Substantial decrease in preeclampsia prevalence and risk over two decades: A population-based study of 1,153,227 deliveries in Norway

Sole, Kristina Baker; Staff, Anne Cathrine; Räisänen, Sari; Laine, Katariina

doi:10.1016/j.preghy.2022.02.001

Cited by 17 publications

(23 citation statements)

References 37 publications

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“…This may limit generalization to other populations. The proportion of women with preeclampsia was 3.7%, which is in line with other population‐based cohort studies 27,28 . We also performed a sensitivity analysis to ensure that the sample did not differ from the underlying cohort in any clinical characteristics.…”

Section: Discussionsupporting

confidence: 71%

“…The proportion of women with preeclampsia was 3.7%, which is in line with other population-based cohort studies. 27,28 We also performed a sensitivity analysis to ensure that the sample did not differ from the underlying cohort in any clinical characteristics. Only three women gave birth before 34 weeks of gestation; hence, our findings are limited to late-onset preeclampsia.…”

Section: Discussionmentioning

confidence: 99%

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Metabolic profiling of pregnancies complicated by preeclampsia: A longitudinal study

Skytte

Christensen

Gunnes

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Preeclampsia is associated with maternal metabolic disturbances, but longitudinal studies with comprehensive metabolic profiling are lacking. We aimed to determine metabolic profiles across gestation in women who developed preeclampsia compared with women with healthy pregnancies. We also explored the respective effects of body mass index (BMI) and preeclampsia on various metabolic measures. Material and methods We measured 91 metabolites by high‐throughput nuclear magnetic resonance spectroscopy at four time points (visits) during pregnancy (weeks 14–16, 22–24, 30–32 and 36–38). Samples were taken from a Norwegian pregnancy cohort. We fitted a linear regression model for each metabolic measure to compare women who developed preeclampsia (n = 38) and healthy controls (n = 70). Results Among women who developed preeclampsia, 92% gave birth after 34 weeks of gestation. Compared to women with healthy pregnancies, women who developed preeclampsia had higher levels of several lipid‐related metabolites at visit 1, whereas fewer differences were observed at visit 2. At visit 3, the pattern from visit 1 reappeared. At visit 4 the differences were larger in most subgroups of very‐low‐density lipoprotein particles, the smallest high‐density lipoprotein, total lipids and triglycerides. Total fatty acids were also increased, of which monounsaturated fatty acids and saturated fatty acids showed more pronounced differences. Concentration of glycine tended to be lower in pregnancies with preeclampsia until visit 3, although this was not significant after correction for multiple testing. After adjustment for age, BMI, parity and gestational weight gain, all significant differences were attenuated at visits 1 and 2. The estimates were less affected by adjustment at visits 3 and 4. Conclusions In early pregnancy, the metabolic differences between preeclamptic and healthy pregnancies were primarily driven by maternal BMI, probably representing the women's pre‐pregnancy metabolic status. In early third trimester, several weeks before clinical manifestation, the differences were less influenced by BMI, indicating preeclampsia‐specific changes. Near term, women with preeclampsia developed an atherogenic metabolic profile, including elevated total lipids, very‐low‐density lipoprotein, triglycerides, and total fatty acids.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Metabolic profiling of pregnancies complicated by preeclampsia: A longitudinal study

Skytte

Christensen

Gunnes

et al. 2023

Acta Obstet Gynecol Scand

View full text Add to dashboard Cite

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“…During our study period, there was an increase in women 30 years or older at delivery, pregnancies after assisted reproductive technology or with any diabetes. The proportion of multiparous women and smokers and women with preeclampsia decreased 17 …”

Section: Resultsmentioning

confidence: 99%

“…The proportion of multiparous women and smokers and women with preeclampsia decreased. 17 The prevalence of labor induction increased from 9.7% (5195/53 702) of all deliveries in gestational weeks 37-42 in 1999 to 25.9% (13 215/50 968) in 2019 (Figure 2, Table 2). The increase was observed in all gestational weeks, but was particularly high in gestational week 41, from 7.5% (817/10 935) in 1999 to 28.6% (3070/10 748) in 2019…”

Section: Re Sultsmentioning

confidence: 99%

Is the increasing prevalence of labor induction accompanied by changes in pregnancy outcomes? An observational study of all singleton births at gestational weeks 37–42 in Norway during 1999–2019

Haavaldsen

Morken

Saugstad

et al. 2022

Acta Obstet Gynecol Scand

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Introduction Induction of labor is often performed to prevent adverse perinatal and maternal outcomes, and has become increasingly common. We studied whether changes in prevalence of labor induction in gestational weeks 37–42 weeks were accompanied by changes in adverse pregnancy outcomes or mode of delivery. