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

{"title":"Meta-analysis evaluating the risks and outcomes of pulmonary hypertension in pregnant women","authors":"Yangting Li ,&nbsp;Xiaolei Yang ,&nbsp;Maoni Zeng ,&nbsp;Tao Luo ,&nbsp;Xiaoyuan Lian ,&nbsp;Jiali Liu ,&nbsp;Qiaolin Liu ,&nbsp;Fei Xiao","doi":"10.1016/j.preghy.2025.101241","DOIUrl":"10.1016/j.preghy.2025.101241","url":null,"abstract":"<div><h3>Objectives</h3><div>Pulmonary hypertension (PH) in pregnancy has traditionally been linked to a higher likelihood of negative outcomes for both the mother and the fetus. A systematic analysis of published papers in recent decades regarding outcomes of pregnancy in patients with PH.</div></div><div><h3>Methods</h3><div>To comprehensively investigate the dangers and final results associated with PH in pregnant women, this study conducted an extensive search across multiple databases. It mainly includes authoritative databases both domestically and internationally, such as PubMed, Web of Science, EMBASE, Cochrane Library, etc. Two authors screened the retrieved articles independently using predefined screening criteria, and assessed the quality of the included studies using the “RevMan5.3 Risk of Bias Assessment Tool”.</div></div><div><h3>Results</h3><div>By searching EMBASE, a total of 10 studies were deemed appropriate and brought into the subsequent <em>meta</em>-analysis. Among all the included studies, 10 trials reported the incidence of adverse pregnancy outcomes. The homogeneity test (<em>P</em> &lt; 0.01, <em>I² =</em> 64 %) showed the existence of heterogeneity, and a random effects model was employed for the analysis. The results of the <em>meta</em>-analysis indicate a significant difference in the incidence of adverse pregnancy outcomes between pregnant women with mild to moderate PH and those with severe PH (<em>RR</em> = 0.67, 95 % CI 0.60 ∼ 0.75, <em>P</em> &lt; 0.01). Among the included studies, 5 trials reported the incidence of adverse pregnancy outcomes. The homogeneity test (<em>P</em> = 0.05, <em>I² =</em> 58 %) showed the existence of heterogeneity, and a random effects model was employed for statistical analysis. The <em>meta</em>-analysis results revealed a significant difference in the proportion of patients with mild to moderate pulmonary arterial hypertension compared to pregnant women with severe disease in cardiac function grades III to IV (<em>RR</em> = 0.48, 95 % CI 0.39 ∼ 0.58, <em>P</em> &lt; 0.01). Using region and sample size as subgroup classifications, large samples (n &gt; 100, n &gt; 70) and small sample (n ≤ 100, n ≤ 70), the heterogeneity of non-China patients was lower (I² = 0 %); meanwhile, the heterogeneity of n &gt; 100, n &gt; 70 was higher than that of studies with n 100 and n 70, indicating that the heterogeneity decreased with the decrease in sample size.</div></div><div><h3>Conclusions</h3><div>After conducting a <em>meta</em>-analysis, it was found that the severity of pH is closely associated with maternal and fetal outcomes. In the subsequent analysis, we will further explore the impact of different treatments and nursing methods on maternal and infant results in patients who have PH.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101241"},"PeriodicalIF":2.9,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749339","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":"Perspectives of Ghanaian pregnant women on family involvement in home blood pressure Monitoring: A qualitative analysis","authors":"Noah Newman ,&nbsp;Titus K. Beyuo ,&nbsp;Betty A. Nartey ,&nbsp;Makafui Aku Klutse ,&nbsp;Cheryl A. Moyer ,&nbsp;Jody R. Lori ,&nbsp;Samuel A. Oppong ,&nbsp;Emma R. Lawrence","doi":"10.1016/j.preghy.2025.101245","DOIUrl":"10.1016/j.preghy.2025.101245","url":null,"abstract":"<div><h3>Objectives</h3><div>(1) To explore pregnant Ghanaian women’s perspectives on family involvement in their home blood pressure monitoring (HBPM); (2) to define forms of family involvement in pregnant women’s HBPM; and (3) to understand how family involvement influences HBPM for pregnant women in this setting.</div><div>Study Design.