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

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Neonatal cost savings in hypertensive disorders of pregnancy: Economic evaluation of the sFlt-1/PlGF test with real world implementation of biomarkers 妊娠期高血压疾病的新生儿成本节约:sFlt-1/PlGF测试与现实世界生物标志物实施的经济评估
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-17 DOI: 10.1016/j.preghy.2025.101190
Marly Azzi , Michelle Silasi , Sanela Potchileev , Padmashree C. Woodham , Amalia Brawley , Ariel Mueller , Teofilo Borunda Duque , Sarosh Rana
{"title":"Neonatal cost savings in hypertensive disorders of pregnancy: Economic evaluation of the sFlt-1/PlGF test with real world implementation of biomarkers","authors":"Marly Azzi ,&nbsp;Michelle Silasi ,&nbsp;Sanela Potchileev ,&nbsp;Padmashree C. Woodham ,&nbsp;Amalia Brawley ,&nbsp;Ariel Mueller ,&nbsp;Teofilo Borunda Duque ,&nbsp;Sarosh Rana","doi":"10.1016/j.preghy.2025.101190","DOIUrl":"10.1016/j.preghy.2025.101190","url":null,"abstract":"<div><h3>Background</h3><div>Preeclampsia is a key cause of prematurity in the U.S. and incurs significant healthcare costs. An imbalance between soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) predicts severe preeclampsia and aids in its management.</div></div><div><h3>Objective</h3><div>This study aimed to assess the cost-effectiveness of the sFlt-1/PlGF test as an addition to standard care for patients at risk of developing preeclampsia.</div></div><div><h3>Study design</h3><div>A decision tree analysis was conducted to assess the cost effectiveness of the ratio test in the United States, using data from <em>Preeclampsia Risk Assessment: Evaluation of Cut-offs to Improve Stratification [PRAECIS]</em> and from a real-world evidence study conducted after the implementation of sFlt-1/PlGF testing into routine clinical practice (Biomarker Examination and Analysis for Clinical Obstetrical Navigation Study [BEACON]). The model compared standard of care alone versus a biomarker-based approach utilizing the sFlt-1/PlGF test for managing patients at risk of preeclampsia with severe features. Published data was used to estimate theoretical cost values of infants for their first six months of life.</div></div><div><h3>Results</h3><div>The analysis indicated potential total neonatal cost savings of nearly $10,595,332 (95% CI: $6,555,439 to $14,730,536) per 1,000 patients using the sFlt-1/PlGF ratio test, translating to about $10,595 saved per patient. The incremental cost-effectiveness ratio (ICER) analysis showed a mean cost savings of $62,572 for each pregnancy prolonged by two weeks.</div></div><div><h3>Conclusion</h3><div>The sFlt-1/PlGF test, when used alongside standard care, enhances risk stratification for severe preeclampsia and may lead to significant neonatal cost savings by reducing preterm deliveries and neonatal intensive care admissions.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101190"},"PeriodicalIF":2.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014622","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}
引用次数: 0
A pilot and feasibility study investigating the abundance and activity of nitrate-reducing bacteria in women with pre-eclampsia 一个试点和可行性研究调查丰度和活性的硝酸盐减少细菌妇女先兆子痫。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-14 DOI: 10.1016/j.preghy.2025.101188
Lisa du Toit , Ifeoma Offiah , Alvaro Redondo-Rio , Tanya Kahawita , Michele Kiernan , Yen Ming Lin , Louise Belfield , Gemma Montagut , Alicia Benavente , Tomas Nicholas , Amazon Doble , Renske Dikkers , Robert Freeman , Toni Gabaldón , Zoe Brookes , Raul Bescos
