Competing‐risks model for pre‐eclampsia and adverse pregnancy outcomes

Syngelaki, Argyro; Magee, Laura A.; Dadelszen, Peter von; Akolekar, Ranjit; Wright, Alan; Wright, David; Nicolaides, Kypros H.

doi:10.1002/uog.26036

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…Several studies 29 have shown that patients with pre-eclampsia have a higher incidence of SGA and FGR. Panaitescu et al showed that the incidence of SGA below the tenth percentile was 28.9% and 11.1% in women with and without pre-eclampsia, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Association between hypoproteinaemia with massive proteinuria and small for gestational age in pre-eclampsia: a single-centre, retrospective cohort study using propensity score matching

Zhao

Yan

et al. 2023

BMJ Open

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ObjectiveTo investigate the association between hypoproteinaemia with massive proteinuria and the incidence of small for gestational age in pre-eclampsia.DesignRetrospective cohort study using propensity score matching.SettingNorthwest Women’s and Children’s Hospital in Shaanxi Province, China, using data from January 2016 to December 2021.ParticipantsPatients diagnosed with pre-eclampsia were grouped into the massive proteinuria group if the maximum proteinuria was >3.5 g/day and the minimum serum albumin was <30 g/L; otherwise, they were placed in the control group.Outcome measuresThe primary outcome was the incidence of small for gestational age infants. Secondary outcomes included fetal death, admission to the neonatal intensive care unit, a 5 min APGAR score <7, severe small for gestational age, fetal growth restriction, birth weight, premature birth, and maternal outcomes such as eclampsia, encephalopathy, placental abruption, haemolysis, elevated liver enzymes and low platelet syndrome, heart failure and retinal detachment.ResultsIn total, 468 patients (234 from each group) were included, and the groups were well matched. The incidences of small for gestational age (33.76% vs 20.51%, OR 1.646, 95% CI 1.208 to 2.243, p=0.001), severe small for gestational age (14.70% vs 7.69%, OR 1.833, 95% CI 1.063 to 3.162, p=0.026), fetal growth restriction (23.93% vs 16.24%, OR 1.474, 95% CI 1.018 to 2.133, p=0.038), and the numbers of infants admitted to the neonatal intensive care unit (67.52% vs 58.55%, OR 1.153, 95% CI 1.003 to 1.326, p=0.044) were significantly higher in patients with hypoproteinaemia and massive proteinuria than in the control group. In addition, the median birth weight was significantly lower in the massive proteinuria group. There were no significant differences in maternal outcomes except for renal parameters, which were worse in the massive proteinuria group.ConclusionHypoproteinaemia with massive proteinuria was associated with fetal growth and a higher incidence of small for gestational age infants in pre-eclampsia.

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Section: Discussionmentioning

confidence: 99%

“…Several studies 29 have shown that patients with preeclampsia have a higher incidence of SGA and FGR.…”

Section: Discussionmentioning

confidence: 99%

Association between hypoproteinaemia with massive proteinuria and small for gestational age in pre-eclampsia: a single-centre, retrospective cohort study using propensity score matching

Zhao

Yan

et al. 2023

BMJ Open

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“…The small proportion of MCDA twins scanned at 36 weeks reflects the higher frequency of births occurring before 36 weeks in this group. For comparison, data were available on 29 035 singletons 11 . The median maternal age in DC twins was higher than that in singletons and MCDA twins, reflecting the relatively high proportion of pregnancies conceived by in-vitro fertilization in the DC twin population.…”

Section: Methodsmentioning

confidence: 99%

“…Data on singletons were obtained from a prospective non-interventional observational study of women with a singleton pregnancy attending for a routine hospital visit at 35 + 0 to 36 + 6 weeks' gestation at King's College Hospital, London, and Medway Maritime Hospital, Gillingham, UK, between October 2016 and September 2021 11 .…”

Section: Study Populationmentioning

confidence: 99%

Incidence of neonatal morbidity in small‐for‐gestational‐age twins based on singleton and twin charts

