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Hung TH, Hsu TY, Hsu J, Ou CY, Liu PH, Lo LM, Shaw SW, Wan GH. Influence of gestational hypertension and maternal air pollutant exposure on birth outcomes. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:42264-42276. [PMID: 38865044 DOI: 10.1007/s11356-024-33944-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 06/04/2024] [Indexed: 06/13/2024]
Abstract
The relationship between exposure to air pollutants and fetal growth outcomes has shown inconsistency, and only a limited number of studies have explored the impact of air pollution on gestational hypertension and birth outcomes. This study aimed to evaluate how maternal exposure to air pollutants and blood pressure could influence fetal birth outcomes. A total of 55 women with gestational hypertension and 131 healthy pregnant women were enrolled in this study. Data pertaining to personal characteristics, prenatal examinations, outdoor air pollutant exposure, and fetal birth outcomes were collected. The study revealed that fetal birth weight and abdominal circumference exhibited a significant reduction among women with gestational hypertension compared to healthy pregnant women, even after adjustments for body mass index, gestational age, and exposure to air pollutants had been made. Moreover, maternal exposure to outdoor air pollutants displayed a notable correlation with decreased birth length of fetuses. Consequently, the study concluded that maternal blood pressure and exposure to outdoor air pollutants during pregnancy potentially stand as pivotal factors influencing fetal birth outcomes.
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Affiliation(s)
- Tai-Ho Hung
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Te-Yao Hsu
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jie Hsu
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yu Ou
- Department of Obstetrics, Po-Jen Hospital, Kaohsiung, Taiwan
| | - Pi-Hua Liu
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Liang-Ming Lo
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Steven W Shaw
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Gwo-Hwa Wan
- Department of Obstetrics and Gynecology, Taipei Chang Gung Memorial Hospital, Taipei, Taiwan.
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, 259, Wen-Hwa 1st Road, Kwei-Shan, Taoyuan, 333, Taiwan.
- Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
- Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, Taishan, New Taipei, Taiwan.
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Maraschini A, Salvi S, Colciago E, Corsi E, Cetin I, Lovotti M, Donati S. Eclampsia in Italy: A prospective population-based study (2017–2020). Pregnancy Hypertens 2022; 30:204-209. [DOI: 10.1016/j.preghy.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
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Ozdemir ME, Demirci O, Ozturkmen HA, Ulusoy NB, Ohanoglu K, Cilingir IU. What Is the Role of the Maternal Ophthalmic and Cervical Internal Carotid Arteries in Predicting Maternal Adverse Outcomes in Preeclampsia? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1527-1535. [PMID: 32049383 DOI: 10.1002/jum.15241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 01/22/2020] [Accepted: 01/27/2020] [Indexed: 05/27/2023]
Abstract
OBJECTIVES We aimed to investigate the efficacy of maternal ophthalmic artery (OA) and cervical internal carotid artery (CICA) in predicting adverse maternal outcomes and gestational age at birth in preeclampsia (PE). METHODS The study was performed at the Zeynep Kamil Women and Children's Diseases Training and Research Hospital. Measurements were made in 2 groups consisting of 50 pregnant women with PE and 50 healthy pregnant women. The peak systolic velocity (PSV), end-diastolic velocity, PI, RI, first diastolic peak velocity, systolic/diastolic (S/D) ratio, and peak ratio of the maternal OA were measured by a transorbital Doppler ultrasound (US) scan. The PSV, end-diastolic velocity, PI, RI, and S/D ratio of the CICA were measured. The differences of Doppler indices between groups with P < .05 were considered statistically significant. Cutoff values were calculated, which could be used to predict adverse maternal outcomes and gestational age at birth. RESULTS The RI and PI values of the OA were lower, and the first diastolic peak velocity, PSV, and peak ratio values were higher among the PE group. The RI and S/D values of the CICA were significantly lower in the PE group compared to the healthy group. The OA RI was determined to be the strongest US variable in predicting adverse maternal outcomes and gestational age at birth, with a cutoff value of 0.72, 76% sensitivity, and 76% specificity. CONCLUSIONS Maternal OA Doppler indices can be used as US markers to predict adverse maternal outcomes.
