Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health最新文献

{"title":"Hypertensive disorders of pregnancy trends in the United States post aspirin recommendation guidelines","authors":"Mariam K. Ayyash ,&nbsp;Rodney A. Mclaren Jr. ,&nbsp;Huda B. Al-Kouatly ,&nbsp;Majid Shaman","doi":"10.1016/j.preghy.2025.101210","DOIUrl":"10.1016/j.preghy.2025.101210","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate changes in the rates of hypertensive disorders of pregnancy (HDP) in the US after the publication of aspirin (ASA) recommendation guidelines by the USPSTF and ACOG.</div></div><div><h3>Methods</h3><div>A population-based retrospective cohort study was performed using the US Natality database. The pre-ASA group included births between 2010–2014. The post-ASA group were births between 2016–2021. Births in 2015 were excluded. Outcomes were rates of HDP. Univariate and multivariate analyses were performed. Using the 2010–2014 HDP trend, a projected trend was calculated and compared to the actual trend across the entire cohort.</div></div><div><h3>Results</h3><div>There were 12,127,659 births in the pre-ASA group and 17,665,217 births in the post-ASA group. The post-ASA group had a significantly higher rate of overall HDP than the pre-ASA group (7.7 % vs 4.9 %; aOR 1.58, 95 % CI [1.57–1.59]). When stratified by gestational age at delivery, the post-ASA group had a significantly lower rate of preterm HDP prior to 37 weeks (21.6 % vs 23.7 %; aOR 0.90, 95 % CI [0.89–0.91]) and preterm HDP prior to 34 weeks (6.0 % vs 7.5 %; aOR 0.79, 95 % CI [0.78–0.81]). The actual HDP trend post-ASA recommendation was higher than projected for overall HDP and preterm HDP &lt; 37 weeks but was not different for preterm HPD &lt; 34 weeks.</div></div><div><h3>Conclusion</h3><div>While overall HDP is increasing, the rate of preterm births complicated by HDP has been decreasing. The actual trend for the overall HDP category and the two preterm HDP categories, however, remains either higher or no different compared to the projected trend post aspirin recommendation guidelines.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"40 ","pages":"Article 101210"},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating follistatin-like 3 and its association with postpartum cardiovascular dysfunction and severe maternal morbidity","authors":"Junaid Nizamuddin ,&nbsp;Elizabeth Hall ,&nbsp;John Dreixler ,&nbsp;Ana Palei ,&nbsp;Joey Granger ,&nbsp;Avery Tung ,&nbsp;Ariel Mueller ,&nbsp;Sarosh Rana ,&nbsp;Sajid Shahul","doi":"10.1016/j.preghy.2025.101206","DOIUrl":"10.1016/j.preghy.2025.101206","url":null,"abstract":"<div><h3>Objectives</h3><div>Despite postpartum cardiovascular dysfunction being the leading cause of pregnancy-related mortality in the United States, it is difficult to identify at-risk patients. The objective of this study was to determine if antepartum follistatin-like 3 levels correlate with postpartum cardiovascular dysfunction and maternal morbidity.</div></div><div><h3>Study Design</h3><div>This observational cohort study included pregnant patients ≥ 18 years old and singleton gestation &lt; 41 weeks who delivered at the University of Chicago between May 2017 and November 2020.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was postpartum cardiovascular dysfunction, defined as postpartum hypertension, cardiomyopathy, and pulmonary edema. The secondary outcome was severe maternal morbidity.</div></div><div><h3>Results</h3><div>The final cohort included 408 women. Elevated FSTL3 levels were associated with postpartum cardiovascular dysfunction (OR per unit increase in FSTL3, 1.02 [95 % CI: 1.01, 1.04]; p &lt; 0.001). After adjustment for gestational age at delivery, maternal age, BMI, nulliparous status, hypertensive disorders of pregnancy, smoking, and diabetes, the association between FSTL3 levels and cardiovascular dysfunction persisted (p = 0.03), with good model discrimination between events (c-statistic 0.88). FSTL3 levels were also associated with severe maternal morbidity (OR per unit increase 1.02 [95 % CI: 1.01, 1.03]; p &lt; 0.0001). Additionally, Activin A levels were associated with cardiovascular dysfunction and severe maternal morbidity (c = 0.84, p = 0.01; c = 0.87, p = 0.02 respectively).</div></div><div><h3>Conclusions</h3><div>Higher follistatin-like 3 levels were associated with postpartum cardiovascular dysfunction and severe maternal morbidity. Follistatin-like 3 may be causal in cardiovascular dysfunction, and further work should define its potential as a biomarker.