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Bawah AT, Yeboah FA, Nanga S, Alidu H, Ngala RA. Serum adipocytokines and adiposity as predictive indices of preeclampsia. Clin Hypertens 2020; 26:19. [PMID: 33014422 PMCID: PMC7528484 DOI: 10.1186/s40885-020-00152-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 08/27/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND This study was aimed at determining the levels of serum adiponectin, leptin, resistin, visfatin and lipids during the first trimester in pregnant women and to evaluate the relationship between these biochemical markers and preeclampsia (PE). Available evidence point to changes in the levels of these adipokines in PE hence this study examined the potential of using these biomarkers in the prediction of the disease. METHODS This was a case-control study which compared first trimester serum biochemical and anthropometric parameters in pregnant women who subsequently developed PE and those who did not. Blood pressure and urine protein were determined after 20 weeks of gestation and diagnosis of PE performed according to the guidelines of the American Heart Association. RESULTS There was no significant difference (p > 0.05) in the lipid profile with the exception of HDL cholesterol which was significantly lower (p = 0.043) in the PE group compared to the normotensive group. There were, however, significant differences (p < 0.05) in the adipokines between the PE group and those without PE. Analyses of area under the receiver operating characteristic curves (AUCs) for the adipokines, showed their ability to correctly predict PE even after controlling for body mass index (BMI) and family history of hypertension. CONCLUSION Adiponectin, leptin, resistin and visfatin were found to be significant predictors of PE, with resistin being the best predictor after controlling for BMI. However, adiponectin was the best predictor after controlling for BMI, age, parity and family history of diabetes and preeclmapsia.
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Affiliation(s)
- Ahmed Tijani Bawah
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Health Sciences, PMB 31, Ho, Ghana
| | - Francis Agyemang Yeboah
- Department of Molecular Medicine, Kwame Nkrumah University Science and Technology, Kumasi, Ghana
| | - Salifu Nanga
- School of Basic and Biomedical Science, University of Health and Allied Sciences, Ho, Ghana
| | - Huseini Alidu
- Department of Medical Laboratory Science, School of Allied Health Sciences, University of Health and Allied Health Sciences, PMB 31, Ho, Ghana
| | - Robert A Ngala
- Department of Molecular Medicine, Kwame Nkrumah University Science and Technology, Kumasi, Ghana
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Beyuo T, Lawrence E, Langen ES, Oppong SA. Open-labelled randomised controlled trial of 12 hours versus 24 hours modified Pritchard regimen in the management of eclampsia and pre-eclampsia in Ghana (MOPEP Study): study protocol. BMJ Open 2019; 9:e032799. [PMID: 31641005 PMCID: PMC6830657 DOI: 10.1136/bmjopen-2019-032799] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/12/2019] [Accepted: 09/24/2019] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Hypertensive disorders of pregnancy continue to be a major contributor to maternal and perinatal morbidity and mortality. Magnesium sulfate therapy is the standard of care for seizure prophylaxis and treatment for pre-eclampsia and eclampsia respectively, despite wide disparities in dosing regimens and routes of administration. This study compares the clinical efficacy of magnesium sulfate in the reduction of seizure occurrence or recurrence with the 12 hours versus 24 hours modified Pritchard regimens in the management of severe pre-eclampsia and eclampsia. METHODS AND ANALYSIS This study is an open labelled randomised controlled trial. The study participants are patients admitted to the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana with a diagnosis of antepartum, intrapartum or postpartum eclampsia or pre-eclampsia with severe features. All study participants will be administered a loading dose of magnesium sulfate, followed by maintenance dosing. Participants in the control group will receive magnesium sulfate for 24 hours after diagnosis, while those in the treatment group will receive magnesium sulfate for 12 hours after diagnosis. The primary outcome of this study is the occurrence of a seizure any time after the completion of treatment in the assigned group. Secondary outcome measures include maternal health outcomes, magnesium sulfate toxicities and fetal health outcomes. Data collection was started in October 2018 with a target enrolment of 1245 participants with severe pre-eclampsia and 844 participants with eclampsia with a projected study period of 2-3 years. ETHICS AND DISSEMINATION Ethical approval was obtained from the KBTH Institutional Review Board (IRB) in Ghana. University of Michigan involvement is limited to protocol development and statistical analysis of de-identified data, and has been granted a Not Regulated Determination by the University of Michigan IRB. Results of the study will be shared at clinical forums at the KBTH and will be submitted for publication in an international peer-reviewed journal. TRIAL REGISTRATION NUMBER Pan African Clinical Trial Registry through the South African Medical Research Council (PACTR201811515303983).