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Affiliation(s)
- Mucize Eric Ozdemir
- Departments of Perinatology, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Oya Demirci
- Departments of Perinatology, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Hatice Akay Ozturkmen
- Department of Radiology, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Nuray Bakal Ulusoy
- Department of Radiology, Health Science University, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Karolin Ohanoglu
- Health Science University, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Isil Uzun Cilingir
- Health Science University, Istanbul Training and Research Hospital, Istanbul, Turkey
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Jelena M, Sopić M, Joksić I, Zmrzljak UP, Karadžov-Orlić N, Košir R, Egić A, Miković Ž, Ninić A, Spasojević-Kalimanovska V. Placenta-specific plasma miR518b is a potential biomarker for preeclampsia. Clin Biochem 2020; 79:28-33. [PMID: 32092293 DOI: 10.1016/j.clinbiochem.2020.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/06/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION MicroRNAs have a significant role in the pathogenesis of preeclampsia. Circulating microRNAs could represent a potential biomarker for preeclampsia. The aim of this study was to evaluate plasma miR210-3p and miR518b in preeclampsia and healthy pregnancy for the first time by digital droplet PCR (ddPCR). METHODS Thirty-six pregnant women (seventeen healthy pregnancies, nineteen preeclampsia patients) were involved from the Clinic for Gynaecology and Obstetrics "Narodni front" in Belgrade, Serbia. Plasma miR210-3p, miR518b and cel-miR-39 as a spike-in control were measured by ddPCR. RESULTS MiR518b was significantly elevated in preeclampsia compared to a healthy pregnancy (P = 0.034; 0.302(0.217-0.421) vs. 0.171(0.110-0.266)). MiR210-3p showed no significant difference between the two groups (P = 0.951). The adjustment of miR518b was made for a gestational age and smoking status and the difference between the preeclampsia and healthy pregnancy group was more significant (P = 0.026; 0.300(0.216-0.419) vs. 0.172(0.121-0.245)). Plasma miR-518b was significantly higher in the group of preeclampsia patients with proteinuria above the 75th percentile for the group (P = 0.033), in women who smoked (P = 0.039), and was positively related to uric acid in preeclampsia (P = 0.018, r = 0.536). Plasma miR518b was able to significantly discriminate between preeclampsia and healthy pregnancy, yielding AUC of 0.712 (95%CI:0.539-0.891), P = 0.028. CONCLUSIONS In this study plasma microRNA were measured for the first time in preeclampsia and healthy pregnancies with ddPCR. Placenta-specific miR-518b could serve as a potential biomarker for discriminating preeclampsia and healthy pregnancy, which should be confirmed on a larger study population. This study has failed to confirm the same potential for miR210-3p.
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Affiliation(s)
- Munjas Jelena
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Street Vojvode Stepe 450, 11000 Belgrade, Serbia.
| | - Miron Sopić
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Street Vojvode Stepe 450, 11000 Belgrade, Serbia.
| | - Ivana Joksić
- Genetic Laboratory Department, Obstetrics and Gynaecology Clinic "Narodni Front", Street Kraljice Natalije 62, 11000 Belgrade, Serbia
| | | | - Nataša Karadžov-Orlić
- High-Risk Pregnancy Department, Obstetrics and Gynaecology Clinic "Narodni Front", Street Kraljice Natalije 62, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Street Dr Subotica 8, 11000 Belgrade, Serbia
| | - Rok Košir
- BIA Separations CRO, Labena Ltd., Street Verovškova 64, 1000 Ljubljana, Slovenia.
| | - Amira Egić
- High-Risk Pregnancy Department, Obstetrics and Gynaecology Clinic "Narodni Front", Street Kraljice Natalije 62, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Street Dr Subotica 8, 11000 Belgrade, Serbia
| | - Željko Miković
- High-Risk Pregnancy Department, Obstetrics and Gynaecology Clinic "Narodni Front", Street Kraljice Natalije 62, 11000 Belgrade, Serbia; School of Medicine, University of Belgrade, Street Dr Subotica 8, 11000 Belgrade, Serbia
| | - Ana Ninić
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Street Vojvode Stepe 450, 11000 Belgrade, Serbia.
| | - Vesna Spasojević-Kalimanovska
- Department of Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Street Vojvode Stepe 450, 11000 Belgrade, Serbia.
