A global view of hypertensive disorders and diabetes mellitus during pregnancy

Abstract

Two important maternal cardiometabolic disorders (CMDs), hypertensive disorders in pregnancy (HDP) (including pre-eclampsia) and gestational diabetes mellitus (GDM), result in a large disease burden for pregnant individuals worldwide. A global consensus has not been reached about the diagnostic criteria for HDP and GDM, making it challenging to assess differences in their disease burden between countries and areas. However, both diseases show an unevenly distributed disease burden for regions with a low income or middle income, or low-income and middle-income countries (LMICs), or regions with lower sociodemographic and human development indexes. In addition to many common clinical, demographic and behavioural risk factors, the development and clinical consequences of maternal CMDs are substantially influenced by the social determinants of health, such as systemic marginalization. Although progress has been occurring in the early screening and management of HDP and GDM, the accuracy and long-term effects of such screening and management programmes are still under investigation. In addition to pharmacological therapies and lifestyle modifications at the individual level, a multilevel approach in conjunction with multisector partnership should be adopted to tackle the public health issues and health inequity resulting from maternal CMDs. The current COVID-19 pandemic has disrupted health service delivery, with women with maternal CMDs being particularly vulnerable to this public health crisis.

Low prevalence of high blood pressure in pregnant women in Burkina Faso: a cross-sectional study

“…In 2020, Gemechu et al reported a prevalence of 0.9% (95% CI: 0.4–1.8) for only gestational hypertension in a systematic review and meta-analysis of 70 studies [ 4 ]. The prevalence found in our study is relatively high compared to the prevalence of 0.3% for women of childbearing age reported by Jiang et al in 2022 [ 12 ]. However, large differences have been reported in the prevalence of HBP [ 8 , 20 , 20 , 22 – 24 ].…”

“…Maternal age, household income, occupation, parity, and residential area were not associated with HBP during pregnancy in our study. Several studies have reported an association between sociodemographic characteristics [ 12 , 20 , 25 ]. This difference may be explained by the lack of statistical power because we conducted this study to identify the prevalence of HBP during pregnancy [ 30 ].…”

“…Many studies have investigated the prevalence of high blood pressure (HBP) in pregnant women, with most studies being conducted in tertiary hospitals [7][8][9]. Very different prevalence of HDP has been reported, ranging from 1.3% in China to 26.7% in Tanzania [10,11]; in 2022, a prevalence of 0.3% in women of childbearing age was reported in sub-Saharan Africa [12]. Few studies, however, have investigated HBP prevalence at the healthcare system level; furthermore, no studies have been conducted in Burkina Faso.…”

Genome-wide meta-analysis identifies novel maternal risk variants and enables polygenic prediction of preeclampsia and gestational hypertension

“…Individual-level polygenic scores were generated in the tuning and test datasets as the sum of genotypes*weights using PLINK. We used logistic regression to test the association of each PRS with preeclampsia/eclampsia and gestational hypertension with adjustment for age, age 2 , and PC 1-10. PRS were tuned in the UK Biobank.…”

Novel therapeutic and diagnostic approaches for preeclampsia

“…It complicates up to 10% of pregnancies [5,6] and presents with a combination of different signs and symptoms such as hypertension, proteinuria, biochemical abnormalities, headaches, edema and/or abdominal pain [5]. If left untreated, it can rapidly progress to multiorgan failure, seizures, stroke and death (in the mother) and intrauterine growth restriction, neurological injuries, for example cerebral palsy and death (in the baby) [5,7 ▪ ,8]. These patients and their offspring are also at increased risk of cardiometabolic disorders later in life [4 ▪ ,5,8]…”