Wright,

Rehal

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectiveUsing lengths of stay in neonatal intensive care unit (NICU) as a measure of morbidity, the objective is to compare twins and singletons according to classification of small for gestational age (SGA) using the 10th percentile for twins or the 10th percentile for singletons.MethodsNICU lengths of stay were compared in 1,150 twins neonates and 29,035 singleton neonates all scanned at between 35+0 and 36+6 weeks’ gestation. Estimated fetal weights were obtained from measurements of head circumference, abdominal circumference and femur length using the Hadlock formula. Gestational ages were obtained from first trimester crown rump length measurements using the larger of the two twins. Singletons and twins were compared for NICU lengths of stay according to classification as small relative to the Fetal Medicine Foundation singleton and twin reference distributions.ResultsThe overall proportions of neonates entering NICU for twins and singletons were similar (7.3% vs, 7.4%), but twins tended to have longer lengths of stay in NICU (≥7 days: 2.4% of twins vs. 0.8% of singletons, relative risk 3.0, 95% CI: 1.6 – 4.4). Using singleton charts, a much higher proportion of twins were classified as SGA than singletons (37.2% vs. 7.0%). However, the proportion of SGA neonates entering NICU was similar (10.3% for twins and 10.1% for singletons) and the proportions of SGA neonates spending ≥7 days in NICU was substantially higher for twins than for singletons (3.7% vs. 1.4%, risk ratio 2.6, 95% CI: 1.1 – 4.7).ConclusionsWhen singleton charts are used to define SGA in twins and in singletons, there is a greater degree of growth‐related neonatal morbidity amongst SGA twins than in SGA singletons. Consequently, use of singleton charts in twins does not inappropriately over diagnose fetal growth restriction and they should be used for monitoring fetal growth both in twins and in singletons.This article is protected by copyright. All rights reserved.

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“…Its offspring are prone to premature delivery, fetal distress, fetal growth restriction (FGR), neonatal hypoglycemia, and even death ( Govender et al, 2023 ). The etiology of preeclampsia is multifactorial, including maternal factors such as family history of preeclampsia, multiple pregnancies, chronic kidney disease, and obesity, and placental factors such as uteroplacental insufficiency and increased placental volume/mass ratio ( Syngelaki et al, 2022 ). However, the pathogenesis of preeclampsia has not been fully clarified.…”

Section: Introductionmentioning

confidence: 99%

Clinical study on the difference in intestinal microecology between patients with preeclampsia and pregnant women at different stages of pregnancy

Xie,

Zhang,

Peng

et al. 2024

Acta Biochim. Pol.

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Objective: To explore the difference in intestinal microecology between patients with preeclampsia and pregnant women at different stages of pregnancy.Methods: From January 2020 to January 2022, clinical data, including blood routine, lipid profile, and renal function indicators, were gathered from a cohort consisting of 5 cases of preeclampsia and 34 cases of non-preeclampsia. The non-preeclampsia group was further categorized into 6 cases in the First trimester, 13 cases in the Second trimester, and 15 cases in the Third trimester. The data collection took place at the Obstetrics Department of the Maternal and Child Health Hospital of Hubei Province. Additionally, fecal samples were obtained from each subject for 16S rDNA gene sequencing and subsequent analysis. The clinical data and composition characteristics of the gut microbiota in each group were analyzed, and the correlation between gut microbiota and clinical data was analyzed by the Spearman correlation analysis method.Results: In comparison to pregnant women without preeclampsia, preeclampsia patients exhibited a statistically significant elevation in blood routine parameters (WBC, N, L, and PLT count), a rise in lipid-related indicators (TC, TG, and LDL-C levels), a reduction in HDL-C levels, and an increase in renal function-related indicators (Cr, BUN, UA and Pro levels). Compared with non-preeclampsia pregnant women, preeclampsia women exhibited an augmented diversity of gut microbiota. Differences in gut microbiota composition between the two groups were observed at the gate and genus levels. Moreover, there are significant differences in the composition of gut microbiota between the preeclampsia group and the third-trimester group in terms of genus and species, and this difference is mainly caused by Prevotella and s_ Bacteroides_ Uniformis and Ruminococcus_ bromii. In addition, actinobacteria, bifidobacterium at the genus level, and Ruminococcus_bromii at the species level are positively correlated with clinically relevant indicators (excluding HDL-C).Conclusion: There are significant differences in gut microbiota between preeclampsia pregnant women and late pregnancy pregnant without preeclampsia, including Prevotella and Bacteroides_ Uniformis, and Ruminococcus_ bromii. In addition, these differential bacteria are correlated with most clinical indicators. However, additional comprehensive analysis is required to ascertain the functional correlation between these bacteria and clinical indicators.

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Competing‐risks model for pre‐eclampsia and adverse pregnancy outcomes

Cited by 4 publications

References 28 publications

Association between hypoproteinaemia with massive proteinuria and small for gestational age in pre-eclampsia: a single-centre, retrospective cohort study using propensity score matching

Association between hypoproteinaemia with massive proteinuria and small for gestational age in pre-eclampsia: a single-centre, retrospective cohort study using propensity score matching

Incidence of neonatal morbidity in small‐for‐gestational‐age twins based on singleton and twin charts

Clinical study on the difference in intestinal microecology between patients with preeclampsia and pregnant women at different stages of pregnancy

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