{"title":"A pilot and feasibility study investigating the abundance and activity of nitrate-reducing bacteria in women with pre-eclampsia","authors":"Lisa du Toit ,&nbsp;Ifeoma Offiah ,&nbsp;Alvaro Redondo-Rio ,&nbsp;Tanya Kahawita ,&nbsp;Michele Kiernan ,&nbsp;Yen Ming Lin ,&nbsp;Louise Belfield ,&nbsp;Gemma Montagut ,&nbsp;Alicia Benavente ,&nbsp;Tomas Nicholas ,&nbsp;Amazon Doble ,&nbsp;Renske Dikkers ,&nbsp;Robert Freeman ,&nbsp;Toni Gabaldón ,&nbsp;Zoe Brookes ,&nbsp;Raul Bescos","doi":"10.1016/j.preghy.2025.101188","DOIUrl":"10.1016/j.preghy.2025.101188","url":null,"abstract":"<div><h3>Background</h3><div>Oral health may influence blood pressure control by modulating the abundance and activity of nitrate-reducing bacteria, which are essential for enhancing nitrite and nitric oxide (NO) bioavailability. This study aimed to investigate the oral health and microbiome composition of women with pre-eclampsia (PET) compared to healthy controls (CN).</div></div><div><h3>Methods</h3><div>Ten PET and eleven CN women participated in this study, respectively. An oral health examination was conducted in all the participants. Saliva and blood samples were collected for analysis of the oral microbiome and NO biomarkers.</div></div><div><h3>Results</h3><div>Higher plaque levels were observed in the PET group compared to the CN group (<em>P</em> = 0.038). The relative abundance of oral bacteria at the genus level did not differ between groups, however, the activity of oral nitrate-reducing bacteria (<em>P</em> = 0.088) and salivary nitrite levels (<em>P</em> = 0.100) appeared lower in the PET group, though not statistically significant. Plasma nitrate levels were significantly lower in the PET group compared to the CN group (<em>P</em> = 0.024).</div></div><div><h3>Conclusion</h3><div>Women with PET showed poorer oral health and potential lower activity of nitrate-reducing bacteria and salivary nitrite, indicating a need for further investigation into treatments targeting oral health and the microbiome in women with PET.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101188"},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014608","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}
引用次数: 0
Response to the Letter to the Editor: “Signs or symptoms of suspected preeclampsia – A retrospective National database study of prevalence, costs, and outcomes” 对致编辑的信的回复:“疑似子痫前期的体征或症状——患病率、成本和结果的回顾性国家数据库研究”。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-10 DOI: 10.1016/j.preghy.2024.101183
Kavia Khosla , Yue Jin , Jimmy Espinoza , Matthew Kent , Mikael Gencay , Liza H. Kunz , Ariel Mueller , Yan Xiao , W. Frank Peacock , Sean-Xavier Neath , Jennifer J. Stuart , Douglas Woelkers , James M. Harris , Sarosh Rana
{"title":"Response to the Letter to the Editor: “Signs or symptoms of suspected preeclampsia – A retrospective National database study of prevalence, costs, and outcomes”","authors":"Kavia Khosla ,&nbsp;Yue Jin ,&nbsp;Jimmy Espinoza ,&nbsp;Matthew Kent ,&nbsp;Mikael Gencay ,&nbsp;Liza H. Kunz ,&nbsp;Ariel Mueller ,&nbsp;Yan Xiao ,&nbsp;W. Frank Peacock ,&nbsp;Sean-Xavier Neath ,&nbsp;Jennifer J. Stuart ,&nbsp;Douglas Woelkers ,&nbsp;James M. Harris ,&nbsp;Sarosh Rana","doi":"10.1016/j.preghy.2024.101183","DOIUrl":"10.1016/j.preghy.2024.101183","url":null,"abstract":"","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101183"},"PeriodicalIF":2.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972858","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}
引用次数: 0
High prevalence of neuroimaging abnormalities in eclampsia: Justifying the routine use of non-contrast CT in resource-limited settings 神经影像学异常在子痫中的高流行率:在资源有限的情况下证明常规使用非对比CT的合理性。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-10 DOI: 10.1016/j.preghy.2024.101184
Jesús A. Velásquez , Ana M. Solorzano , Santiago Guerrero
{"title":"High prevalence of neuroimaging abnormalities in eclampsia: Justifying the routine use of non-contrast CT in resource-limited settings","authors":"Jesús A. Velásquez ,&nbsp;Ana M. Solorzano ,&nbsp;Santiago Guerrero","doi":"10.1016/j.preghy.2024.101184","DOIUrl":"10.1016/j.preghy.2024.101184","url":null,"abstract":"<div><h3>Objectives</h3><div>Eclampsia remains a principal cause of maternal mortality, especially in low- and middle-income countries. The frequent association with Posterior Reversible Encephalopathy Syndrome (PRES) underscores the critical role of neuroimaging in clinical assessment. We aimed to evaluate tomographic findings in women with eclampsia and analyze clinical factors associated with these abnormalities.