Annettee Nakimuli, Emmy Okello, Annette Kesiiga, Moses Adroma, Jackline Akello, Sheila Nabweyambo, Musa Sekikubo, Imelda Namagembe, Robert Kayesubula, Ronald Galiwango, Brittany Jasper, Ashley Moffett, Catherine E. Aiken, Ian B. Wilkinson, Carmel M. McEniery
{"title":"子痫前期非洲妇女产后心血管健康：一项前瞻性队列研究","authors":"Annettee Nakimuli, Emmy Okello, Annette Kesiiga, Moses Adroma, Jackline Akello, Sheila Nabweyambo, Musa Sekikubo, Imelda Namagembe, Robert Kayesubula, Ronald Galiwango, Brittany Jasper, Ashley Moffett, Catherine E. Aiken, Ian B. Wilkinson, Carmel M. McEniery","doi":"10.1111/1471-0528.18192","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To investigate the prevalence of hypertension and cardiovascular dysfunction 1 year postpartum in Black African women who experienced pre-eclampsia in a low-resource setting in Uganda.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Prospective cohort study.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Tertiary referral hospital in urban Uganda.</p>\n </section>\n \n <section>\n \n <h3> Population</h3>\n \n <p>Pregnant women who developed pre-eclampsia between 2019 and 2021, matched to normotensive controls with maternal and gestational age.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Sociodemographic, clinical and laboratory data were collected at recruitment and 1 year postpartum. Baseline characteristics and incidence rate ratios were calculated to assess risk factors for developing hypertension. Multivariable conditional Poisson regression adjusted for matched study design was used to analyse outcomes.</p>\n </section>\n \n <section>\n \n <h3> Main Outcome Measures</h3>\n \n <p>The primary outcome was hypertension (≥ 140/≥ 90 mmHg) at 1 year postpartum. Secondary outcomes included aortic pulse wave velocity, left ventricular mass index, and left ventricular ejection fraction at 1 year postpartum.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>At one-year postpartum, hypertension prevalence was higher among women with pre-eclampsia than controls (36.4% (96/264) versus 4.5% (12/264); aIRR 1.26, 95% CI 1.16–1.36, <i>p</i> < 0.001). Postpartum median aortic pulse wave velocity was increased in women with pre-eclampsia (6.45 ± 0.76 m/s vs. 5.67 ± 0.22 m/s, <i>p</i> < 0.001). Left ventricular mass indexed to body surface area was increased in women with pre-eclampsia (71.7 ± 19.6 g vs. 76.5 ± 23.2 g, <i>p</i> < 0.01). Left ventricular ejection fraction was not influenced by pre-eclampsia (<i>p</i> = 0.35).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In this low-resource setting, black African women with pre-eclampsia had increased cardiovascular risk markers at one year postpartum. Over one-third of women with pre-eclampsia developed hypertension at one year postpartum, emphasising the need for postpartum blood pressure monitoring and early intervention to mitigate long-term cardiovascular risk in this high-risk population.</p>\n </section>\n </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 9","pages":"1319-1328"},"PeriodicalIF":4.7000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18192","citationCount":"0","resultStr":"{\"title\":\"Postpartum Cardiovascular Health in African Women Following Pre-Eclampsia: A Prospective Cohort Study\",\"authors\":\"Annettee Nakimuli, Emmy Okello, Annette Kesiiga, Moses Adroma, Jackline Akello, Sheila Nabweyambo, Musa Sekikubo, Imelda Namagembe, Robert Kayesubula, Ronald Galiwango, Brittany Jasper, Ashley Moffett, Catherine E. Aiken, Ian B. Wilkinson, Carmel M. McEniery\",\"doi\":\"10.1111/1471-0528.18192\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To investigate the prevalence of hypertension and cardiovascular dysfunction 1 year postpartum in Black African women who experienced pre-eclampsia in a low-resource setting in Uganda.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Prospective cohort study.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>Tertiary referral hospital in urban Uganda.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Population</h3>\\n \\n <p>Pregnant women who developed pre-eclampsia between 2019 and 2021, matched to normotensive controls with maternal and gestational age.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Sociodemographic, clinical and laboratory data were collected at recruitment and 1 year postpartum. Baseline characteristics and incidence rate ratios were calculated to assess risk factors for developing hypertension. Multivariable conditional Poisson regression adjusted for matched study design was used to analyse outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Main Outcome Measures</h3>\\n \\n <p>The primary outcome was hypertension (≥ 140/≥ 90 mmHg) at 1 year postpartum. Secondary outcomes included aortic pulse wave velocity, left ventricular mass index, and left ventricular ejection fraction at 1 year postpartum.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>At one-year postpartum, hypertension prevalence was higher among women with pre-eclampsia than controls (36.4% (96/264) versus 4.5% (12/264); aIRR 1.26, 95% CI 1.16–1.36, <i>p</i> < 0.001). Postpartum median aortic pulse wave velocity was increased in women with pre-eclampsia (6.45 ± 0.76 m/s vs. 5.67 ± 0.22 m/s, <i>p</i> < 0.001). Left ventricular mass indexed to body surface area was increased in women with pre-eclampsia (71.7 ± 19.6 g vs. 76.5 ± 23.2 g, <i>p</i> < 0.01). Left ventricular ejection fraction was not influenced by pre-eclampsia (<i>p</i> = 0.35).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>In this low-resource setting, black African women with pre-eclampsia had increased cardiovascular risk markers at one year postpartum. 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Postpartum Cardiovascular Health in African Women Following Pre-Eclampsia: A Prospective Cohort Study
Objective
To investigate the prevalence of hypertension and cardiovascular dysfunction 1 year postpartum in Black African women who experienced pre-eclampsia in a low-resource setting in Uganda.
Design
Prospective cohort study.
Setting
Tertiary referral hospital in urban Uganda.
Population
Pregnant women who developed pre-eclampsia between 2019 and 2021, matched to normotensive controls with maternal and gestational age.
Methods
Sociodemographic, clinical and laboratory data were collected at recruitment and 1 year postpartum. Baseline characteristics and incidence rate ratios were calculated to assess risk factors for developing hypertension. Multivariable conditional Poisson regression adjusted for matched study design was used to analyse outcomes.
Main Outcome Measures
The primary outcome was hypertension (≥ 140/≥ 90 mmHg) at 1 year postpartum. Secondary outcomes included aortic pulse wave velocity, left ventricular mass index, and left ventricular ejection fraction at 1 year postpartum.
Results
At one-year postpartum, hypertension prevalence was higher among women with pre-eclampsia than controls (36.4% (96/264) versus 4.5% (12/264); aIRR 1.26, 95% CI 1.16–1.36, p < 0.001). Postpartum median aortic pulse wave velocity was increased in women with pre-eclampsia (6.45 ± 0.76 m/s vs. 5.67 ± 0.22 m/s, p < 0.001). Left ventricular mass indexed to body surface area was increased in women with pre-eclampsia (71.7 ± 19.6 g vs. 76.5 ± 23.2 g, p < 0.01). Left ventricular ejection fraction was not influenced by pre-eclampsia (p = 0.35).
Conclusions
In this low-resource setting, black African women with pre-eclampsia had increased cardiovascular risk markers at one year postpartum. Over one-third of women with pre-eclampsia developed hypertension at one year postpartum, emphasising the need for postpartum blood pressure monitoring and early intervention to mitigate long-term cardiovascular risk in this high-risk population.
期刊介绍：
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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