Management of Hypertension in the Obese Pregnant Patient

Coroyannakis, Christina; Khalil, Asma

doi:10.1007/s11906-019-0927-x

Cited by 10 publications

(6 citation statements)

References 33 publications

(32 reference statements)

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“…In this two-sample MR study, we firstly assessed the causal association between obesity and HDP based on the European ancestry population. Our findings suggested a causal association between genetically determined obesity and the increased risk of HDP, with an increase in obesity by 1 SD resulting in a 39% increased risk of HDP, which was consistent with previous observational studies ( 5 , 6 ).…”

Section: Discussionsupporting

confidence: 93%

“…Our result suggests that obesity itself can causally increase the risk of HDP, which can be interpreted from the genetic perspective in our MR analysis. The result of this MR was consistent with the findings of previous studies, supporting obesity as a risk predictor for HDP ( 5 , 6 ). We used three different methods to estimate the causal association to minimize potential pleiotropy in the current sensitivity analysis, including IVW, MR-Egger, and weighted median regression.…”

Section: Discussionsupporting

confidence: 92%

“…Therefore, it is of practical significance to explore modifiable risk factors of HDP and make early predictions such that interventions can be carried out in advance to reduce the adverse effect brought by HDP. Many studies have shown that there is an observational correlation between obesity and the risk of HDP ( 5 , 6 ). Since previous studies have only described that obesity can increase the risk of HDP, but how much risk can be increased, there is no relevant research data.…”

Section: Introductionmentioning

confidence: 99%

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Genetically Predicted Obesity Causally Increased the Risk of Hypertension Disorders in Pregnancy

Wang

Tan

Liu

et al. 2022

Front. Cardiovasc. Med.

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AimsThis study aimed to evaluate the causal association between obesity and hypertension disorders in pregnancy.MethodsTwo-sample Mendelian randomization (MR) study was conducted based on the data obtained from the GIANT (n = 98,697 participants) consortium and FinnGen (n = 96,449 participants) consortium to determine the causal effect of obesity on the risk of hypertension disorders in pregnancy. Based on a genome-wide significance, 14 single-nucleotide polymorphisms (SNPs) associated with obesity-related databases were used as instrumental variables. The random-effects inverse-variance weighted (IVW) method was adopted as the main analysis with a supplemented sensitive analysis of the MR-Egger and weighted median approaches.ResultsAll three MR methods showed that genetically predicted obesity causally increased the risk of hypertension disorders in pregnancy. IVW analysis provided obesity as a risk factor for hypertension disorders in pregnancy with an odds ratio (OR) of 1.39 [95% confidence interval (CI) 1.21–1.59; P = 2.46 × 10−6]. Weighted median and MR Egger regression also showed directionally similar results [weighted median OR = 1.49 (95% CI, 1.24–1.79), P = 2.45 × 10−5; MR-Egger OR = 1.95 (95% CI, 1.35–2.82), P = 3.84 × 10−3]. No directional pleiotropic effects were found between obesity and hypertension disorders in pregnancy with both MR-Egger intercepts and funnel plots.ConclusionsOur findings provided directed evidence that obesity was causally associated with a higher risk of hypertension disorders in pregnancy. Taking measures to reduce the proportion of obesity may help reduce the incidence of hypertension disorders in pregnancy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Genetically Predicted Obesity Causally Increased the Risk of Hypertension Disorders in Pregnancy

Wang

Tan

Liu

et al. 2022

Front. Cardiovasc. Med.

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“…The only behavior with strong evidence of effectiveness is control of preexisting diabetes to reduce risk of HDP, which applies only to the small number of women with chronic diabetes ( 16 , 17 ). Although preconception obesity is associated with increased risk of both GDM and HDP ( 18 , 19 ), no evidence indicates that weight loss interventions in the year before pregnancy (eg, diet, exercise) reduce risk of either HDP or GDM ( 14 , 15 , 20 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between Recommended Preconception Health Behaviors and Screenings and Improvements in Cardiometabolic Outcomes of Pregnancy

Stanhope

Kramer

2021

Prev. Chronic Dis.