</div><div>This phenomenological qualitative study was conducted at a tertiary hospital in urban Ghana. Participants were adult pregnant women participating in HBPM. Enrolled participants received audiovisual and hands-on HBPM training and completed daily BP monitoring for 2–4 weeks.</div><div>Main Outcome measures.</div><div>Semi-structured interviews assessed participant perspectives on family involvement with their HBPM. Interviews were audio-recorded, translated, transcribed, coded, and thematically analyzed.</div></div><div><h3>Results</h3><div>Thirty-three participants completed in-depth interviews. Participants had a mean age of 31.2 ± 5.2 years, 30.3 % had not previously given birth, and 39.4 % had less than a senior high school education. Overall, participants felt their family’s involvement made HBPM easier and a more positive experience. There were three forms of family involvement: 1) approval, 2) assistance, and 3) participation. All family members approved of HBPM. Assistance and participation were associated with the most positive perceptions. Participants referenced family togetherness, enjoyment of HBPM, and decreased stress as outcomes. Negative aspects of family involvement were disruptions from children and participants’ preference to monitor alone, were experienced rarely, and were able to be overcome.</div></div><div><h3>Conclusions</h3><div>Among pregnant women in urban Ghana, family involvement in HBPM was perceived as helpful and enjoyable, resulted in psychosocial benefits, and may help overcome barriers to HBPM in low- and middle-income countries.</div><div>Abbreviations: BP, blood pressure; HBPM, home blood pressure monitoring; HDP, hypertensive disorders of pregnancy; LMID, low- and middle-income countries; KBTH, Korle Bu Teaching Hospital; OBGYN, Obstetrics and Gynaecology; ANC, antenatal care.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101245"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724482","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":"Prediction for the development of preeclampsia through non-invasive hemodynamics using machine learning, distinguishing early from late","authors":"D. Olano ,&nbsp;W. Espeche ,&nbsp;J. Minetto ,&nbsp;B.C. Leiva Sisnieguez ,&nbsp;G. Cerri ,&nbsp;C. Martinez ,&nbsp;P. Carrera Ramos ,&nbsp;C.E. Leiva Sisnieguez ,&nbsp;M.R. Salazar","doi":"10.1016/j.preghy.2025.101242","DOIUrl":"10.1016/j.preghy.2025.101242","url":null,"abstract":"<div><div>Preeclampsia (PE) and hypertensive disorders of pregnancy (HDP) are major contributors to maternal-fetal morbidity and prematurity worldwide. These conditions are classified as early- or late-onset based on gestational timing. This study investigates the potential of impedance cardiography (ICG) as a tool for non-invasive hemodynamic assessment to predict early versus late-onset PE risk. Using machine learning techniques, specifically the J48 classification tree algorithm, a predictive model was developed to identify novel hemodynamic patterns beyond conventional metrics. A total of 405 high-risk pregnant patients between 17 and 33 weeks of gestation were evaluated, with hemodynamic parameters assessed using ICG. The study aimed to differentiate between early-onset and late-onset PE and to explore non-traditional hemodynamic variables associated with its development.</div><div>Results demonstrated that the machine learning model accurately identified high-risk pregnant women who developed PE, achieving a 95% correct classification rate. Furthermore, the model effectively distinguished between early- and late-onset cases. Importantly, it incorporated variables related to contractility, cardiovascular performance, and afterload, underscoring the potential of non-invasive hemodynamic assessment for early PE detection.</div><div>Despite certain limitations, including the modest number of PE events and the necessity for external validation, these findings highlight the promise of artificial intelligence in improving risk prediction and advancing clinical management strategies for PE in high-risk pregnancies.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101242"},"PeriodicalIF":2.