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"40 ","pages":"Article 101206"},"PeriodicalIF":2.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title Page","authors":"","doi":"10.1016/S2210-7789(25)00024-8","DOIUrl":"10.1016/S2210-7789(25)00024-8","url":null,"abstract":"","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101208"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143561804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure patterns of gestational hypertension or non-severe pre-eclampsia beyond 36 weeks’ gestation and the adverse maternal outcomes: Secondary analysis of the HYPITAT study","authors":"Guiyou Yang ,&nbsp;Wessel Ganzevoort ,&nbsp;Sanne J. Gordijn ,&nbsp;Ben Mol ,&nbsp;Gerton Lunter ,&nbsp;Henk Groen","doi":"10.1016/j.preghy.2025.101207","DOIUrl":"10.1016/j.preghy.2025.101207","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify patterns in changes of blood pressure for women with gestational hypertension (GH) or non-severe pre-eclampsia (PE) beyond 36 gestational weeks, and assess their association with a composite adverse maternal outcome.</div></div><div><h3>Study design</h3><div>Secondary analysis of a randomized controlled trial (HYPITAT).</div></div><div><h3>Main outcome measures</h3><div>We investigated patterns of one-week blood pressure changes post-admission, explored factors contributing to diverse patterns using ANOVA and Chi-square tests, and assessed the correlation between these patterns and a composite adverse maternal outcome defined as severe maternal morbidity, mortality, post-partum hemorrhage and cesarean section. Among 384 women, 187 developed the composite outcome.</div></div><div><h3>Results</h3><div>We identified three and four typical patterns in systolic and diastolic blood pressure changes, respectively. Diastolic blood pressure patterns statistically significantly varied across maternal ethnicity and diagnosis at admission. Compared to a pattern of steady diastolic blood pressure, the odds ratio (95 % confidence interval) for the composite adverse maternal outcome was 2.59 (1.31, 5.13) or 2.09 (1.02, 4.26), contingent on covariates, when a pattern of increasing diastolic blood pressure was present. The results of sensitivity analysis excluding severe hypertension from the composite outcome indicated that the main findings are robust.</div></div><div><h3>Conclusions</h3><div>Maternal ethnicity and diagnosis may affect diastolic blood pressure patterns, and a pattern of increasing diastolic blood pressure was likely associated with elevated risk of the composite adverse maternal outcome. This underscores the potential significance of recognizing these patterns for sequential risk assessment and individualized management in late GH and non-severe PE.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"40 ","pages":"Article 101207"},"PeriodicalIF":2.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143512497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unintended consequences of modernity: Pollution and its effect on reproductive, maternal and fetal health","authors":"Gregory Ward ,&nbsp;Maria Pinto Correia Watts ,&nbsp;Stefan R. Hansson","doi":"10.1016/j.preghy.2025.101204","DOIUrl":"10.1016/j.preghy.2025.101204","url":null,"abstract":"<div><div>Over the past 50 years there has been an unprecedented increase in pollution globally.</div><div>Population growth and higher standards of living have resulted in increases in global consumption facilitated by industrialisation and globalisation of goods and services thus resulting in the release of environmental pollutants on a mass scale.</div><div>This article analyses the effects and consequences of pollution on important aspects of reproductive health including fertility, pregnancy and infant health. It is a narrative review based on a search of PubMed using the terms ‘pollution and fertility,’ ‘pollution and pregnancy,’ ‘pollution and infant health,’ and ‘history of pollution.’ Additional references were identified through articles provided by the authors of related studies. Studies were included based on their relevance to the topic and were prioritized for their methodological rigour and recency. While no formal quality assessment tools were employed, the potential limitations of individual studies are discussed where applicable.