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Pilot Interventional Study Comparing Fetomaternal Outcomes of 150 mg Versus 75 mg Aspirin Starting Between 11 and 14 Weeks of Pregnancy in Patients with High Risk of Preeclampsia: A Randomized Control Trial. J Obstet Gynaecol India 2019; 70:23-29. [PMID: 32030002 DOI: 10.1007/s13224-019-01277-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/09/2019] [Indexed: 01/15/2023] Open
Abstract
Introduction Hypertensive disorders of pregnancies complicate around 5-10% of pregnancies worldwide, and together they are a member of the deadly triad along with haemorrhage and infection that contribute to a significant amount of maternal morbidity and mortality. Aims and Objectives To compare differences in the fetomaternal outcomes with the use of 150 mg aspirin versus 75 mg aspirin in pregnant women found to be at high risk of PE. Methodology This was a two-armed double-blind parallel randomized control trial conducted in the Department of Obstetrics and Gynaecology, King George's Medical University, carried over a period of 1 year. Results Preeclampsia occurred in 15 of 87 participants (17%) in the 75 mg aspirin group compared with 6 of 91 (6.5%) in the 150 mg aspirin group. There were a significantly higher incidence of PE, its severity and lesser period of gestation at delivery in the group given 75 mg dose compared to the group given 150 mg dose. There were significantly higher values of mean arterial pressure and uterine artery PI in women who developed preeclampsia compared to those who do not in both the groups. Foetal outcomes were observed in both the groups of women, and there was no statistically significant difference between them. Conclusion This randomized trial showed that among women with singleton pregnancies who were identified by means of first-trimester screening as being at high risk of preterm preeclampsia, use of aspirin 150 mg per day started between 11 and 14 weeks till 36 weeks is a potent intervention to reduce the development of both early- and late-onset preeclampsia as compared to a dose of 75 mg per day.
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Sharma K, Singh R, Kumar M, Gupta U, Rohil V, Bhattacharjee J. First-Trimester Inflammatory Markers for Risk Evaluation of Pregnancy Hypertension. J Obstet Gynaecol India 2018; 68:27-32. [PMID: 29391672 PMCID: PMC5783907 DOI: 10.1007/s13224-017-0988-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 03/28/2017] [Indexed: 01/30/2023] Open
Abstract
Introduction Hypertension in pregnancy is one of the potential causes of maternal and fetal morbidity and mortality. It complicates 7-10% of pregnancies. As of today, prediction of pregnancy hypertension is not possible. Aim and Objectives Evaluation of pregnancy associated plasma protein-A (PAPP-A), free β-human chorionic gonadotropin, tumor necrosis factor-α (TNF-α) and interferon gamma (INF-γ) in establishing a biomarker or combination of biomarkers for the early identification of pregnancy hypertension. Methodology This prospective study was carried out in two phases. Phase I was a cohort study in which 2000 pregnant women were enrolled in their first trimester (11 + 0 to 13 + 6 weeks of gestation) and followed till delivery. Women who developed hypertension were compared with normotensive cohort (women who remained normotensive till term). Phase II was a case-control study. The women who were diagnosed with hypertension in phase I were cases and their controls were matched for gestational age and sample storage time from normotensive cohort population. Two additional proinflammatory markers TNF-α and INF-γ were evaluated in this case-control population. Results Out of 2000 women, 199 women developed hypertension and 1454 women remained normotensive throughout their pregnancy. Among 199 hypertensive women, 151 (9.13%) cases had gestational hypertension, 45 (2.72%) had preeclampsia (PE) and 3 (0.18%) had eclampsia (E). First trimester mean arterial pressure (MAP) (p < 0.001) and body mass index (BMI) (p < 0.001) were found significantly higher in hypertensive women when compared with normotensive women. Maternal serum levels of PAPP-A (p < 0.001) were significantly low in hypertensive women as compared to normotensive women, while free β-hCG (p = 0.59) was high, but the difference was not statistically significant. TNF-α (p < 0.001) and INF-γ (p = 0.014) both were high in hypertensive women. When all biomarkers were combined we found the positive predictive value (PPV) of 51.6% an negative predictive value (NPV) of 71.4%. Conclusion Increased levels of proinflammatory cytokines suggest the role of underlying inflammation in pathogenesis of pregnancy hypertension, and low PAPP-A may be attributed to impaired implantation. Combining biomarkers may improve the prediction of pregnancy hypertension in the early stages of gestation. NPV of 71.4% depicts that if woman has all biomarkers in normal ranges during first trimester, she will have 71.4% chances of remaining normotensive during pregnancy.