</div></div><div><h3>Study design</h3><div>This descriptive, retrospective study was conducted at the Hospital Universitario San Vicente Fundación in Medellín, Colombia. A mandatory registry identified women diagnosed with eclampsia between 2011 and 2023. Non-contrast cranial tomography results and clinical data were analyzed using univariate and multivariate logistic regression to determine factors associated with imaging abnormalities.</div></div><div><h3>Main outcome measures</h3><div>The primary outcomes were the presence of abnormalities on non-contrast cranial CT scans and their association with clinical factors such as antepartum eclampsia and HELLP syndrome.</div></div><div><h3>Results</h3><div>Of the eighty-one women with eclampsia, sixty-seven underwent non-contrast cranial tomography. Abnormal findings were observed in 52% of cases, with 74% consistent with PRES and 22% showing evidence of hemorrhage. Antepartum eclampsia and HELLP syndrome are significantly associated with abnormal imaging findings, with odds ratios of 11,72 (2.34 – 106,23) and 9,14 (1.72 – 85,72), respectively, after adjusting for potential confounding variables.</div></div><div><h3>Conclusion</h3><div>Given the high prevalence of tomographic abnormalities, non-contrast cranial tomography should be considered for all women with eclampsia, particularly those with antepartum presentations or HELLP syndrome. These findings support the need for revising neuroimaging guidelines to improve the diagnosis and management of neurological complications associated with eclampsia, especially in resource-limited settings.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101184"},"PeriodicalIF":2.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966772","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}
引用次数: 0
Smaller decrease in late second trimester blood pressure is associated with gestational hypertensive disease development 妊娠中期晚期血压下降幅度较小与妊娠期高血压疾病的发展有关。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-10 DOI: 10.1016/j.preghy.2025.101189
Raina Advani , R. Shree , Catherine M. Albright , Suchitra Chandrasekaran
{"title":"Smaller decrease in late second trimester blood pressure is associated with gestational hypertensive disease development","authors":"Raina Advani ,&nbsp;R. Shree ,&nbsp;Catherine M. Albright ,&nbsp;Suchitra Chandrasekaran","doi":"10.1016/j.preghy.2025.101189","DOIUrl":"10.1016/j.preghy.2025.101189","url":null,"abstract":"<div><h3>Objectives</h3><div>We investigated whether a smaller reduction in 2nd trimester blood pressure (BP) is associated with the development of gestational hypertensive disease.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective cohort study utilizing a clinical database at an urban safety-net hospital. Individuals ages 18–40 with a singleton gestation and 1st trimester prenatal care were included. Those with chronic hypertension were excluded. Systolic BP (SBP), diastolic BP (DBP), &amp; mean arterial pressure (MAP) decrease were calculated. The outcome variable, gestational hypertensive disease (GHDP) included gestational hypertension and preeclampsia with and without severe features.</div></div><div><h3>Results</h3><div>Of N = 3,355 individuals that met inclusion criteria, 18 % had GHDP. The mean gestational age of 1st trimester and 2nd trimester BP values were 9.8 ± 2.1 and 23.5 ± 2.3 weeks. Those with GHDP compared to those without GHDP had a significantly higher mean 1st trimester SBP <em>(p &lt; 0.01)</em>, DBP <em>(p &lt; 0.01)</em>, and MAP <em>(p &lt; 0.01)</em>. Those with GHDP compared to those without GHDP had a significantly smaller decrease between 1st and 2nd trimester SBP (<em>−1.7 ± 12.3 vs −2.9 ± 11.8, p &lt; 0.001</em>) and MAP <em>(−2.1 ± 8.4 vs −2.7 ± 7.9, p = 0.01</em>). Those with GHDP compared to those without GHDP had a smaller DBP decrease but it was not statistically significant (<em>−2.3 ± 8.7 vs −2.7 ± 8.2, p = 0.19).</em></div></div><div><h3>Conclusions</h3><div>Pregnant individuals who experienced a smaller decrease in SBP and MAP were more likely to develop GHDP. A reduced physiologic drop in 2nd trimester BP may suggest underlying vascular dysregulation. Future studies investigating biological mechanisms driving diminished 2nd trimester BP decline, utilizing non-invasive hemodynamic monitoring, are necessary.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101189"},"PeriodicalIF":2.5,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966775","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}
