Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach

Abstract

The study aimed to develop prediction algorithms for hypertensive disorders based on multivariate analysis of factors from the maternal history and compare the estimated performance of such algorithms in the prediction of early preeclampsia (PE), late-PE and gestational hypertension (GH) with that recommended by the National Institute for Clinical Excellence (NICE). Logistic regression analysis was used to determine which of the maternal characteristics and history had significant contribution in predicting early-PE, late-PE and GH. There were 37 cases with early-PE, 128 with late-PE, 140 with GH and 8061 cases that were unaffected by PE or GH. Predictors of early-PE were Black race, chronic hypertension, prior PE and use of ovulation drugs. Predictors of late-PE and GH were increased maternal age and body mass index, and family history or history of PE. Additionally, late-PE was more common in Black, Indian and Pakistani women. The detection rates of early-PE, late-PE and GH in screening by maternal factors were 37.0, 28.9 and 20.7%, respectively, for a 5% false positive rate. Screening as suggested by NICE would have resulted in a false positive rate of 64.1% with detection rates of 89.2, 93.0 and 85.0% for early-PE, late-PE and GH, respectively. Meaningful screening for hypertensive disorders in pregnancy by maternal history necessitates the use of algorithms derived by logistic regression analysis.

Maternal serum insulin-like growth factor-binding protein-3 (IGFBP-3) at 11–13 weeks in preeclampsia

“…38 Similarly, the association between early-PE with high uterine artery PI and low serum PAPP-A is compatible with findings of extensive studies implicating impaired placental development and function in the pathogenesis of early-PE. [7][8][9] In the unaffected controls, the maternal serum concentration of IGFBP-3 decreased with fetal crown-rump length and was lower in women using ovulation induction drugs.…”

Maternal & Perinatal outcome in Hypertensive Disorders of Pregnancy in a Tertiary Care Hospital in Northern India

“…Nulliparity is widely reported as a risk factor for hypertensive disorders in pregnancy [13][14][15]. But in the present study, we found that multiparity was more associated with HDP as compared with nulliparity, however the difference was not statistically significant.…”

Magzati és anyai betegségek kockázata 40 évesnél idősebb édesanyák esetén

“…Ma már számos közlemény [8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50] : 1,32). A császármetszés gyakorisága először szülőknél és többedszer szülőknél egyaránt lényegesen magasabb a 30 éves korosztályhoz képest.…”