Maternal and infant hospitalization costs associated with hypertensive disorders of pregnancy in a California cohort<sup>*</sup>

Hersh, Alyssa R.; Mischkot, Brooke F.; Greiner, Karen S.; Garg, Bharti; Caughey, Aaron B.

doi:10.1080/14767058.2020.1849096

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…In addition, due to the limitations of routinely collected data, we were unable to include all components of both the Delphi‐derived core outcome set for pre‐eclampsia and PIERS combined adverse maternal outcome, as discussed above 5,11 . Finally, we did not have information to inform a health economics analysis, but it has been estimated that treating pre‐eclampsia costs the UK National Health Service an additional UK£9,000 per pregnancy, with major cost drivers including not only care of preterm infants but also surgical intervention and severe maternal morbidity 21,22 …”

Section: Discussionmentioning

confidence: 99%

“…5,11 Finally, we did not have information to inform a health economics analysis, but it has been estimated that treating pre-eclampsia costs the UK National Health Service an additional UK£9,000 per pregnancy, with major cost drivers including not only care of preterm infants but also surgical intervention and severe maternal morbidity. 21,22…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Preterm and term pre‐eclampsia: Relative burdens of maternal and perinatal complications

Dadelszen

Syngelaki

Akolekar

et al. 2023

BJOG

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To determine the relative burdens of maternal and perinatal complications for preterm and term pre-eclampsia. Design: Prospective observational cohort study. Setting: Two English maternity units. Population: Unselected women with singleton pregnancies who developed preeclampsia (International Society for the Study of Hypertension in Pregnancy definition). Methods: Outcomes were ascertained by health record review and compared between pregnancies with preterm (versus term) pre-eclampsia. Main outcome measures: Severe maternal hypertension, maternal mortality or major maternal morbidity, perinatal mortality or major neonatal morbidity, neonatal unit (NNU) admission ≥48 hours, and birthweight <3rd percentile. Results: Among 40 241 singleton pregnancies, 298 (0.7%, 95% confidence interval [CI] 0.66-0.83) and 1194 (3.0%, 95% CI 2.8-3.1) developed preterm and term preeclampsia, respectively. Women with preterm (versus term) pre-eclampsia more commonly experienced adverse maternal or perinatal events: severe hypertension 18.5% (95% CI 14.5-23.3) versus 13.6% (95% CI 11.7-15.6); maternal mortality/major morbidity 7.4% (95% CI 4.9-10.9) versus 2.2% (95% CI 1.5-3.2); perinatal mortality/major neonatal morbidity 29.5% (95% CI 24.6-34.9) versus 2.2% (95% CI 1.5-3.2); and birthweight <3rd percentile 54.4% (95% CI 48.7-59.9) versus 14.2% (95% CI 12.4-16.3). However, in absolute terms, most maternal complications occurred in women with term pre-eclampsia, as did a large proportion of perinatal complications: severe hypertension 74.7% (95% CI 68.5-80.0); maternal mortality/major morbidity 54.2% (95% CI 40.3-67.4); perinatal mortality/major neonatal morbidity 22.8% (95% CI 16.1-31.3); NNU admission ≥48 hours 38.1% (95% CI 32.4-44.1); and birthweight <3rd percentile 51.2% (95% CI 45.8-56.5). Conclusions: Although adverse event risks are greater with preterm (versus term) pre-eclampsia, term disease is associated with at least equivalent total numbers of maternal, and a significant proportion of perinatal, adverse events. Increased efforts should be made to decrease the incidence of term pre-eclampsia. K E Y W O R D S adverse maternal outcomes, adverse perinatal outcomes, pre-eclampsia, preterm, term | 525

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Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Preterm and term pre‐eclampsia: Relative burdens of maternal and perinatal complications

Dadelszen

Syngelaki

Akolekar

et al. 2023

BJOG

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“…Pregnancy-induced hypertension (PIH) is one of the leading causes of maternal and perinatal morbidity and mortality [1] . Preeclampsia (PE) is a serious complication of pregnancy that was characterized by new-onset hypertension around the 20th gestational week (GW) with or without proteinuria [2] and may complicate up to 5% of pregnancies worldwide [3] . The risk of maternal and perinatal complications is considerably higher in cases had early-onset PE (EOPE) and/or severe PE (SPE) [4] .…”

Section: Introductionmentioning

confidence: 99%

The Relation between Deregulated Immune Milieu and Atherogenic Lipids Might Underlie the Development of Pregnancy-induced Hypertensive Disorders

Zaher

Rageh

Morsy

2023

Evidence Based Women's Health Journal

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Objectives: Evaluation of the relation between plasma lipoprotein(a) (LPA) and serum tumor necrosis factor-α (TNF-α) levels estimated in blood samples (S1 sample) obtained at the 6th gestational week (GW; T1 time) and the development of preeclampsia (PE) as judged by blood pressure measures at the time of diagnosis of PE (T2 time). Patients and Methods: 140 newly pregnant women gave S1 sample at T1 time; during pregnancy 19 women developed early-onset PE (EOPE) and 51 women developed late-onset PE (LOPE); 16 women developed severe PE (SPE) and 54 women developed mild PE (MPE), while 70 women were normotensive (NT) till the end of pregnancy. At T2 time, all patients gave S2 sample for ELISA estimation of plasma LPA and serum TNF-α level in both samples. Results: Serum TNF-α and plasma LPA levels were significantly higher in all S2 than S1 samples, in both samples of PE than NT women, and in both samples of women who developed EOPE and/or SPE than in samples of women who developed LOPE and/or MPE, respectively. Regression analysis of T1 data defined high body mass index; BMI (β=0.162, P=0.028), high S1 levels of TNF-α (β=0.424, P<0.001), and LPA (β=0.314, P<0.001) as predictors for development of PE as judged by SBP measures at T2 time. Correlation analysis showed a positive significant (P<0.001) correlation between at-T2-SBP measures with at-T1 BMI and S1 levels of TNF-α and LPA with a positive significant correlation between levels of both variables and with at-T1 BMI. Conclusion: High serum levels of TNF-α and plasma LPA levels early in pregnancy could predict the development of PE and its severity.

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Maternal and infant hospitalization costs associated with hypertensive disorders of pregnancy in a California cohort^*

Cited by 2 publications

References 16 publications

Preterm and term pre‐eclampsia: Relative burdens of maternal and perinatal complications

Preterm and term pre‐eclampsia: Relative burdens of maternal and perinatal complications

The Relation between Deregulated Immune Milieu and Atherogenic Lipids Might Underlie the Development of Pregnancy-induced Hypertensive Disorders

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Maternal and infant hospitalization costs associated with hypertensive disorders of pregnancy in a California cohort*

Cited by 2 publications

References 16 publications

Preterm and term pre‐eclampsia: Relative burdens of maternal and perinatal complications

Preterm and term pre‐eclampsia: Relative burdens of maternal and perinatal complications

The Relation between Deregulated Immune Milieu and Atherogenic Lipids Might Underlie the Development of Pregnancy-induced Hypertensive Disorders

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Maternal and infant hospitalization costs associated with hypertensive disorders of pregnancy in a California cohort^*