引用次数: 0
Association of MTHFR C677T and A1298C variants with preeclampsia risk and angiogenic imbalance in Tunisian women 突尼斯妇女MTHFR C677T和A1298C变异与子痫前期风险和血管生成失衡的关系
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-09 DOI: 10.1016/j.preghy.2025.101187
Hedia Zitouni , Vera Chayeb , Nozha Raguema , Marwa Ben Ali Gannoun , Sameh Bendhaher , Ines Zouari , Fulin Liu , Kamel Gaddour , Touhami Mahjoub , Jean Guibourdenche , Wassim Y Almawi
{"title":"Association of MTHFR C677T and A1298C variants with preeclampsia risk and angiogenic imbalance in Tunisian women","authors":"Hedia Zitouni ,&nbsp;Vera Chayeb ,&nbsp;Nozha Raguema ,&nbsp;Marwa Ben Ali Gannoun ,&nbsp;Sameh Bendhaher ,&nbsp;Ines Zouari ,&nbsp;Fulin Liu ,&nbsp;Kamel Gaddour ,&nbsp;Touhami Mahjoub ,&nbsp;Jean Guibourdenche ,&nbsp;Wassim Y Almawi","doi":"10.1016/j.preghy.2025.101187","DOIUrl":"10.1016/j.preghy.2025.101187","url":null,"abstract":"<div><div>Preeclampsia (PE) is a pregnancy-specific vascular disorder associated with endothelial dysfunction, hypertension, and proteinuria. The methylenetetrahydrofolate reductase (MTHFR) enzyme regulates essential cellular functions in pregnancy owing to its effects on folate metabolism and DNA methylation. Previous studies implicated the association of rs1801133 (C677T; Ala222Val) and rs1801131 (A1298C; Glu429Ala) in the <em>MTHFR</em> gene with PE in different ethnic groups, but with mixed outcomes.</div></div><div><h3>Methods</h3><div>Study cases comprised 675 Tunisian pregnant women, of whom 350 PE presented with PE, and the remaining 325 normotensive women served as controls. Genotyping of C677T and A1298C variants was performed by real-time PCR.</div></div><div><h3>Results</h3><div>There was no statistically significant difference in the minor allele frequencies of C677T and A1298C between preeclampsia cases and controls after adjusting for key covariates. In addition, the prevalence of <em>MTHFR</em> C677T and A1298C minor allele homozygote genotypes was significantly higher in PE cases. The association of 1298C/C, but not 677T/T, with PE persisted after adjusting for the main covariates. Carrying the (minor) 677T allele was associated with marginally higher BMI, significantly higher sFlt-1 serum levels, and median sFlt-1/PlGF ratio and sFlt-1/PlGF ratio ≥ 85. Setting the major allele homozygotes (C677/A1298) as a reference, haplotype analysis demonstrated a higher prevalence of C677/C1298 and T677/C1298 haplotypes (<em>P</em> = 0.03) in PE cases compared to controls, which persisted for C677/C1298, but not T677/C1298 after controlling for key covariates.</div></div><div><h3>Discussion</h3><div>Our results support an association between <em>MTHFR</em> polymorphisms and increased risk of PE, and an imbalance of PE-associated sFLT-1/PlGF.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101187"},"PeriodicalIF":2.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966770","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}
引用次数: 0
Barriers and facilitators for adequate calcium intake during pregnancy: A mixed methods study 怀孕期间摄入充足钙的障碍和促进因素:一项混合方法研究。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2025-01-08 DOI: 10.1016/j.preghy.2024.101182
I. Mesters , J.P.M.M. Willemse , P. van Montfort , L.J.E. Meertens , J. Kruitwagen , L.J.M. Smits , H.C.J. Scheepers