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Affiliation(s)
- Karuna Sharma
- Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - Ritu Singh
- Biochemistry, Lady Hardinge Medical College, New Delhi, India
| | - Manisha Kumar
- Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi, India
| | - Usha Gupta
- ESIC Medical College, Faridabad, Haryana India
| | - Vishwajeet Rohil
- Clinical Biochemistry, Vallabhbhai Patel Chest Institute, New Delhi, India
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Meeme A, Buga GA, Mammen M, Namugowa AV. Angiogenic imbalance as a contributor to the pathophysiology of preeclampsia among black African women. J Matern Fetal Neonatal Med 2016; 30:1335-1341. [DOI: 10.1080/14767058.2016.1212832] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Olatunji RB, Adekanmi AJ, Obajimi MO, Roberts OA, Ojo TO. Maternal ophthalmic artery Doppler velocimetry in pre-eclampsia in Southwestern Nigeria. Int J Womens Health 2015; 7:723-34. [PMID: 26229508 PMCID: PMC4514353 DOI: 10.2147/ijwh.s86314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Pre-eclampsia (PE) poses a serious challenge to maternal and fetal health in Africa. It is associated with hemodynamic changes that may affect the internal carotid/ophthalmic artery circulation with consequent neuro-ophthalmic manifestations. Ophthalmic artery Doppler (OAD) ultrasound is an important tool that can be used to detect hemodynamic changes in PE and monitor its severity. In this study, we evaluated hemodynamic changes on OAD ultrasound in the ophthalmic arteries of pre-eclamptic women and compared these with values in healthy pregnant women. METHODS OAD parameters, such as, peak systolic velocity, peak diastolic velocity, end diastolic velocity, pulsatility index, and peak ratio, were measured on transorbital triplex ultrasound scan with a 7-10 MHz multifrequency linear transducer in 42 consenting pre-eclamptic patients and 41 pregnant controls matched for maternal age, gestational age, and parity at the Department of Radiology, University College Hospital, Ibadan. Univariate, bivariate, and receiver operating characteristic curve data analyses were performed. P<0.05 was considered to be statistically significant. RESULTS Mean resistivity index, pulsatility index, and peak systolic velocity were significantly lower in pre-eclamptic patients than in the controls. Mean peak diastolic velocity, end diastolic velocity, and peak ratio were significantly higher in the pre-eclamptic group. The receiver operating characteristic curve showed that the resistivity index (sensitivity 75%, specificity 77.8%) could distinguish mild from severe PE while the peak ratio (sensitivity 90.5%, specificity 81.3%) could accurately detect PE. CONCLUSION OAD ultrasound can be used to monitor patients with PE for early detection of progression to severe forms before cerebral complications develop. OAD screening of patients at high risk for PE can also detect early changes of hemodynamic derangement.