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Affiliation(s)
- Titus Beyuo
- Obstetrics and Gynaecology, University of Ghana School of Medicine and Dentistry, Accra, Ghana
| | - Emma Lawrence
- Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth S Langen
- Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
| | - Samuel A Oppong
- Obstetrics and Gynaecology, University of Ghana School of Medicine and Dentistry, Accra, Ghana
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Ephraim RKD, Osakunor DNM, Denkyira SW, Eshun H, Amoah S, Anto EO. Serum calcium and magnesium levels in women presenting with pre-eclampsia and pregnancy-induced hypertension: a case-control study in the Cape Coast metropolis, Ghana. BMC Pregnancy Childbirth 2014; 14:390. [PMID: 25410280 PMCID: PMC4243325 DOI: 10.1186/s12884-014-0390-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 11/06/2014] [Indexed: 01/25/2023] Open
Abstract
Background Hypertensive disorders of pregnancy are important causes of morbidity and mortality. The levels of calcium (Ca2+) and magnesium (Mg2+) in pregnancy may implicate their possible role in pregnancy-induced hypertension. This study assessed serum Ca2+ and Mg2+ levels in women with PIH (pregnancy-induced hypertension) and PE (pre-eclampsia), compared to that in normal pregnancy. Methods This case–control study was conducted on 380 pregnant women (≥20 weeks gestation) receiving antenatal care at three hospitals in the Cape Coast metropolis, Ghana. This comprised 120 women with PIH, 100 women with PE and 160 healthy, age-matched pregnant women (controls). Demographic, anthropometric, clinical and obstetric data were gathered using an interview-based questionnaire. Venous blood samples were drawn for the estimation of calcium and magnesium. Results Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly raised in women with PIH (p < 0.0001) and PE (p < 0.0001). Women with hypertensive disorders (PE and PIH) had significantly lower serum calcium and magnesium levels than those in the control group (p < 0.0001 each). Of those with PIH, SBP correlated positively with BMI (r = 0.575, p < 0.01) and Ca2+ correlated positively with Mg2+ (r = 0.494, p < 0.01). This was similar amongst the PE group for SBP and BMI as well as for Ca2+and Mg2+ but was not significant. Multivariate analysis showed that women aged ≥40 years were at a significant risk of developing PIH (OR = 2.14, p = 0.000). Conclusion In this study population, serum calcium and magnesium levels are lower in PIH and PE than in normal pregnancy. Mineral supplementation during the antenatal period may influence significantly, the occurrence of hypertensive disorders in pregnancy.
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Ephraim R, Doe P, Amoah S, Antoh E. Lipid Profile and High Maternal Body Mass Index is Associated with Preeclampsia: A Case-Control Study of the Cape Coast Metropolis. Ann Med Health Sci Res 2014; 4:746-50. [PMID: 25328787 PMCID: PMC4199168 DOI: 10.4103/2141-9248.141542] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Preeclampsia is a leading cause of maternal mortality worldwide and a serious health problem that affects the majority of women. Aim: We investigated the association between lipid profile and maternal obesity among preeclamptic women in the Cape Coast Metropolis. Subject and Methods: This case–control study involved 60 preeclamptics and 50 healthy pregnant controls matched for age and gestational weeks consecutively recruited from two major hospitals in the Cape Coast Metropolis. Blood samples were collected after overnight fasting and enzymatic spectrophotometric tests used to estimate lipid concentrations. The independent samples t-test, Chi-square, and Pearson's correlation were used in the analysis of data gathered. Results: Serum triglyceride (TG) (P = 0.04), very low density lipoprotein (VLDL) (P = 0.02), TC (P = 0.01) and low density lipoprotein (LDL) (P = 0.03) levels were higher in preeclamptic participants than in the controls. High density lipoprotein concentration showed no significant variation between the two groups (P = 0.83). Preeclamptic women were more obese (P = 0.07). High body mass index (OR = 1.501; CI = 0.926-2.106, P = 0.01), high TG level (OR = 5.026; CI = 0.794-31.818, P = 0.01), were associated with preeclampsia. Conclusion: Lipid abnormalities, mostly elevated levels of TG, TC, LDL, and VLDL are present in preeclamptics. High TG levels and maternal obesity are associated with preeclampsia among pregnant women in the Cape Coast Metropolis.
