Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The...Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.展开更多
The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: ...The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had </span><span style="font-family:Verdana;">the hypertensive</span><span style="font-family:Verdana;"> disorders of pregnancy. </span><span style="font-family:Verdana;">The Gestational</span><span style="font-family:Verdana;"> HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> < 0.05). Conclusion: HDP </span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> common in Parakou. Some factors previously described in the literature are associated with them.展开更多
Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved problems.It is one of the major causes of maternal and perinatal morbidity and mortality.This study estimate...Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved problems.It is one of the major causes of maternal and perinatal morbidity and mortality.This study estimates the prevalence of hypertensive disorders of pregnancy,their associated risk factors and pregnancy complications in primiparous women.Methods:All primigravida who gave birth in our hospital from December 2020 to December 2021 were included in the study.The prevalence,risk factors,mode of delivery,and maternal and fetal outcomes of hypertensive disorders of pregnancy in primigravidae were collected from the patient's medical records.Statistical analysis was done using the SPSS 18.0 software package.The Chi-square test was used to analyse the association between the risk factors and hypertensive disorders of pregnancy in primigravida.Results:A total of 807 women were included in the study,and the mean age was 26.34±3.84 years.The prevalence of hypertensive disorders of pregnancy in primigravidae was found to be 18.6%.Among the prevalent population,79.3%of women had gestational hypertension.The findings indicate that hypertension in pregnancy has a significant relationship with risk factors such as increased maternal age(p<0.004),family history of hypertension in pregnancy(p<0.001),body mass index>30 kg/m^(2)(p<0.001),hyperglycaemia in pregnancy(p<0.001),IVF pregnancy(p<0.004)and polycystic ovary syndrome(p<0.001).The most reported adverse maternal and perinatal outcomes were placental abruption(p<0.001),postpartum haemorrhage(p<0.001),prematurity(p<0.001),and fetal growth restriction(p<0.001).Conclusion:The study emphasises the importance of knowledge and timely assessment of risk factors of HDP.It also highlights the need for pre-conceptional counselling,which includes early detection,careful monitoring and treatment of HDP for preventing morbidity and mortality related to this disorder and it should be followed up even in the postpartum period.展开更多
Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9...Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.展开更多
文摘Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.
文摘The purpose of this study was to evaluate the prevalence of Hypertensive Disorders in Pregnancy (HDP) and to determine the factors associated with them in the city of Parakou in Benin, a West African country. Method: It has been a descriptive cross-sectional study with a prospective collection of data using a questionnaire in prenatal consultation in the health center of Parakou’s commune for 4 months (May 1 to August 31, 2019). Result: A proportion of 8.2% (55/671) of the pregnancy had </span><span style="font-family:Verdana;">the hypertensive</span><span style="font-family:Verdana;"> disorders of pregnancy. </span><span style="font-family:Verdana;">The Gestational</span><span style="font-family:Verdana;"> HyperTension was the most common type of arterial hypertension (AHT) with a proportion of 49.1%. The factors associated with HDP were the age of 30 to 34 (OR: 11.9;95% CI: 1.54 - 92.29;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0346), the family history of Arterial HyperTension (AHT) (OR: 1.5;95% CI: 1.03 - 4.66;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0481), the BMI > 30 (OR:14.2;95% IC: 7.02 - 28.69;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0235), being married or in a common-law relationship (OR = 2.51;95% CI: 1.30 - 4.86;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0412), the stress (OR: 2.0;95% CI:1.09 - 3.32;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> = 0.0209), the history of HDP (OR: 9.0;95% CI: 2.53 - 15.23;</span><i><span style="font-family:Verdana;">p</span></i><span style="font-family:Verdana;"> < 0.05). Conclusion: HDP </span><span style="font-family:Verdana;">are</span><span style="font-family:Verdana;"> common in Parakou. Some factors previously described in the literature are associated with them.
文摘Background:Hypertensive disorders of pregnancy(HDP)are among obstetrics'most intriguing and yet unsolved problems.It is one of the major causes of maternal and perinatal morbidity and mortality.This study estimates the prevalence of hypertensive disorders of pregnancy,their associated risk factors and pregnancy complications in primiparous women.Methods:All primigravida who gave birth in our hospital from December 2020 to December 2021 were included in the study.The prevalence,risk factors,mode of delivery,and maternal and fetal outcomes of hypertensive disorders of pregnancy in primigravidae were collected from the patient's medical records.Statistical analysis was done using the SPSS 18.0 software package.The Chi-square test was used to analyse the association between the risk factors and hypertensive disorders of pregnancy in primigravida.Results:A total of 807 women were included in the study,and the mean age was 26.34±3.84 years.The prevalence of hypertensive disorders of pregnancy in primigravidae was found to be 18.6%.Among the prevalent population,79.3%of women had gestational hypertension.The findings indicate that hypertension in pregnancy has a significant relationship with risk factors such as increased maternal age(p<0.004),family history of hypertension in pregnancy(p<0.001),body mass index>30 kg/m^(2)(p<0.001),hyperglycaemia in pregnancy(p<0.001),IVF pregnancy(p<0.004)and polycystic ovary syndrome(p<0.001).The most reported adverse maternal and perinatal outcomes were placental abruption(p<0.001),postpartum haemorrhage(p<0.001),prematurity(p<0.001),and fetal growth restriction(p<0.001).Conclusion:The study emphasises the importance of knowledge and timely assessment of risk factors of HDP.It also highlights the need for pre-conceptional counselling,which includes early detection,careful monitoring and treatment of HDP for preventing morbidity and mortality related to this disorder and it should be followed up even in the postpartum period.
文摘Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.
