-
European Journal of Epidemiology Oct 2018Women with a history of hypertensive disorders of pregnancy (HDP; preeclampsia and gestational hypertension) or delivering low birth weight offspring (LBW; < 2500 g)...
Women with a history of hypertensive disorders of pregnancy (HDP; preeclampsia and gestational hypertension) or delivering low birth weight offspring (LBW; < 2500 g) have twice the risk of cardiovascular disease (CVD). We aimed to study the extent to which history of these pregnancy complications improves CVD risk prediction above and beyond conventional predictors. Parous women attended standardized clinical visits in Sweden. Data were linked to registries of deliveries and CVD. Participants were followed for a first CVD event within 10 years from age 50 (n = 7552) and/or 60 years (n = 5360) and the predictive value of each pregnancy complication above and beyond conventional predictors was investigated. History of LBW offspring was associated with increased risk of CVD when added to conventional predictors in women 50 years of age [Hazard ratio 1.68, 95% Confidence interval (CI) 1.19, 2.37] but not at age 60 (age interaction p = 0.04). However, at age 50 years CVD prediction was not further improved by information on LBW offspring, except that a greater proportion of the women who developed CVD were assigned to a higher risk category (categorical net reclassification improvement for events 0.038, 95% CI 0.003, 0.074). History of HDP was not associated with CVD when adjusted for reference model predictors. In conclusion, a history of pregnancy complications can identify women with increased risk of CVD midlife. However, considered with conventional risk factors, history of HDP or having delivered LBW offspring did not meaningfully improve 10-year CVD risk prediction in women age 50 years or older.
Topics: Cardiovascular Diseases; Female; Humans; Hypertension; Hypertension, Pregnancy-Induced; Middle Aged; Myocardial Infarction; Pregnancy; Pregnancy Complications, Cardiovascular; Prospective Studies; Registries; Reproductive History; Risk Assessment; Risk Factors; Stroke; Surveys and Questionnaires; Sweden; Time Factors
PubMed: 30062549
DOI: 10.1007/s10654-018-0429-1 -
Infection, Genetics and Evolution :... Aug 2021With the background of association of oxidative stress and Hepatitis E virus (HEV) infection in pregnancy complications the present novel study aimed to evaluate the...
With the background of association of oxidative stress and Hepatitis E virus (HEV) infection in pregnancy complications the present novel study aimed to evaluate the significance of changes in maternal homocysteine levels and the related mechanism(s) in the pathophysiology of HEV related pregnancy complications and negative outcomes. Term delivery (TD, N = 194) and HEV-IgM positive pregnancy cases [N = 109] were enrolled. Serum and placental homocysteine levels were evaluated by ELISA and immunofluorescence and in turn correlated with serum Vitamin B12 levels. Distribution of variant MTHFR C➔T and TYMS1494del6bp genotyping were studied by PCR-RFLP. Differential folate receptor alpha (FR-α) expression in placenta was evaluated by real-time PCR and immunofluorescence respectively. The HEV viral load was significantly higher in both FHF and AVH cases. Higher serum homocysteine levels was associated with preterm delivery (PTD) and fetal death in HEV infected cases and was significantly inversely correlated with serum VitaminB12 levels in HEV cases. Placental homocysteine expression was upregulated in HEV cases, and in cases with negative pregnancy outcome. A Homocysteine level was associated with MTHFR C677T status. Genetic alterations in folate pathway was associated with increased risk of PTD in HEV infected pregnancy cases, disease severity, and negative pregnancy outcome in AVH and FHF groups. FR-α expression was downregulated in placental tissues of HEV infected pregnancy.Placental stress caused by HEV inflicted increased homocysteine due to alterations in maternal vitamin B12 levels and folate pathway components is detrimental mechanism in PTD and negative pregnancy outcome in HEV infected pregnancy cases and holds prognostic and therapeutic significance.
Topics: Adult; Female; Hepatitis E; Hepevirus; Homocysteine; Humans; India; Oxidative Stress; Pregnancy; Pregnancy Complications, Infectious; Young Adult
PubMed: 33905889
DOI: 10.1016/j.meegid.2021.104882 -
CMAJ : Canadian Medical Association... Nov 2012Adults who were born with low birth weights are at increased risk of cardiovascular and metabolic conditions, including pregnancy complications. Low birth weight can... (Comparative Study)
Comparative Study
BACKGROUND
Adults who were born with low birth weights are at increased risk of cardiovascular and metabolic conditions, including pregnancy complications. Low birth weight can result from intrauterine growth restriction, preterm birth or both. We examined the relation between preterm birth and pregnancy complications later in life.
METHODS
We conducted a population-based cohort study in the province of Quebec involving 7405 women born preterm (554 < 32 weeks, 6851 at 32-36 weeks) and a matched cohort of 16 714 born at term between 1976 and 1995 who had a live birth or stillbirth between 1987 and 2008. The primary outcome measures were pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia or eclampsia).
