Masked hypertension and neonatal outcome in high-risk pregnancies

Salazar, Martín R.; Espeche, Walter G; Sisnieguez, Carlos Enrique Leiva; Juliano, Paola L.; Vulcano, María V.; Sánchez-Lorenzo, Luisa; Minetto, Julián; Balbín, Eduardo; Carbajal, Horacio A

doi:10.1038/s41371-021-00649-7

Cited by 11 publications

(10 citation statements)

References 23 publications

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“…Therefore, there is a need for a concise, evidence-based, and effective tool that clinicians can use to screen women at high risk of PE in the early second trimester. This study's Previous studies have found that maternal age ≥35 years, family history of hypertension or DM, history of PE, chronic hypertension, duration of hypertension, GDM, and pre-pregnancy BMI ≥30 kg/m 2 are all associated with an increased incidence of PE (18)(19)(20)(21)(22)(23)(24)32,33). In this study, kidney disease and a family history of PE was shown to be the most important factor in predicting PE, followed by a family history of hypertension, pBMI ≥27.7 kg/m 2 , and BP ≥130/80 mmHg in the first trimester.…”

Section: Discussionmentioning

confidence: 65%

“…The pathogenesis of PE is complex, and its etiology is somewhat unclear (1,30,31). Numerous studies have attempted to assess the predictive performance of various factors for PE, including clinical features, biomarkers, and ultrasound indicators (18)(19)(20)(21)(22)(23)(24). Identification of early risk factors is the best way to prevent PE.…”

Section: Discussionmentioning

confidence: 99%

“…An accurate diagnosis of PE using clinically accessible risk factors in the early second trimester is crucial to the prevention of PE progression. At present, many studies have assessed the predictive ability of various factors for predicting PE, including clinical features, biomarkers, and ultrasound markers (18)(19)(20)(21)(22)(23)(24). Nevertheless, no consensus has been reached on the best strategy for predicting the likelihood of PE (6,25).…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of the prediction models for preeclampsia: a retrospective, single-center, case-control study

Chen¹,

Li²,

Ji³

et al. 2022

Ann Transl Med

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Background: Preeclampsia (PE) is a major cause of adverse maternal and infant outcomes. Accurate screening of PE is currently the focus of clinical attention. This study aimed to develop a model for predicting PE.Methods: A retrospective case-control study was conducted with 916 pregnant women who received care at the Second Hospital of Tianjin Medical University (October 2018 to July 2020). Women were randomly divided into the training (n=680) and testing (n=236) sets based on a ratio of 3:1. Demographic and clinical data of women were collected. In training set, logistic regression (LR), classification tree model (CT), and random forest algorithm (RF) were used to develop prediction models for PE. Using the testing set was to validate these prediction models. The predictive performance of three models were assessed by the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).Results: Of the total 916 women, 237 had PE. The family history of hypertension, pre-pregnancy body mass index (pBMI), blood pressure (BP) ≥130/80 mmHg in early pregnancy, age, chronic hypertension, and duration of hypertension were the predictors of PE. The AUCs for the LR, CT, and RF models were 0.778, 0.850, and 0.871, respectively (all P<0.05 for all pair-wise comparisons). The RF had the best predictive efficiency with sensitivity, specificity, PPV, and NPV of 79.6%, 94.7%, 79.6%, and 94.7%, respectively. Conclusions:The RF model could be a practical screening approach for predicting PE, which is helpful for clinicians to identify high-risk individuals and prevent the occurrence of adverse pregnancy outcomes.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and validation of the prediction models for preeclampsia: a retrospective, single-center, case-control study

Chen¹,

Li²,

Ji³

et al. 2022

Ann Transl Med

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“…Our working groups have shown that ~30% of high-risk pregnancies have masked hypertension [ 20 ]. Moreover, masked hypertension is a strong and independent predictor for the development of PE and poor neonatal outcomes [ 20 , 21 , 22 ]. Thus, in high-risk pregnant women, the detection of masked hypertension is necessary.…”

Section: Out-of-office Blood Pressure In Hypertension Diagnosis In Pr...mentioning

confidence: 99%

“…This modulating effect of aspirin use suggests that nocturnal hypertension could be an indication for aspirin treatment. Moreover, masked hypertension, but not masked white-coat hypertension, increases the risk for poor neonatal outcomes (adjusted OR 2.58 95% CI 1.23–5.40) [ 22 ].…”

Section: Timeliness Of Performing Out-of-office Blood Pressure Measur...mentioning

confidence: 99%

Ambulatory Blood Pressure Monitoring for Diagnosis and Management of Hypertension in Pregnant Women

Espeche

Salazar

2023

Diagnostics

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Hypertension disorders during pregnancy has a wide range of severities, from a mild clinical condition to a life-threatening one. Currently, office BP is still the main method for the diagnosis of hypertension during pregnancy. Despite of the limitation these measurements, in clinical practice office BP of 140/90 mmHg cut point is used to simplify diagnosis and treatment decisions. The out-of-office BP evaluations are it comes to discarding white-coat hypertension with little utility in practice to rule out masked hypertension and nocturnal hypertension. In this revision, we analyzed the current evidence of the role of ABPM in diagnosing and managing pregnant women. ABPM has a defined role in the evaluation of BP levels in pregnant women, being appropriate performing an ABPM to classification of HDP before 20 weeks of gestation and second ABMP performed between 20–30 weeks of gestation to detected of women with a high risk of development of PE. Furthermore, we propose to, discarding white-coat hypertension and detecting masked chronic hypertension in pregnant women with office BP > 125/75 mmHg. Finally, in women who had PE, a third ABPM in the post-partum period could identify those with higher long-term cardiovascular risk related with masked hypertension.

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Consecuencia de los trastornos hipertensivos durante el embarazo (THE) sobre la salud cardiovascular de la mujer

Espeche,

Carrera Ramos,

Minetto

et al. 2024

Hipertensión y Riesgo Vascular

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Masked hypertension and neonatal outcome in high-risk pregnancies

Cited by 11 publications

References 23 publications

Development and validation of the prediction models for preeclampsia: a retrospective, single-center, case-control study

Development and validation of the prediction models for preeclampsia: a retrospective, single-center, case-control study

Ambulatory Blood Pressure Monitoring for Diagnosis and Management of Hypertension in Pregnant Women

Consecuencia de los trastornos hipertensivos durante el embarazo (THE) sobre la salud cardiovascular de la mujer

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