated with HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.MethodsThe clinical data of 50 pregnant women diagnosed with SPE complicated with HELLP syndrome in our hospital from January 2014 to January 2021 were retrospectively analyzed, and they were selected as the observation group. An additional 50 maternities diagnosed with preeclampsia (PE) during the same period were selected as the control group. The clinical classification and pregnancy outcomes of pregnant women in the observation group were recorded. The age and gestational age of onset of pregnancy were recorded and compared between the two groups. Univariate analysis and multivariate logistic regression model were used to analyze the risk factors for its occurrence.ResultsAmong the 50 maternities in the observation group, there were 10 cases of type I, accounting for 20.00%; 35 cases of type II, accounting for 70.00%; 5 cases of type III, accounting for 10.00%. Partial 33 cases, the composition ratio of 66.00%; complete 17 cases, the composition ratio of 34.00%. Among the fetuses of 50 maternities in the observation group, 35 were premature, accounting for 70.00%; 13 had fetal growth restriction, accounting for 26.00%; and 2 died during perinatal period, accounting for 4.00%. Among the 50 maternities in the observation group, 48 cases were cesarean section, the composition ratio was 96.00%; 2 cases were induced labor, the composition ratio was 4.00%; there was no natural birth, the composition ratio was 0.00%. Univariate analysis showed that age, gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, PT, and FIB were all associated with the occurrence of SPE complicated with HELLP syndrome (P < 0.05). Multivariate logistic analysis showed that gestational age at onset, gestational age at termination of pregnancy, HGB, LDH, ALT, AST, TBIL, PLT, and FIB were independent risk factors for SPE complicated with HELLP syndrome (P < 0.05).ConclusionSPE complicated with HELLP syndrome has significantly increased adverse pregnancy outcomes. Understanding its clinical classification is of great significance for the preventive application of platelet transfusion therapy and the selection of transfusion timing. Gestational age at onset and gestational age at termination of pregnancy are independent risk factors for its occurrence. Fully understanding the high-risk factors of HELLP syndrome, taking preventive measures in time, and carrying out targeted nursing can effectively improve the prognosis of pregnant women and reduce the risk of HELLP syndrome.

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“…In recent years, several studies have reported that higher BPV is associated with more severe maternal hypertension and preeclampsia, regardless of BP level. In addition, studies have shown [10][11][12] that determining the BPV of pregnant women with the ABPM guide can predict the occurrence of pregnancy-induced hypertension or preeclampsia before any symptoms occur. A comprehensive review examining the clinical importance of BPV in pregnancy also reported that BPV is valuable in predicting pregnancy-induced hypertension and preeclampsia in pregnancy and is important in the evaluation of hypertension in pregnancy [13].…”

Section: Discussionmentioning

confidence: 99%

Left atrial structure and function: association with blood pressure variability in pregnant women

Murat

Velipaşaoğlu

Murat

et al. 2022

Blood Pressure Monitoring

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Background The aim of this study was to investigate the relationship between left atrial (LA) abnormalities and ambulatory blood pressure variability (BPV) in pregnant women and their relationship with hypertension-related clinical outcomes in pregnancy. Methods This single-center, prospective study included 119 pregnant women. All participants underwent 24-h ambulatory blood pressure (BP) monitoring and echocardiographic examination before 20 weeks of gestation. BPV was evaluated using 24-h ambulatory BP monitoring. SD of the mean of SBP (SBP-SD) and DBP variability was calculated as 24-h, daytime and nighttime SBP and DBP. The patients were classified into two groups based on median 24-h SBP-SD (11.3 mmHg). LA features of the patients were compared according to the high and low BPV groups. Results One hundred and nineteen pregnant women (mean age, 28.6 ± 5.2 years) were included in the study. The mean office SBP and DBP were 108.7 ± 15.4 mmHg and 68.2 ± 10.2 mmHg, respectively. In pregnant women with high BPV, even though BP is normal, reservoir and conduit LA functions have decreased and LA stiffness has increased. Gestational hypertension and composite outcomes were more common in pregnant women with high BPV. Among the LA parameters, the most associated with composite outcome was conduit LA function. Conclusion In pregnancy, higher BPV is associated with worse LA function. The LA conduit strain offers potential value in predicting hypertension-related clinical outcomes in pregnancy.

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The relationship between circadian blood pressure variability and maternal/perinatal outcomes in women with preeclampsia with severe features

Cited by 7 publications

References 30 publications

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Clinical Classification, Pregnancy Outcomes and Risk Factors Analysis of Severe Preeclampsia Complicated With HELLP Syndrome

Left atrial structure and function: association with blood pressure variability in pregnant women

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