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"40 ","pages":"Article 101204"},"PeriodicalIF":2.5,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of antenatal SARS-CoV-2 infection on development of hypertensive disorders of pregnancy in a large, diverse, cohort","authors":"Alexandra N. Mills ,&nbsp;Bethany Dubois ,&nbsp;Corina Lesseur ,&nbsp;Anna-Sophie Rommel ,&nbsp;Rushna Tubassum ,&nbsp;Elianna Kaplowitz ,&nbsp;Natalie Boychuk ,&nbsp;Toni Stern ,&nbsp;Jia Chen ,&nbsp;Whitney Lieb ,&nbsp;Teresa Janevic ,&nbsp;Rebecca H. Jessel","doi":"10.1016/j.preghy.2025.101205","DOIUrl":"10.1016/j.preghy.2025.101205","url":null,"abstract":"<div><h3>Objectives</h3><div>Various studies have noted an association between antenatal SARS-CoV-2 infection and increased risk for development of hypertensive disorders of pregnancy (HDP). Both disease processes have been shown to involve endothelial dysfunction systemically and in the placenta, suggesting common pathogenesis. We aim to further investigate this association in a diverse urban population.</div></div><div><h3>Study Design</h3><div>Generation C is a prospective pregnancy cohort study at a large academic institution in NYC established between April 2020 and February 2022. SARS-CoV-2 infection during pregnancy was ascertained using a combination of spike and nucleocapsid IgG antibodies, RT-PCR testing, and electronic medical record (EMR) diagnoses. Maternal demographic and medical data were ascertained from the EMR and/or self-report survey.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was HDP defined using the American College of Obstetrics and Gynecology diagnostic criteria. Covariates included maternal age ≥ 35 years, BMI ≥ 30, high social vulnerability index based on patient zip code, maternal chronic hypertension, pregestational diabetes, and nulliparity. Univariable and multivariable logistic regression was used to examine the association between antenatal SARS-CoV-2 infection and HDP.</div></div><div><h3>Results</h3><div>Among the 2402 participants, 15.4 % (369) were infected with SARS-CoV-2 during pregnancy and 18.2 % (67/369) of those exposed developed an HDP. In participants without evidence of antenatal SARS-COV-2 infection, 18.0 % (365/2033) developed an HDP. In an adjusted multivariable model, antenatal SARS-CoV-2 infection was not associated with HDP (aOR 0.89; 95 % CI, 0.65–1.22).</div></div><div><h3>Conclusions</h3><div>This study did not find an increased risk of HDP associated with antenatal SARS-CoV-2 infection in a diverse prospective cohort.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101205"},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk management after hypertensive disorders and diabetes during pregnancy, in a multi-ethnic population: A qualitative study among women and healthcare providers","authors":"Annemarie Y.A.M. Reilingh ,&nbsp;Renée J. Burger ,&nbsp;Souraya el Bachiri ,&nbsp;Stephen McCarthy ,&nbsp;Sanne J. Gordijn ,&nbsp;Wessel Ganzevoort ,&nbsp;Irene G.M. Valkengoed van ,&nbsp;on behalf of the project group: ’Obstetric history and cardiovascular health across ethnicity, in The Netherlands’","doi":"10.1016/j.preghy.2025.101203","DOIUrl":"10.1016/j.preghy.2025.101203","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy complications like gestational diabetes and hypertensive disorders increase maternal cardiovascular risk. However, evidence on how to best implement cardiovascular risk management (CVRM) in multi-ethnic contexts remains limited. Existing studies primarily focus on white populations, despite disparities in CVD risk and the risk of pregnancy complications across ethnic groups.</div></div><div><h3>Objective</h3><div>This study explores experiences, barriers, and improvements in postpartum CVRM from women’s and healthcare providers’ perspectives, aiming to enhance cardiovascular disease prevention in multi-ethnic contexts.</div></div><div><h3>Study Design</h3><div>We conducted semi-structured interviews with 25 postpartum women who experienced hypertensive disorders of pregnancy or gestational diabetes, recruited to reflect diverse ethnic and socioeconomic backgrounds. Using a narrative approach, interviews covered CVRM experiences and preferences. Themes were triangulated with findings from 16 healthcare providers, including general practitioners, midwives, and specialists, discussing care delivery, optimal practices, and multi-ethnic considerations. Results were integrated in a patient journey map.