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

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"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}

{"title":"Inpatient versus outpatient management of gestational hypertension or preeclampsia without severe features","authors":"Blake Neuburg ,&nbsp;Meghan Gallagher ,&nbsp;Melodee Liegl ,&nbsp;Amy Y Pan ,&nbsp;Anna Palatnik","doi":"10.1016/j.preghy.2024.101173","DOIUrl":"10.1016/j.preghy.2024.101173","url":null,"abstract":"<div><h3>Objective</h3><div>To compare<!--> <!-->maternal and neonatal outcomes in patients diagnosed with gestational hypertension or preeclampsia without severe features by outpatient versus inpatient management.</div></div><div><h3>Materials and methods</h3><div>This was a single center, retrospective, cohort study of patients with hypertensive disorder of pregnancy (HDP) before 37 weeks’ gestation from January 2014 to March 2022. Patients were triaged to inpatient or outpatient management at the discretion of their obstetrician. Patients with an initial presentation of severe features were excluded. Bivariate and multivariate analyses were used to compare the primary outcome, severe maternal morbidity (SMM) as defined by one or more of the 21 CDC maternal morbidity identifiers, and the secondary outcomes of maternal ICU admission, development of severe features, placental abruption, time from diagnosis to giving birth, preterm birth &lt; 37 weeks, low birthweight (&lt;2500 g), 5-minute Apgar score &lt; 7, and stillbirth.</div></div><div><h3>Results</h3><div>A total of 272 patients met the inclusion criteria with 229 (84.2 %) being managed outpatient and 43 (15.8 %) managed inpatient. In univariate analysis, outpatient management was associated with lower incidence of SMM, an increased interval from diagnosis of HDP to giving birth, an increased interval to onset of severe features, and a lower incidence of maternal ICU admission. In multivariate analysis, outpatient management remained associated with lower odds of SMM, (aOR 0.18, 95 % CI 0.05–0.59) and improved neonatal outcomes with lower incidence of 5-minute APGAR score less than 7 (aOR 0.32, 95 % CI 0.13–0.82), low birth weight (aOR 0.37 95 % CI 0.17–0.79), and preterm birth (aOR 0.31, 95 % CI 0.15–0.67).</div></div><div><h3>Conclusion</h3><div>Outpatient management of HDP was associated with lower rates of SMM and adverse maternal and neonatal outcomes. While not all confounding factors were measured, the clinical decision regarding HDP management settings was associated with good diagnostic capability.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101173"},"PeriodicalIF":2.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814275","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":"Glycosylated fibronectin as a biomarker for preeclampsia and preeclampsia-related complications","authors":"Anna C.M. Kluivers ,&nbsp;Rugina I. Neuman ,&nbsp;Bhanu Kalra ,&nbsp;Ajay Kumar ,&nbsp;Willy Visser ,&nbsp;A.H. Jan Danser ,&nbsp;Langeza Saleh","doi":"10.1016/j.preghy.2024.101177","DOIUrl":"10.1016/j.preghy.2024.101177","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate glycosylated fibronectin (GlyFn) as a novel biomarker for preeclampsia and preeclampsia-related complications, and to compare GlyFn to traditional biomarkers, including soluble Fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF).</div></div><div><h3>Study Design</h3><div>Secondary analysis of a prospective cohort study (n = 524) with suspected preeclampsia (control), gestational hypertension (GH), or confirmed preeclampsia/hemolysis, elevated liver enzymes and low platelets syndrome (PE/HELLP).</div></div><div><h3>Main outcome Measures</h3><div>GlyFn levels in PE/HELLP versus control and GH. Its association with preeclampsia-related complications, and its added value on top of a traditional model incorporating gestational age, proteinuria, parity, and blood pressure. A comparison of all GlyFn-related performances versus those of sFlt-1 and PlGF.</div></div><div><h3>Results</h3><div>A significant elevation in GlyFn levels in patients with GH and PE/HELLP was observed versus control. Notably, GlyFn displayed positive correlations with sFlt-1 and the sFlt-1/PlGF ratio, and a negative correlation with PlGF. GlyFn alone outperformed the traditional model in predicting maternal but not fetal complications. This pattern was also observed for sFlt-1, PlGF and their ratio. Combining GlyFn with the traditional model, enhanced the C-index for maternal complications. However, the GlyFn/PlGF ratio, when added to the traditional model, yielded the best results for predicting fetal complications in the overall cohort. In women with a GA &lt; 37 weeks, the latter combination also showed the best predictive value for predicting maternal complications.</div></div><div><h3>Conclusions</h3><div>GlyFn is a novel biomarker for PE diagnosis and its complications, particularly at GA &lt; 37 weeks. Prospective studies should evaluate to what degree it outperforms traditional biomarkers.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"39 ","pages":"Article 101177"},"PeriodicalIF":2.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814290","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":"Effectiveness of calcium supplementation in the prevention of gestational hypertension: A systematic review and meta-analysis of randomised controlled trials","authors":"Qing Zhu,&nbsp;Qin Yu,&nbsp;Mengyao Liu,&nbsp;Yongqing Wei","doi":"10.1016/j.preghy.2024.101174","DOIUrl":"10.1016/j.preghy.2024.101174","url":null,"abstract":"<div><h3>Background</h3><div>Gestational hypertension and related disorders, such as preeclampsia, pose significant risks to maternal and foetal health. Calcium supplementation has been proposed as a preventive measure, but its effectiveness remains debated. This review assess the impact of calcium supplementation in prevention of gestational hypertension.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across multiple databases, including Scopus, EMBASE, PubMed, Web of Science, CINAHL, Cochrane CENTRAL, from inception to July 2024. Eligibility criteria included studies involving pregnant women at risk of gestational hypertension, comparing calcium supplementation to control group, and reporting on outcomes such as preeclampsia, pregnancy-induced hypertension, HELLP syndrome, preterm birth, and maternal mortality. Data were analysed using a random-effects inverse-variance model to calculate pooled risk ratios (RRs) and assess heterogeneity using Cochran’s Q and I2 statistics. Publication bias was evaluated using funnel plots and Egger’s test.</div></div><div><h3>Results</h3><div>22 studies with 39,270 individuals were included. Most studies had higher risk of bias. Calcium supplementation significantly reduced the risk of preeclampsia (pooled RR = 0.606, 95 %CI: 0.483–0.761, p &lt; 0.001) and pregnancy-induced hypertension (pooled RR = 0.870, 95 %CI: 0.759–0.996, p = 0.044). However, it showed no significant effect on HELLP syndrome, preterm birth, or mortality. Heterogeneity was moderate to substantial across outcomes, and publication bias was detected for preterm birth and pregnancy-induced hypertension.</div></div><div><h3>Conclusion</h3><div>Calcium supplementation during pregnancy significantly reduces the risk of preeclampsia and pregnancy-induced hypertension, highlighting its value as a cost-effective intervention for improving maternal health. These findings support integrating calcium supplementation into prenatal care strategies, particularly for populations with low dietary calcium intake.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":"38 ","pages":"Article 101174"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142747540","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}