{"title":"Barriers and facilitators for adequate calcium intake during pregnancy: A mixed methods study","authors":"I. Mesters ,&nbsp;J.P.M.M. Willemse ,&nbsp;P. van Montfort ,&nbsp;L.J.E. Meertens ,&nbsp;J. Kruitwagen ,&nbsp;L.J.M. Smits ,&nbsp;H.C.J. Scheepers","doi":"10.1016/j.preghy.2024.101182","DOIUrl":"10.1016/j.preghy.2024.101182","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the effectiveness of calcium supplementation as a preventive measure for pregnant women with insufficient calcium intake, examining adherence to the recommended 1000 mg daily intake and identifying influencing factors.</div></div><div><h3>Methods</h3><div>A survey (Expect cohort II, n = 823) evaluated calcium adherence among pregnant women, followed by interviews with sixteen purposefully selected participants. Verbatim transcripts were independently analyzed to identify key themes.</div></div><div><h3>Results</h3><div>Among survey participants, 82 % discussed the importance of calcium intake, with 83 % expressing intent to improve intake. Of those counselled on calcium, 48 % had insufficient intake, compared to 64 % without counseling. Facilitators included perceived safety, maternal motivation to keep child safe, trust in professionals, supportive environments, and increased awareness. Obstacles included lack of knowledge on calcium sources, pill dosage, low intrinsic motivation, information comprehension and novelty of the advice.</div></div><div><h3>Conclusion</h3><div>Despite of awareness raising efforts through counseling, only half of the women reached adequate calcium levels, with interviews revealing limited understanding. Clear messages on calcium benefits, dispelling concerns about potential harm, and offering concrete guidance can improve intake. Repetition of advice and increase publicity can normalize and enhance acceptability of calcium consumption during pregnancy.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101182"},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957273","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}
引用次数: 0
Transparency, trustworthiness and usefulness in pre-eclampsia randomised controlled trials in the last three decades 过去三十年子痫前期随机对照试验的透明度、可信度和有效性。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2024-12-24 DOI: 10.1016/j.preghy.2024.101181
Hannah T Y Wang , Yichi Zhang , Rivani Porwal , James M. Kemper , Alston G.J. Ong , Ben W. Mol , Daniel L. Rolnik
{"title":"Transparency, trustworthiness and usefulness in pre-eclampsia randomised controlled trials in the last three decades","authors":"Hannah T Y Wang ,&nbsp;Yichi Zhang ,&nbsp;Rivani Porwal ,&nbsp;James M. Kemper ,&nbsp;Alston G.J. Ong ,&nbsp;Ben W. Mol ,&nbsp;Daniel L. Rolnik","doi":"10.1016/j.preghy.2024.101181","DOIUrl":"10.1016/j.preghy.2024.101181","url":null,"abstract":"<div><h3>Objectives</h3><div>Over the last decades, there has been a rising number of randomised controlled trials (RCTs) on pre-eclampsia. We investigated pre-eclampsia RCTs between 1987 and 2021 and reported on trustworthiness, risk of biases, p-values, transparency, and usefulness.</div></div><div><h3>Methods</h3><div>We searched PubMed for RCTs containing “pre-eclampsia” or “hypertensive disorders of pregnancy” in the title between 1987 and 2021. We created a transparency, trustworthiness and usefulness checklist, and recorded the characteristics of p-value reporting, RCT characteristics including registration, journal of publication, and outcomes.</div></div><div><h3>Results</h3><div>We found 202 RCTs, with the median number of authors increasing from four in 1987 to 12 in 2021. Trial registration increased nearly seven-fold from 17/93 between 1987–2010 to 79/109 RCTs registered between 2011–2021. Between 2010–2021, 338 p-values were published in the abstract with a rise in non-significant p-values (significant vs non-significant: 214/338, 63% vs 124/338, 37%). The number of effect sizes published increased by 58% from 659 in 1987–2010 to 1,038 in 2011–2021. The median of combined transparency and usefulness scores of RCTs improved from 6 to 9 out of 13, between 1987–1991 and 2017–2021. From the trustworthiness checklist, trials performed worst at adequate registration (43/202, 21%). Risk of reporting, performance, and detection biases were detected in most RCTs (166/202, 82%, 131/202, 65% and 141/202, 70% respectively).</div></div><div><h3>Conclusion</h3><div>The reporting of non-significant p-values and effect sizes increased after mandatory trial registration in 2010, along with the transparency and trustworthiness of most trials. RCTs need to be more transparent, trustworthy, and useful to increase the value of research.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101181"},"PeriodicalIF":2.5,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899496","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}