RESULTS
Overall, 19.9% of women born at less than 32 weeks, 13.2% born at 32-36 weeks and 11.7% born at term had at least 1 pregnancy complication at least once during the study period (p < 0.001). Women born small for gestational age (both term and preterm) had increased odds of having at least 1 pregnancy complication compared with women born at term and at appropriate weight for gestational age. After adjustment for various factors, including birth weight for gestational age, the odds of pregnancy complications associated with preterm birth was elevated by 1.95-fold (95% confidence interval [CI] 1.54-2.47) among women born before 32 weeks' gestation and 1.14-fold (95% CI 1.03-1.25) among those born at 32-36 weeks' gestation relative to women born at term.
INTERPRETATION
Being born preterm, in addition to, and independent of, being small for gestational age, was associated with a significantly increased risk of later having pregnancy complications.
Topics: Adult; Confidence Intervals; Cross-Sectional Studies; Eclampsia; Female; Gestational Age; Humans; Incidence; Infant, Newborn; Infant, Premature; Infant, Small for Gestational Age; Maternal Age; Maternal Welfare; Odds Ratio; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Quebec; Risk Assessment; Young Adult
PubMed: 23008489
DOI: 10.1503/cmaj.120143 -
Critical Care Medicine Oct 2005To provide an evidence-based, up-to-date review of the literature regarding the assessment and management of acute renal failure that may affect women during pregnancy... (Review)
Review
OBJECTIVES
To provide an evidence-based, up-to-date review of the literature regarding the assessment and management of acute renal failure that may affect women during pregnancy and the postpartum period.
DESIGN
A review of the current literature was performed.
RESULTS
Acute renal failure is a rare complication of pregnancy but is associated with significant morbidity and mortality. Management requires knowledge of the renal physiologic changes occurring in pregnancy and the relevant diagnoses, both pregnancy-specific and those that may coincidentally occur with pregnancy. In addition, fetal effects must be taken into consideration.
CONCLUSIONS
Ideal care for women with acute renal failure in pregnancy or postpartum requires a multidisciplinary approach that may include maternal-fetal medicine, critical care medicine, nephrology, and neonatology specialists.
Topics: Acid-Base Equilibrium; Acute Kidney Injury; Critical Care; Female; Humans; Pregnancy; Pregnancy Complications
PubMed: 16215361
DOI: 10.1097/01.ccm.0000183155.46886.c6 -
American Journal of Reproductive... Aug 2010Pregnancy outcome in women with a previous history of drug allergy and the role of drug allergies in adverse pregnancy outcomes is unclear.
PROBLEM
Pregnancy outcome in women with a previous history of drug allergy and the role of drug allergies in adverse pregnancy outcomes is unclear.
METHOD OF STUDY
A retrospective cohort study comparing pregnancies of women with and without history of drug allergy was conducted. Data were collected from the computerized perinatal database. A multiple logistic regression model, with background elimination, was constructed to control for confounders.
RESULTS
Of 186,443 deliveries, 4.6% (n = 8647) occurred in patients with a history of drug allergy. The following conditions were significantly associated with a history of drug allergy: advanced maternal age, recurrent abortions, fertility treatments, hypertensive disorders, and diabetes mellitus. Using multivariate analysis, with background elimination, history of drug allergy was significantly associated with intrauterine growth restriction (OR = 1.52, CI = 1.3-0.8, P < 0.001) and with preterm delivery (OR = 1.26, CI = 1.14-1.38, P < 0.001).
CONCLUSION
A history of drug allergy is an independent risk factor for intrauterine growth restriction and preterm delivery. Further prospective studies are needed to investigate the nature of this association.
Topics: Adult; Cohort Studies; Databases, Factual; Drug Hypersensitivity; Female; Fetal Growth Retardation; Humans; Logistic Models; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Retrospective Studies; Risk Factors
PubMed: 20384621
DOI: 10.1111/j.1600-0897.2010.00845.x -
International Journal of Molecular... Oct 2022Briefly, 25-hydroxyvitamin D (25(OH)D) plays an essential role in embryogenesis and the course of intra- and postnatal periods and is crucially involved in the... (Review)
Review
Briefly, 25-hydroxyvitamin D (25(OH)D) plays an essential role in embryogenesis and the course of intra- and postnatal periods and is crucially involved in the functioning of the mother-placenta-fetus system. The low quantity of 25(OH)D during pregnancy can lead to an elevated risk for preeclampsia occurrence. Despite the numerous studies on the association of 25(OH)D deficiency and preeclampsia development, the current research on this theme is contradictory. In this review, we summarize and analyze study data on the effects of 25(OH)D deficiency and supplementation on pregnancy, labor, and fetal and neonatal outcomes.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Vitamin D Deficiency; Pre-Eclampsia; Vitamin D; Dietary Supplements; Pregnancy Complications
PubMed: 36361738
DOI: 10.3390/ijms232112935 -
The Journal of Perinatal & Neonatal... 2006Peripartum cardiomyopathy is a rare and potentially lethal cardiac complication of pregnancy occurring in the final month of pregnancy through the first 5 months after... (Review)
Review
Peripartum cardiomyopathy is a rare and potentially lethal cardiac complication of pregnancy occurring in the final month of pregnancy through the first 5 months after birth. It is characterized by the development of congestive heart failure and left ventricular systolic dysfunction, in previously healthy women with no other identifiable cause for heart failure. The etiology of peripartum cardiomyopathy is not well understood. Potential causal mechanisms include infection, autoimmune disease, and abnormal response to the hemodynamic stresses of pregnancy. There is significant risk of reoccurrence in subsequent pregnancies. The purpose of this article is to review the pathophysiology, diagnosis, management, prognosis, and nursing implications of peripartum cardiomyopathy.