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722043","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":"Awareness and knowledge of preeclampsia among women in Palestine","authors":"Oadi N. Shrateh ,&nbsp;Jalal Al Khateeb ,&nbsp;Ashna Habib ,&nbsp;Sahar Kateeb ,&nbsp;Hashem Khdour ,&nbsp;Tamara Said ,&nbsp;Abdallah Qawasmeh ,&nbsp;Ahmad w haleem","doi":"10.1016/j.preghy.2025.101238","DOIUrl":"10.1016/j.preghy.2025.101238","url":null,"abstract":"<div><h3>Background and objectives</h3><div>PE is a serious condition that can affect pregnant women. Early management can improve healthcare outcomes for the mother and the baby. But there is no data on the level of awareness of Palestinian women on this condition. Hence, this study aims to measure the level of awareness and knowledge among Palestinian women and to find out the factors associated with it.</div></div><div><h3>Material and methods</h3><div>Cross-sectional design was used for this study. Questions were created from two Preeclampsia Awareness Surveys developed by the Preeclampsia Foundation. PE knowledge was measured with 29 items from the 2014 Preeclampsia Awareness Survey, and a knowledge score was calculated.</div></div><div><h3>Results</h3><div>A total of 836 women completed questionnaire. Over half (60.6%) of women reported their healthcare provider described the signs and symptoms of PE to them. The mean PE knowledge score was 13.9. A higher education level was significantly associated with a higher PE knowledge score. While previous PE experience, parity, having the signs and symptoms of PE described by a healthcare provider were significantly associated with a lower PE knowledge score.</div></div><div><h3>Conclusion</h3><div>The study emphasizes on the necessity of improving PE awareness among Palestinian women. In addition to improving the patient-provider communication. Raising PE awareness among Palestinian women is a priority for stakeholders and health institutions. A detailed discussion using effective communication about PE should be offered in Prenatal care visits.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101238"},"PeriodicalIF":2.5,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663347","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":"Modified multiple marker aneuploidy screening as a primary screening test for preeclampsia: A validation study","authors":"Tianhua Huang ,&nbsp;Shamim Rashid ,&nbsp;Yanbo (George) Wang ,&nbsp;Rachel S. Woo ,&nbsp;Megan Priston ,&nbsp;Clare Gibbons ,&nbsp;Melanie Bedford ,&nbsp;Elad Mei-Dan","doi":"10.1016/j.preghy.2025.101239","DOIUrl":"10.1016/j.preghy.2025.101239","url":null,"abstract":"<div><h3>Objectives</h3><div>Our previous case-controlled study indicates that the combination of maternal characteristics, serum placental growth factor (PlGF), and pregnancy-associated plasma protein A (PAPP-A) can predict early-onset and preterm preeclampsia with reasonable accuracy. This study aims to validate whether our preeclampsia screening algorithm can be applied to a large general obstetric population by using serum markers obtained from routine aneuploidy screening.</div></div><div><h3>Study design</h3><div>This retrospective cohort study analyzed maternal characteristics, serum markers, and pregnancy outcomes from pregnant individuals who underwent enhanced first-trimester screening and delivered at a Toronto tertiary center between December 2017 and June 2021.</div></div><div><h3>Main outcome measures</h3><div>Logistic regression was used to assess prediction accuracy and compare screening performance with algorithm from our previous case-control study. The multiple of the median (MoM) of serum markers were compared between cases and controls using Mann-Whitney U tests.</div></div><div><h3>Results</h3><div>The study included 340 preeclampsia cases (15 delivered &lt; 34 weeks, 77 delivered &lt; 37 weeks and 263 delivered ≥ 37 weeks) and 10,145 controls. Preeclampsia cases had significantly lower MoM of PlGF (0.83 vs 1.02) and PAPP-A (0.89 vs 1.07) (p &lt; 0.0001 for both). At a 20 % false-positive rate, 80 % of early-onset, 68 % of preterm, and 58 % of term preeclampsia cases could be predicted using maternal characteristics and serum markers. Applying our previously developed algorithm achieved a comparable accuracy in this population.</div></div><div><h3>Conclusion</h3><div>Our findings support expanding multiple marker aneuploidy screening to include accurate, cost-effective preeclampsia risk prediction, enabling early intervention for high-risk pregnant individuals.