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Introduction Gestational diabetes (GDM) and hypertensive disorders of pregnancy (HDP) are associated with increased risk of maternal and infant illness and long-term elevated cardiometabolic risk. Little information exists on the prevention of either disorder before pregnancy. Our goal was to describe the association between preconception indicators and risk of gestational diabetes and hypertensive disorders of pregnancy. Methods We used logistic regression to analyze cross-sectional data from the 2016–2017 Pregnancy Risk Assessment Monitoring System (N = 68,493) to quantify the association between 14 preconception health indicators (across domains of health care, nutrition and physical activity, tobacco and alcohol, chronic conditions, mental health, and emotional and social support) and, separately, GDM and HDP. We accounted for sampling weights and controlled for maternal age, race/ethnicity, prepregnancy insurance, prepregnancy body mass index, and report of a check-up in the year before pregnancy. Results Prepregnancy obesity was the strongest predictor of both HDP (adjusted odds ratio [aOR], 3.1; 95% CI, 2.8–3.5) and GDM (aOR, 3.1; 95% CI, 2.7–3.5). Individual behaviors (eg, exercise, attending a check-up) were not associated with either HDP or GDM. A diagnosis of diabetes before pregnancy predicted HDP (aOR, 2.3; 95% CI, 1.7–3.0). Conclusion Prepregnancy chronic disease and obesity predicted pregnancy complications (ie, GDM and HDP). Given the challenges in reversing these conditions in the year before pregnancy, efforts to improve preconception health may be best directed broadly to expand access to primary care for all women.

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“…Загальновідомо, що вагітність на тлі цього захворювання асоційована з низкою материнських і перинатальних ризиків, ступінь і частота яких збільшуються залежно від вираженості ожиріння [2,3]. Ожиріння під час вагітності збільшує ризик виникнення: невиношування вагітності, прееклампсії (ПЕ), дистресу плода, затримки внутрішньоутробного розвитку плоду (ЗВУРП), гестаційного цукрового діабету, гестаційної гіпертензії, мертвонародження, макросомій, частоти виконання кесаревого розтину, пологових травм та інших ускладнень [4].…”

Section: вступunclassified

Peculiarities of Pregnancy Course in Women With Concomitant Obesity Who Take Therapeutic and Prophylactic Complex Aimed to Prevent Preeclampsia

Zelinka-Khobzey

2021

Act. Probl. of the Modern Med.

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The rapid growth in the incidence of overweight and obesity among women of childbearing age is posing specific issues related to their pregnancy, thereupon choosing adequate and effective tactics for the prevention of preeclampsia in women with concomitant obesity who are at high risk group for this complication is of undoubted relevance. The aim of this study is to assess the occurrence and characteristic of obstetric and prenatal complications in women with concomitant obesity, who receive therapeutic and prophylactic complex designed to prevent the development of preeclampsia. We studied the course of pregnancy of 255 women, who were divided into 3 groups according to the class of obesity, and then, in turn, were subdivided into subgroups taking into account the presence of preeclampsia and the therapeutic and prophylactic complex course. The high efficiency of the therapeutic and prophylactic complex including L-arginine and diosmin for obese women enables to reduce the manifestations of endothelial dysfunction, the occurrence of preeclampsia and its severe forms; to lower down the occurrence of other complications during the pregnancy (risks of premature birth, placental insufficiency, distress and foetal growth retardation); to avoid perinatal mortality and improve the condition of the foetus. Applying this pathogenetically grounded therapeutic and prophylactic complex we elaborated (acetylsalicylic acid, L-arginine, calcium supplements and semisynthetic diosmin) to prevent the occurrence of preeclampsia in pregnant women with concomitant obesity, who are at high-risk group, promotes the reduction of occurrence and intensity of obstetric and prenatal complications resulted from endothelial dysfunction. We can suggest the therapeutic and prophylactic complex for pregnant women with concomitant obesity as effective therapy because no cases of severe and early preeclampsia have been registered.

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Management of Hypertension in the Obese Pregnant Patient

Cited by 10 publications

References 33 publications

Genetically Predicted Obesity Causally Increased the Risk of Hypertension Disorders in Pregnancy

Genetically Predicted Obesity Causally Increased the Risk of Hypertension Disorders in Pregnancy

Association Between Recommended Preconception Health Behaviors and Screenings and Improvements in Cardiometabolic Outcomes of Pregnancy

Peculiarities of Pregnancy Course in Women With Concomitant Obesity Who Take Therapeutic and Prophylactic Complex Aimed to Prevent Preeclampsia

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