Maternal haemodynamic function differs in pre‐eclampsia when it is associated with a small‐for‐gestational‐age newborn: a prospective cohort study

Perry, Helen; Binder, Julia; Gutiérrez, J.; Thilaganathan, B.; Khalil, Asma

doi:10.1111/1471-0528.16269

Cited by 19 publications

(22 citation statements)

References 53 publications

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“…Of the 31 studies analyzed in the review, 17 (55%) ( 12 , 18 , 22 - 27 , 29 , 34 - 39 , 41 ) referred to the DCO phenomenon, and 14 (45%) ( 13 - 17 , 19 - 21 , 28 , 30 - 33 , 40 ) , to DCO. The studies were mostly carried out in countries in South America (n=12;38%) ( 13 - 15 , 17 , 19 , 21 , 28 , 30 - 33 , 40 ) and in Europe (n=9;29%) ( 16 , 18 , 22 , 29 , 35 - 38 , 42 ) , with emphasis on Brazilian publications (n=11; 35%) ( 13 - 15 , 17 , 19 , 21 , 28 , 30 - 32 , 40 ) , that were exclusively related to DCO. In publications related to ND, which aimed to identify its occurrence in an isolated way (n=3;21%) ( 15 , 21 , 33 ) or together with other diagnoses (n=i11.79%) ( 13 - 14 , 16 - 17 , 19 - 20 , 28 , 30 - 32 , 40 ) , the breadth in the prevalence estimates is highlighted, which ranged from 6.7% ( 13 - 14 ) to 100% ( 15 - 16 , 28 , 33 ) .…”

Section: Resultsmentioning

confidence: 99%

Decreased cardiac output: an integrative review

et al. 2023

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Objective: to identify, in the scientific literature, the defining characteristics and contributing factors (related factors, associated conditions and populations at risk) for nursing diagnosis decreased cardiac output. Method: an integrative literature review, conducted between September and October 2020, with an update in March 2022, in the MEDLINE via PubMed, LILACS, SciELO, CINAHL and EMBASE databases. Using acronym PEO, studies published in the last 10 years in Portuguese, English and Spanish were included. A descriptive analysis was carried out to present the elements mapped in the literature. Results: analysis of 31 articles identified different elements, highlighting 4 new related factors: hyperglycemic stress, prone position, left lateral position, sleep deprivation. Individuals with a history of cardiovascular disease and males were identified as possible populations at risk. Final considerations: the elements for decreased cardiac output, identified in the literature, add evidence that justifies the permanence of this diagnosis in the NANDA-I classification.

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Section: Resultsmentioning

confidence: 99%

Decreased cardiac output: an integrative review

et al. 2023

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“…In the present study of 3713 women who delivered, only 1426 (38.4%) had NW babies (≥2.5 kg), 1208 (32.5%) babies were of (≥2 to <2. [25]. Central haemodynamic changes may play a role in the pathogenesis of pre-eclampsia and should be considered alongside placental aetiology.…”

Section: Discussionmentioning

confidence: 99%

Community Based Study of Preterm Births, Small for Gestation and Low Birth Weight Babies in Rural Tribal Women with Extreme Poverty

2021

JPNB

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Background: Globally one-sixth of new-borns are Low Birth Weight (LBW), single most important risk factor for Neonatal deaths (NNDs), Preterm births (PTB), Small for gestational age (SGA), Foetal Growth Restriction (FGR) are responsible for LBW and most of perinatal mortality. Objective: Present community-based study was carried out to know burden of PTB, SGA, LBW babies among rural, tribal women. Material and Methods: After ethics committee’s approval prospective study was conducted in 100 villages. Results: Over 2 years, 3713 women delivered, 2287 (61.6%) babies were LBW, 239 (6.4%) PT, 165 (69%) PT SGA, 916 (26.4%) of 3474 term babies were SGA. Overall 26.4% babies were <2 kg, 32.5% ≥2 to <2.5 kg, only 38.4% babies ≥2.5 kg. Of 55 mothers who had very very very (VVV) LBW (<1 kg) babies, 4 (7.3%) had hypertensive disorders of pregnancy (HDsP), 45 (81.8%) anaemic 3 (5.5%) had other disorders, 3 (5.5%) had no obvious disorder (P-value 0.7754). Of 129 women with VVLBW (≥1 to <1.5 kg) babies, 10 (7.8%) had HDsP,107 (83.9%) anaemia, 9 (7.0%) other disorders, 3 (2.3%) had no obvious disorder (P-value 0.4842). Of 895 women with VLBW (≥1.5 to <2 kg) babies, 84 (9.4%) mothers had HDsP,733 (81.9%) anaemia, 49 (5.5%) other disorders, 29 (3.2%) no obvious disorder (P-value<0.0001). Of 1208 women with babies of ≥2 to <2.5 kg babies, 112 (9.3%) had HDsP, 971(80.4%) had anaemia, 87 (7.2%) other disorders, 38 (3.1%) no obvious disorder (P-value 0.0205). There were 6.4% perinatal deaths 7.4% amongst 2287 <2.5kg, 4.8% of 1426 ≥2.5kg (P-value 0.0085). Conclusion: Preterm births were not high but many babies were LBW, only 38.4% NW, 69% PT and 26.4% term babies were SGA. Anaemia seemed to be a major contributor