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101239"},"PeriodicalIF":2.5,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653584","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":"First trimester preeclampsia screening and risk of placental lesions","authors":"Camilla Bellingeri ,&nbsp;Fausta Beneventi ,&nbsp;Irene De Maggio ,&nbsp;Carolina Spada ,&nbsp;Alessina Bini Smaghi ,&nbsp;Maura Cortese ,&nbsp;Elisa Ligari ,&nbsp;Claudia Alpini ,&nbsp;Arsenio Spinillo","doi":"10.1016/j.preghy.2025.101236","DOIUrl":"10.1016/j.preghy.2025.101236","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of our study was evaluate differences in placental histopathology basing on first trimester preeclampsia screening.</div></div><div><h3>Study Design</h3><div>Observational case-control study; monocentric enrolment at first trimester ultrasound at the department of Obstetrics and Gynecology of IRCCS Policlinico San Matteo; 278 placental specimen from 234 non-preeclamptic women and 44 preeclamptic women; histopathological examination and evaluation basing on first trimester preeclampsia multiparametric screening; continuous variables were compared by Kruskal-Wallis analysis of variance, categorical variables were compared by Fisher exact test or chi-square test.</div></div><div><h3>Main outcome measures</h3><div>Placental lesions prevalence according to first trimester screening result.</div></div><div><h3>Results</h3><div>preeclamptic screen-positive patients had higher frequency of adverse pregnancy outcomes and higher frequency of placental MVM lesions. Screen-positive patients who do not developed preeclampsia had poor maternal and fetal outcomes and higher prevalence of MVM, FVM and placental chronic inflammatory lesions.</div></div><div><h3>Conclusions</h3><div>Our results shows that the screening identifies pregnancies with placental lesions, which, irrespectively of the development of preeclampsia, correlate with impaired fetal growth and poor pregnancy outcomes. The presence of MVM, FVM and VUE in patients at high risk for preeclampsia reflects the need for close clinical follow-up during pregnancy due to the increased risk of adverse outcomes.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101236"},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534167","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":"Effect of supine or semi-recumbent positions on arterial stiffness among pregnant women","authors":"Sam Ali ,&nbsp;Brendah Nambozo ,&nbsp;Evalyne Tusiimirwe ,&nbsp;Irene Ajenga ,&nbsp;Eliot T. Kanyesigye ,&nbsp;Jillian Awati ,&nbsp;Adam Eminai ,&nbsp;Helen Perry ,&nbsp;Josaphat Byamugisha ,&nbsp;Aris T. Papageorghiou","doi":"10.1016/j.preghy.2025.101235","DOIUrl":"10.1016/j.preghy.2025.101235","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to evaluate whether there was a difference in arterial stiffness measurements in supine and semirecumbent positions among pregnant women.</div></div><div><h3>Methods</h3><div>This was a cross-sectional study in four public hospitals in Uganda. Women were interviewed to capture demographic data and obstetric history before undergoing arterial stiffness examinations using the Arteriograph device (TensioMed, Budapest, Hungary) in supine and semirecumbent positions. Three consecutive measurements were acquired per position and were transformed to gestational age adjusted z-scores for analysis using a two-sample <em>t</em>-test, paired <em>t</em>-test and Pearson correlation coefficients.</div></div><div><h3>Results</h3><div>We included 194 pregnant women, with median age of 25 years (interquartile rage (IQR), 21–29), and body mass index of 23.9 kg/m² (IQR, 21.1–27.6). None was smoking or had renal and cardiac diseases. The procedure failure rate was less than 3 %. There were no significant differences in measurements between supine and semirecumbent positions at 11–42 weeks. We found a strong positive correlation between hemodynamic indices performed in supine and semirecumbent positions: aortic pulse wave velocity z-scores (r = 0.84 (95 % CI, 0.77–0.89)) and aortic augmentation index z-scores (r = 0.95 (95 % CI, 0.92–0.97)) at 11–27 weeks’ gestation, and central systolic blood pressure z-scores (r = 0.81 (95 % CI, 0.72–0.87)) and mean arterial pressure z-scores (r = 0.84 (95 % CI, 0.77–0.89)) at 28–42 weeks’ gestation. Repeated measurements taken in same position were strongly correlated throughout gestation.