</div></div><div><h3>Results</h3><div>Significant dropout occurred at the transition from obstetric to primary care and during long-term monitoring, especially among ethnic minorities and women with lower socioeconomic status and disease severity. Women often lacked risk awareness and missed follow-ups when self-scheduling was required. Most supported tailored cardiovascular risk education, lifestyle interventions, and proactive outreach. Healthcare providers emphasized the need for interdisciplinary communication, regional protocols, and clearer guidelines, noting variability in general practitioners’ support for routine monitoring.</div></div><div><h3>Conclusion</h3><div>Postpartum CVRM in multi-ethnic contexts could be improved with active outreach, better follow-up utilization, culturally tailored interventions, and regional multidisciplinary protocols to streamline care and address guideline inconsistencies.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101203"},"PeriodicalIF":2.5,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quality improvement intervention to optimize the management of severe hypertension during pregnancy and postpartum","authors":"Marie-Julie Trahan ,&nbsp;Marianne Plourde ,&nbsp;Ana Clouatre ,&nbsp;Karen Wou ,&nbsp;Antonina Pavilanis ,&nbsp;Ruth-Lynn Fortune ,&nbsp;Sabrina Haas ,&nbsp;Jennifer Pepin ,&nbsp;Sophia Kapellas ,&nbsp;Anne-Maude Morency ,&nbsp;Ginette Aucoin ,&nbsp;Alexandria Flannery ,&nbsp;Pierre-Olivier Monast ,&nbsp;Noura Hassan ,&nbsp;Maral Koolian ,&nbsp;Thiphavone Oudanonh ,&nbsp;Nisha Almeida ,&nbsp;Eva Suarthana ,&nbsp;Stella S. Daskalopoulou ,&nbsp;Isabelle Malhamé","doi":"10.1016/j.preghy.2025.101192","DOIUrl":"10.1016/j.preghy.2025.101192","url":null,"abstract":"<div><h3>Objective</h3><div>Severe hypertension (two systolic blood pressure [BP] values ≥ 160 mm Hg or diastolic BP values ≥ 110 mm Hg, 15–60 min apart) is a modifiable cause of maternal morbidity and mortality. We aimed to assess the impact of a quality improvement (QI) intervention to optimize the management of severe hypertension during pregnancy and postpartum.</div></div><div><h3>Study design</h3><div>We developed and implemented a QI intervention for severe hypertension management at a Canadian tertiary care center and conducted a quasi-experimental pre- and post-intervention cohort study. Pregnant and postpartum patients with a hypertensive disorder of pregnancy (HDP) between 2020 and 2022 were identified, and pre- and post-intervention cohorts were constructed.</div></div><div><h3>Main outcome measures</h3><div>Severe hypertension management was assessed according to quality indicators, including time-to-target BP within 60 min and use of appropriate antihypertensive therapy.</div></div><div><h3>Results</h3><div>Among 697 patients with HDP, 134 (19 %) experienced severe hypertension (pre-intervention: n = 56; post-intervention: n = 78). Immediate release oral nifedipine was the most frequently used medication to treat severe hypertension episodes (63 %). Median time-to-target BP was 49.5 min pre-intervention (interquartile range [IQR] 28.0–69.8) vs. 33.5 min (IQR 19.8–65.2) post-intervention (p = 0.102). Time-to-target BP within 60 min was achieved in 64 % of patients pre- vs. 74 % post-intervention (p = 0.209), meeting our pre-established institutional target. Appropriate antihypertensive administration increased from 55 % pre-intervention to 76 % post-intervention (p = 0.014).</div></div><div><h3>Conclusion</h3><div>Developing and implementing a QI intervention resulted in achievement of our institutional target for time-to-severe hypertension resolution and increased use of appropriate antihypertensive medications. Standardized protocols and QI interventions can optimize severe hypertension management to reduce severe maternal morbidity.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101192"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a relationship between visit-to-visit blood pressure variability and adverse perinatal outcomes?","authors":"Laura Ormesher ,&nbsp;Jill Stewart ,&nbsp;Beth Renwick ,&nbsp;Emma Shawkat ,&nbsp;Jenny E Myers","doi":"10.1016/j.preghy.2025.101200","DOIUrl":"10.1016/j.preghy.2025.101200","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the relationship between blood pressure (BP) variability and perinatal outcomes.