Topics: Cardiomyopathies; Female; Humans; Pregnancy; Pregnancy Complications, Cardiovascular; Prognosis; Puerperal Disorders
PubMed: 17310673
DOI: 10.1097/00005237-200610000-00011 -
Public Health Nutrition Jul 2016To investigate associations of maternal periconceptional shellfish, lean fish and fatty fish intake with risk of pregnancy complications.
OBJECTIVE
To investigate associations of maternal periconceptional shellfish, lean fish and fatty fish intake with risk of pregnancy complications.
DESIGN
In this prospective cohort study, we collected information on intake of seafood subtypes using FFQ. We categorized seafood intake into frequencies of 1 servings/week. We ascertained gestational hypertension, pre-eclampsia, gestational diabetes and preterm birth diagnoses from medical records. Using generalized linear models with a log link, the Poisson family and robust standard errors, we estimated risk ratios and 95 % confidence intervals across seafood intake categories.
SETTING
The Omega study, a study of risk factors for pregnancy complications among women recruited from prenatal clinics in Washington State, USA, 1996-2008.
SUBJECTS
The current study included 3279 participants from the Omega study.
RESULTS
Median (interquartile range) shellfish, lean fish and fatty fish intake was 0·3 (0-0·9), 0·5 (0-1·0) and 0·5 (0·1-1·0) servings/week, respectively. Lean fish intake of >1 servings/week (v. <0·2 servings/month) was associated with a 1·55-fold higher risk of preterm birth (95 % CI 1·04, 2·30) and was not associated with the other pregnancy complications. Higher intake of seafood (total or other subtypes) was not associated with pregnancy complications (separately or combined).
CONCLUSIONS
Higher intake of lean fish, but not fatty fish or shellfish, was associated with a higher risk of preterm birth; these findings may have significance for preterm birth prevention. Studies of mechanisms and potential contributing factors (including seafood preparation and nutrient/contaminant content) are warranted.
Topics: Adult; Animals; Diabetes, Gestational; Diet; Fatty Acids, Omega-3; Female; Humans; Hypertension, Pregnancy-Induced; Maternal Nutritional Physiological Phenomena; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Premature Birth; Prospective Studies; Seafood; Washington
PubMed: 26626702
DOI: 10.1017/S136898001500316X -
Zeitschrift Fur Rheumatologie Oct 2021For some rare rheumatic diseases the data situation on fertility and pregnancy is still scant. This article attempts to present the data known so far and to derive and... (Review)
Review
For some rare rheumatic diseases the data situation on fertility and pregnancy is still scant. This article attempts to present the data known so far and to derive and supplement some treatment recommendations from the data. A stable disease situation before the pregnancy drastically reduces the risk of complications for mother and child; therefore, an appropriate and timely adjustment of treatment in consultation with patients and gynecologists is important.
Topics: Female; Humans; Pregnancy; Pregnancy Complications; Rare Diseases; Rheumatic Diseases
PubMed: 34535819
DOI: 10.1007/s00393-021-01074-4 -
The American Journal of Clinical... Dec 2017Pregnant women are particularly vulnerable to iron deficiency and related adverse pregnancy outcomes and, as such, are routinely recommended for iron supplementation.... (Review)
Review
Pregnant women are particularly vulnerable to iron deficiency and related adverse pregnancy outcomes and, as such, are routinely recommended for iron supplementation. Emerging evidence from both animal and population-based studies, however, has raised potential concerns because significant associations have been observed between greater iron stores and disturbances in glucose metabolism, including increased risk of type 2 diabetes among nonpregnant individuals. Yet, the evidence is uncertain regarding the role of iron in the development of gestational diabetes mellitus (GDM), a common pregnancy complication which has short-term and long-term adverse health ramifications for both women and their children. In this review, we critically and systematically evaluate available data examining the risk of GDM associated with dietary iron, iron supplementation, and iron status as measured by blood concentrations of several indicators. We also discuss major methodologic concerns regarding the available epidemiologic studies on iron and GDM.
Topics: Diabetes, Gestational; Diet; Dietary Supplements; Female; Ferritins; Hepcidins; Humans; Iron; Iron Deficiencies; Iron, Dietary; Meta-Analysis as Topic; Observational Studies as Topic; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Randomized Controlled Trials as Topic; Receptors, Transferrin
PubMed: 29070554
DOI: 10.3945/ajcn.117.156034