引用次数: 0
Systematic treatment and management of postpartum hypertension using remote patient monitoring 产后高血压远程监护的系统治疗与管理。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2024-12-21 DOI: 10.1016/j.preghy.2024.101180
Easha Patel , Courtney Bisson , Sunitha Suresh , Ariel Mueller , Colleen Duncan , Sajid Shahul , Ernst Lengyel , Sarosh Rana
{"title":"Systematic treatment and management of postpartum hypertension using remote patient monitoring","authors":"Easha Patel ,&nbsp;Courtney Bisson ,&nbsp;Sunitha Suresh ,&nbsp;Ariel Mueller ,&nbsp;Colleen Duncan ,&nbsp;Sajid Shahul ,&nbsp;Ernst Lengyel ,&nbsp;Sarosh Rana","doi":"10.1016/j.preghy.2024.101180","DOIUrl":"10.1016/j.preghy.2024.101180","url":null,"abstract":"<div><h3>Objective</h3><div>To describe postpartum visit attendance and postpartum blood pressure control among patients enrolled in a remote patient monitoring program and compare these outcomes by race.</div></div><div><h3>Study design</h3><div>A prospective cohort study of postpartum patients with a diagnosis of hypertensive disorders of pregnancy at the University of Chicago between October 2021 and April 2022. All patients received remote patient monitoring as routine care but consented separately for the use of their data. Data were obtained from the electronic medical record for up to six weeks postpartum.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was attendance at the first postpartum blood pressure check visit. Secondary outcomes included postpartum blood pressure control, readmissions, and remote patient monitoring response rates. Outcomes were compared by patient-reported race.</div></div><div><h3>Results</h3><div>545 patients were enrolled in the remote patient monitoring program, of which 306 consented to data collection. 64.7% of patients identified as Black/African American. Attendance for first postpartum blood pressure check was high (overall 84.0%, Black 81.3% and non-Black 88.9%, p = 0.08). The rate of Stage 2 hypertension at six weeks was higher among Black patients than non-Black patients (22.4% vs 2.2%, p &lt; 0.0001). Engagement with remote patient monitoring decreased over the 6-week period, with more attrition among Black patients.</div></div><div><h3>Conclusion</h3><div>There was a high follow-up rate across all patients regardless of race and a decrease in hypertension over the six-week period. However, rates of hypertension were higher, and engagement with the program lower in Black patients, suggesting further work is needed to address this gap.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101180"},"PeriodicalIF":2.5,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878231","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}
引用次数: 0
Letter to the editor: Signs or symptoms of suspected preeclampsia – A retrospective national database study of prevalence, costs, and outcomes 致编辑的信:疑似子痫前期的体征或症状--关于患病率、费用和结果的全国性回顾性数据库研究。
IF 2.5 4区 医学
Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health Pub Date : 2024-12-12 DOI: 10.1016/j.preghy.2024.101176
Ramsha Naeem , Mahima Khatri , Satesh Kumar
{"title":"Letter to the editor: Signs or symptoms of suspected preeclampsia – A retrospective national database study of prevalence, costs, and outcomes","authors":"Ramsha Naeem ,&nbsp;Mahima Khatri ,&nbsp;Satesh Kumar","doi":"10.1016/j.preghy.2024.101176","DOIUrl":"10.1016/j.preghy.2024.101176","url":null,"abstract":"","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101176"},"PeriodicalIF":2.5,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819746","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}
引用次数: 0
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