</div></div><div><h3>Study design</h3><div>This was a retrospective study of 996 pregnant women with hypertension/risk factors for hypertension in pregnancy. BP variability was calculated by visit-to-visit standard deviation (SD) and mean difference (MD). Logistic regression explored the relationship between BP variability and perinatal outcome, adjusting for confounders.</div></div><div><h3>Main Outcome Measures</h3><div>Correlation between BP variability and i) fetal growth restriction (FGR) and ii) preterm birth (PTB).</div></div><div><h3>Results</h3><div>FGR and PTB complicated 128/996 (13 %) and 233/996 (23 %) pregnancies. At visit 1, 61 (6 %) women were taking labetalol, 125 (13 %) were taking calcium channel blockers and 780 (78 %) were not taking antihypertensives. Increased BP variability was associated with FGR and PTB. These relationships persisted after adjustment for number of antihypertensives, pre-pregnancy BP, BMI, ethnicity and previous FGR for systolic but not diastolic BP variability (adjusted OR for FGR: 1.16 [95 % C.I. 1.03–1.30]; PTB: 1.16 [1.05–1.29]). However, statistical significance was lost after adjustment for maximum BP. Nifedipine was associated with increased BP variability, compared with labetalol, despite adjustment for ethnicity and pre-existing hypertension (adjusted difference: 1.93 mmHg [0.13–3.73], p = 0.04).</div></div><div><h3>Conclusions</h3><div>Increased visit-to-visit systolic but not diastolic BP variability is associated with adverse perinatal outcomes. Nevertheless, it is unclear whether BP lability directly influences perinatal outcome, or merely reflects peak BP. The difference in BP variability between antihypertensives may reflect varying effectiveness or factors influencing antihypertensive choice. Prospective research is needed to investigate any potential link between antihypertensive medications, BP variability and perinatal outcome.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101200"},"PeriodicalIF":2.5,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnocultural status and risk of preeclampsia in a Canadian setting","authors":"Nathalie Auger ,&nbsp;Aimina Ayoub ,&nbsp;Marianne Bilodeau-Bertrand ,&nbsp;Nahantara Lafleur ,&nbsp;Shu Qin Wei","doi":"10.1016/j.preghy.2025.101202","DOIUrl":"10.1016/j.preghy.2025.101202","url":null,"abstract":"<div><h3>Objectives</h3><div>Disparities in hypertensive disorders of pregnancy are prevalent in the U.S., but are understudied in other settings. Our objective was to determine if ethnocultural disparity in the risk of preeclampsia was present in Canada.</div></div><div><h3>Study design</h3><div>We carried out a retrospective cohort study of 862,759 pregnancies between 2008 and 2020 in Quebec, Canada. The exposure was the ethnocultural status of women, defined by linguistic origin (Anglophone or Francophone).</div></div><div><h3>Main outcome measures</h3><div>The outcome was preeclampsia, including severity (severe, superimposed, mild), presence of fetal growth restriction, and gestational onset time (early or late onset of hypertension). We estimated risk ratios (RR) and 95 % confidence intervals (CI) for the association between ethnocultural status and risk of preeclampsia adjusted for maternal characteristics.</div></div><div><h3>Results</h3><div>In adjusted models, Anglophones had a slightly elevated risk of preeclampsia compared with Francophones (40.5 vs. 37.2 per 1000 pregnancies; RR 1.03, 95 % CI 1.00–1.07). Associations were stronger for selected subtypes of preeclampsia, with Anglophones at greater risk of mild preeclampsia (RR 1.09, 95 % CI 1.04–1.13), preeclampsia without fetal growth restriction (RR 1.04, 95 % CI 1.00–1.08), and late onset preeclampsia (RR 1.04, 95 % CI 1.01–1.08). An association with severe preeclampsia was less apparent, although Anglophones lacking a high school diploma (RR 1.46, 95 % CI 1.12–1.90) or who were younger than 25 years (RR 1.19, 95 % CI 1.01–1.40) had a greater risk of severe preeclampsia compared with Francophones.</div></div><div><h3>Conclusions</h3><div>Anglophones, especially Anglophones in vulnerable subgroups, have a slightly elevated risk of preeclampsia compared with Francophones.</div><div>Abbreviations: CI, confidence interval; HELLP, hemolysis, elevated liver enzymes, and low platelets; ICD-10-CA, International Classification of Diseases, 10th revision; mmHg, millimeter of mercury; No., number; RR, risk ratio; U.S., United States.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101202"},"PeriodicalIF":2.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143334198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}