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Affiliation(s)
| | | | | | | | - Temitope Olumuyiwa Ojo
- Department of Community Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
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Li LJ, Cheung CYL, Ikram MK, Gluckman P, Meaney MJ, Chong YS, Kwek K, Wong TY, Saw SM. Blood Pressure and Retinal Microvascular Characteristics During Pregnancy. Hypertension 2012; 60:223-30. [DOI: 10.1161/hypertensionaha.112.195404] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Changes in maternal blood pressure during pregnancy are associated with poor maternal and neonatal outcomes. We investigated whether maternal blood pressure during midpregnancy has an impact on the retinal microcirculation among pregnant Asian women. A total of 665 pregnant women aged 18 to 46 years were recruited from the Growing Up in Singapore Towards Healthy Outcomes Study. Blood pressure and retinal vascular parameters were both measured at 26 weeks' gestation following a standardized protocol. Blood pressure was measured by a digital automatic blood pressure monitor (Omron HEM 705 LP). Quantitative retinal vascular parameters were assessed by a semiautomated computer-based program (Singapore I Vessel Assessment, version 3.0). In multiple linear regression models, every 10-mm Hg increase in mean arterial blood pressure was associated with a 1.9-μm (
P
<0.001) reduction in retinal arteriolar caliber, a 0.9° (
P
=0.05) reduction in retinal arteriolar branching angle, and a 0.07 (
P
<0.01) reduction in retinal arteriolar fractal dimension, respectively. Patients classified into a high-risk group in developing preeclampsia (mean arterial blood pressure ≥90 mm Hg) were twice as likely (odds ratio 2.1 [95% CI, 1.0–4.4]) to have generalized retinal arteriolar narrowing compared with those classified into a low-risk group (mean arterial blood pressure <90 mm Hg). Retinal venular caliber and vascular tortuosity were not associated with blood pressure measures. Elevated blood pressure is associated with a range of retinal arteriolar changes in pregnant women, providing evidence for an impact of blood pressure on the microcirculation during pregnancy.
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Affiliation(s)
- Ling-Jun Li
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Carol Yim-Lui Cheung
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - M. Kamran Ikram
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Peter Gluckman
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Michael J. Meaney
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Yap-Seng Chong
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Kenneth Kwek
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Tien-Yin Wong
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
| | - Seang-Mei Saw
- From the Saw Swee Hock School of Public Health (L.-J.L., M.K.I., T.-Y.W., S.-M.S.), National University of Singapore, Singapore; Singapore Eye Research Institute (C.Y.-L.C., M.K.I., T.-Y.W., S.-M.S.), Singapore National Eye Centre, Singapore; Departments of Ophthalmology (C.Y.-L.C., T.-Y.W.) and Obstetrics and Gynecology (Y.-S.C.), National University Hospital, Singapore; DUKE-NUS Graduate Medical School (C.Y.-L.C., M.K.I.), Singapore; Department of Ophthalmology, Erasmus Medical Centre (M.K.I.),
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Moist L, Sontrop JM, Garg AX, Clark WF, Suri RS, Gratton R, Salvadori M, Nevis I, Macnab JJ. Risk of pregnancy-related hypertension within 5 years of exposure to drinking water contaminated with Escherichia coli O157:H7. J Clin Hypertens (Greenwich) 2010; 12:613-20. [PMID: 20695938 PMCID: PMC8816438 DOI: 10.1111/j.1751-7176.2010.00288.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Revised: 12/12/2009] [Accepted: 01/01/2010] [Indexed: 12/01/2022]
Abstract
The authors evaluated the risk for pregnancy-related hypertension among previously healthy women who conceived within 5 years of exposure to drinking water contaminated with Escherichia coli O157.H7 in Walkerton, Canada (2000). Chronic hypertension was defined as systolic/diastolic blood pressure >/=140/90 mm Hg before 20 weeks gestation; gestational hypertension was defined as new onset systolic/diastolic blood pressure >/=140/90 mm Hg >/=20 weeks gestation. The incidence of hypertension was compared between women who were asymptomatic during the outbreak to those who experienced acute gastroenteritis. Blood pressure data were available for 135 of 148 eligible pregnancies. The adjusted relative risks for chronic and gestational hypertension were 1.5 (95% confidence interval [CI]: 0.3-7.7) and 1.0 (95% CI: 0.4-2.5), respectively. Mean arterial pressure before 20 weeks gestation was 2.7 mm Hg higher in women who had acute gastroenteritis (95% CI: 0.05-5.4). A trend toward higher chronic hypertension and mean arterial pressure in early pregnancy was observed among women who experienced gastroenteritis after exposure to bacterially-contaminated drinking water.
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Affiliation(s)
- Louise Moist
- Division of Nephrology, Department of Medicine, Victoria Hospital-London Health Sciences Centre, 800 Commissioners Road East, London, Ontario, Canada.
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Kent A. Diagnosing preeclampsia. REVIEWS IN OBSTETRICS & GYNECOLOGY 2008; 1:146-147. [PMID: 19015767 PMCID: PMC2582640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Athol Kent
- Department of Obstetrics & Gynaecology, University of Cape Town Rondebosch, South Africa
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