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Affiliation(s)
- Rkd Ephraim
- Department of Medical Laboratory Technology, University Health Services, University of Cape Coast, Cape Coast, Ghana
| | - Pa Doe
- Department of Medical Laboratory Technology, University Health Services, University of Cape Coast, Cape Coast, Ghana
| | - S Amoah
- Department of Laboratory, University Health Services, University of Cape Coast, Cape Coast, Ghana
| | - Eo Antoh
- Department of Medical Laboratory Technology, University Health Services, University of Cape Coast, Cape Coast, Ghana
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Singh S, Ahmed EB, Egondu SC, Ikechukwu NE. Hypertensive disorders in pregnancy among pregnant women in a Nigerian Teaching Hospital. Niger Med J 2014; 55:384-8. [PMID: 25298602 PMCID: PMC4178334 DOI: 10.4103/0300-1652.140377] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Hypertensive disorders in pregnancy (HDP) represent a group of conditions associated with high blood pressure during pregnancy. It is an important cause of feto-maternal morbidity and mortality, particularly in developing countries. The aims of the study were to find the prevalence of hypertensive disorders and its associated risk factors among women attending the antenatal clinic of Usmanu Danfodiyo University Teaching Hospital,(UDUTH) Sokoto. Materials and Methods: A longitudinal study of 216 consecutively recruited women that were less than 20 weeks pregnant at booking was carried out. Blood pressure was measured for each woman at booking and at subsequent visits. Urinalysis was done at booking and whenever blood pressure was elevated. Patients were followed-up to delivery and 6 weeks postpartum. Data entry and analysis was done using Statistical Analysis System (SAS) statistical package. Results: The prevalence of HDP in the study was 17% while preeclampsia was 6%. Previous history of preeclampsia (P < 0.001; Relative risk (RR) 4.2; conficence interval (CI) 2.144-6.812), multiple gestation (P < 0.03; RR 3.8; CI 1.037-6.235), gestational diabetes (P < 0.02; RR 4.8; CI 1.910-6.751) and obesity (P < 0.002; RR 2.7; CI 1.373-5.511) were the significant risk factors in the development of HDP among the study population. Conclusion: The prevalence of HDP in the study group is high. Therefore, paying attention to the risk factors will ensure early detection and prevention of the progression of the disease and its sequelae.
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Affiliation(s)
- Swati Singh
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | - Shehu Constance Egondu
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Nwobodo Emmanuel Ikechukwu
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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Mahande MJ, Daltveit AK, Mmbaga BT, Masenga G, Obure J, Manongi R, Lie RT. Recurrence of preeclampsia in northern Tanzania: a registry-based cohort study. PLoS One 2013; 8:e79116. [PMID: 24223889 PMCID: PMC3815128 DOI: 10.1371/journal.pone.0079116] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 09/18/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Preeclampsia occurs in about 4 per cent of pregnancies worldwide, and may have particularly serious consequences for women in Africa. Studies in western countries have shown that women with preeclampsia in one pregnancy have a substantially increased risk of preeclampsia in subsequent pregnancies. We estimate the recurrence risks of preeclampsia in data from Northern Tanzania. METHODS A prospective cohort study was designed using 19,811 women who delivered singleton infants at a hospital in Northern Tanzania between 2000 and 2008. A total of 3,909 women were recorded with subsequent deliveries in the hospital with follow up through 2010. Adjusted recurrence risks of preeclampsia were computed using regression models. RESULTS The absolute recurrence risk of preeclampsia was 25%, which was 9.2-fold (95% CI: 6.4 - 13.2) compared with the risk for women without prior preeclampsia. When there were signs that the preeclampsia in a previous pregnancy had been serious either because the baby was delivered preterm or had died in the perinatal period, the recurrence risk of preeclampsia was even higher. Women who had preeclampsia had increased risk of a series of adverse pregnancy outcomes in future pregnancies. These include perinatal death (RR= 4.3), a baby with low birth weight (RR= 3.5), or a preterm birth (RR= 2.5). These risks were only partly explained by recurrence of preeclampsia. CONCLUSIONS Preeclampsia in one pregnancy is a strong predictor for preeclampsia and other adverse pregnancy outcomes in subsequent pregnancies in Tanzania. Women with previous preeclampsia may benefit from close follow-up during their pregnancies.
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Affiliation(s)
- Michael J. Mahande
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for International Health, University of Bergen, Bergen, Norway
- * E-mail:
| | - Anne K. Daltveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Blandina T. Mmbaga
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Centre for International Health, University of Bergen, Bergen, Norway
- Department of Pediatrics, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Gileard Masenga
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Joseph Obure
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Rachel Manongi
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Rolv T. Lie
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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