</div></div><div><h3>Conclusion</h3><div>Arterial stiffness parameters measured in supine and semirecumbent positions were comparable and had very minimal failure rates. As a supine position is often not tolerated well in late gestation, our study suggests that pregnant women could assume a semirecumbent position during Arteriograph test procedures between 11 and 42 weeks of gestation.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101235"},"PeriodicalIF":2.5,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144534168","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":"Validation of the fullPIERS model in a tertiary hospital in southern Brazil","authors":"Pedro do Valle Teichmann ,&nbsp;Rafaella Aléssio Naibo ,&nbsp;Marina Abs da Cruz Rodrigues ,&nbsp;Mariana Wollmann de Matos ,&nbsp;Sergio Hofmeister de Almeida Martins Costa ,&nbsp;José Geraldo Lopes Ramos","doi":"10.1016/j.preghy.2025.101237","DOIUrl":"10.1016/j.preghy.2025.101237","url":null,"abstract":"<div><h3>Objective</h3><div>To validate the fullPIERS model’s efficacy in predicting adverse maternal and neonatal outcomes in women with preeclampsia at a tertiary teaching hospital in southern Brazil.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed data from women diagnosed with preeclampsia at the Hospital de Clínicas de Porto Alegre (HCPA) between January 2017 and August 2024. Patient data extracted from hospital records was used to calculate the fullPIERS score. Adverse maternal outcomes, including HELLP syndrome, placental abruption and pulmonary edema, were assessed within 48 h and 7 days post-admission, as well as adverse neonatal outcomes. Model performance was assessed by calculating the area under the curve (AUC) from ROC analysis, and the optimal threshold for predicting adverse maternal outcomes was determined.</div></div><div><h3>Results</h3><div>A total of 665 women with preeclampsia were included in the study, of whom 124 (18.6 %) experienced adverse maternal outcomes. The median fullPIERS was higher among women with maternal complications (1.55 % [IQR 0.55–5.9] vs. (0.6 % [IQR 0.3–1.2]; p &lt; 0.001). The fullPIERS model demonstrated acceptable accuracy for predicting adverse maternal outcomes (AUC = 0.721, CI 0.652 – 0.790, p-value &lt; 0.01). A threshold of 2.26 % yielded the best predictive performance, with an accuracy of 70.26 %, sensitivity of 51.1 % and specificity of 89.4 %. FullPIERS also showed a moderate performance in predicting adverse neonatal outcome (AUC = 0.736, 95 % CI 0.686–0.786, p &lt; 0.001) and for combined maternal and neonatal outcomes (AUC = 0.742, 95 % CI 0.689–0.785, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The fullPIERS model is a reliable tool for predicting adverse maternal and neonatal outcomes; however, its performance appears suboptimal compared to data from high-income countries.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101237"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522971","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":"Peripartum antihypertensive use and the risk of neonatal hypoglycemia and postpartum uterine atony: a retrospective cohort study","authors":"Amnon A. Berger ,&nbsp;Samantha L. Armstrong ,&nbsp;Alina Fischer ,&nbsp;JoAnn Jordan ,&nbsp;Megha Gupta ,&nbsp;Yunping Li ,&nbsp;Philip E. Hess ,&nbsp;John J. Kowalczyk","doi":"10.1016/j.preghy.2025.101232","DOIUrl":"10.1016/j.preghy.2025.101232","url":null,"abstract":"<div><h3>Objectives</h3><div>Determine whether peripartum antihypertensive use increases secondary uterotonic use, neonatal hypoglycemia, bradycardia, or NICU admission. Hypertensive disorders of pregnancy are common and increasing. Treatment includes beta- and calcium channel- blocking medications. Outpatient beta-blockers were associated with increases in neonatal bradycardia, hypoglycemia, and NICU admissions. Calcium channel blockers are weak tocolytics and may precipitate uterine atony and hemorrhage.