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“…In addition to the gestational age at onset of pre-eclampsia, the coexistence of fetal growth restriction is also a marker of disease severity 6,7 . We demonstrated recently that pregnancies complicated by pre-eclampsia with a small-for-gestational-age (SGA) neonate have worse hemodynamic function than do those with pre-eclampsia or gestational hypertension alone 8 .…”

Section: Introductionmentioning

confidence: 99%

Maternal arterial stiffness in hypertensive pregnancies with and without small‐for‐gestational‐age neonate

Perry

Gutiérrez

Binder

et al. 2020

Ultrasound in Obstet & Gyne

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Objective Pregnancies complicated by pre‐eclampsia with a small‐for‐gestational‐age (SGA) neonate have poorer maternal hemodynamic function compared to those with hypertensive disorders of pregnancy (HDP) and an appropriately grown neonate. Arterial stiffness is a recognized prognostic marker of cardiovascular disease in the general population. The aim of this study was to compare maternal arterial stiffness between hypertensive pregnancies with, and those without, a SGA neonate and normotensive control pregnancies. Methods This was a prospective cohort study of pregnancies complicated by pre‐eclampsia or gestational hypertension and healthy normotensive control pregnancies, presenting to a tertiary referral hospital between January 2012 and May 2018. Maternal arterial stiffness was assessed by aortic pulse‐wave velocity (PWV) and aortic augmentation index (AIx), which were recorded using a non‐invasive device (Arteriograph®). Maternal and hemodynamic factors were adjusted for using linear regression analysis. Pregnancies with HDP were divided into those that delivered a SGA (birth weight < 10th percentile) neonate (HDP + SGA group) and those that delivered an appropriately grown neonate (HDP‐only group). Comparisons between groups were carried out using the Mann–Whitney U‐test for continuous variables and the chi‐square (or Fisher's exact) test for categorical variables. Results Included in the analysis were 69 patients with HDP who delivered a SGA neonate, 129 with HDP who delivered a normally grown neonate and 220 healthy controls. Maternal age, weight, height and heart rate were associated significantly with brachial and aortic AIx. Maternal weight, height, mean arterial pressure, heart rate and gestational age were significant predictors of aortic PWV. Adjusted aortic AIx was significantly higher in both the HDP + SGA and HDP‐only groups, compared with in controls (12.5% and 10.0% vs 7.6%; both P < 0.01), and was significantly different between the two HDP groups (P = 0.002). Adjusted PWV was significantly higher in the HDP‐only group compared with in controls and the HDP + SGA group (7.7 m/s vs 7.1 m/s and 7.1 m/s; both P < 0.001). Conversely, unadjusted PWV was not significantly different between the two HDP groups (P = 0.414). Conclusions Pregnancies complicated by HDP with, and those without, a SGA neonate have significantly higher aortic AIx compared with uncomplicated normotensive pregnancies. Aortic AIx was highest in those pregnancies complicated by HDP with a SGA neonate, reflecting a progression in severity of arterial stiffness abnormality with a worsening clinical picture. These findings most likely reflect systemic reduced vascular compliance and increased systemic vascular resistance in pregnancy complicated by HDP. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Maternal haemodynamic function differs in pre‐eclampsia when it is associated with a small‐for‐gestational‐age newborn: a prospective cohort study

Abstract: Objective To describe maternal haemodynamic differences in gestational hypertension with small-for-gestational-age babies (HDP + SGA), gestational hypertension with appropriate-forgestational-age babies (HDP-only) and control pregnancies. Design Prospective cohort study.

Cited by 19 publications

References 53 publications

Decreased cardiac output: an integrative review

Decreased cardiac output: an integrative review

Community Based Study of Preterm Births, Small for Gestation and Low Birth Weight Babies in Rural Tribal Women with Extreme Poverty

Maternal arterial stiffness in hypertensive pregnancies with and without small‐for‐gestational‐age neonate

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