</div></div><div><h3>Study Design</h3><div>Retrospective, single-center study at a tertiary academic hospital. Records of 26,058 parturients over 5 years were reviewed. We compared exposure to labetalol and nifedipine in separate analyses. We calculated univariate odds ratio and binomial generalized models to account for covariates. P &lt; 0.05 was considered significant.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcomes were incidence of 1-hour neonatal hypoglycemia and maternal secondary uterotonic or antifibrinolytic use. Additional maternal outcomes were change in hemoglobin concentration and estimated blood loss; neonatal outcomes included hypoglycemia at 24-hours, bradycardia, and NICU admissions.</div></div><div><h3>Results</h3><div>We analyzed 24,845 records. Labetalol exposure occurred in 605 (2.4 %) deliveries and nifedipine in 426 (1.7 %). In multivariate analyses in the full cohort and matched cohorts, labetalol administration was significantly associated with 1-hour hypoglycemia (p &lt; 0.001, OR 1.72, 95 %CI 1.33–2.23), but not 24-hour hypoglycemia (p = 0.12), bradycardia (p = 0.65), or NICU admissions (p = 0.86). Labetalol and nifedipine were associated with uterine atony (p = 0.006 and p = 0.027). Confounders and sensitivity analyses accounted for magnesium exposure, general anesthesia, and hypertensive diagnoses.</div></div><div><h3>Conclusion</h3><div>Labetalol exposure was significantly and independently associated with neonatal hypoglycemia. Any hypertensive use associated with uterine atony. Clinicians should consider 1-hour assessment of glucose in neonates born to labetalol-treated mothers.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101232"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472288","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":"Long-term follow-up of a neonatal cohort after intrauterine exposure to maternal heparin-mediated extracorporal LDL-precipitation (HELP)-apheresis in very preterm preeclampsia","authors":"Martin Kuntz ,&nbsp;Cornelia Lorey ,&nbsp;Christine Contini ,&nbsp;Karl Winkler ,&nbsp;Hans Fuchs ,&nbsp;Filiz Markfeld-Erol ,&nbsp;Mirjam Kunze","doi":"10.1016/j.preghy.2025.101234","DOIUrl":"10.1016/j.preghy.2025.101234","url":null,"abstract":"<div><h3>Objectives</h3><div>Preterm preeclampsia represents a significant contributor to maternal and fetal/neonatal morbidity and frequently results in preterm delivery. The Freiburg preeclampsia HELP (heparin-mediated extracorporal LDL-precipitation)-Apheresis study was a pilot study designed to investigate the effects of HELP-apheresis on the clinical and laboratory outcome of severe preeclampsia. Results of the study were promising, indicating that this approach may be beneficial in prolonging pregnancy. Nevertheless, the long-term effects on the children were not determined yet.</div></div><div><h3>Study design and main outcome measures</h3><div>Long-term outcomes of the 12 children from the Freiburg preeclampsia HELP-Apheresis study (6 from the intervention group, 6 from the control cohort) were assessed using <em>Bayley Scales</em> at 24 months corrected age and a parent questionnaire (CBCL4-18) at approximately 10 years of age.</div></div><div><h3>Results</h3><div>Children exposed to maternal HELP-apheresis demonstrated a generally favorable outcome in terms of <em>Bayley Scales</em>, school and social skills, as well as body growth at 10 years of age. No significant difference between the intervention and the control cohort was observed. The results were consistent with larger cohorts studying the long-term outcomes of very low birth weight infants.</div></div><div><h3>Conclusions</h3><div>Prenatal exposure to maternal HELP-apheresis did not have any negative effect on the long-term outcome of very preterm infants born to mothers with severe preeclampsia. However, a potential beneficial impact of the intervention due to the prolongation of pregnancy would have been too small to be discernible. The results of this study justify further investigation of lipid-apheresis as a possible treatment option in severe, very preterm preeclampsia.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"41 ","pages":"Article 101234"},"PeriodicalIF":2.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364890","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}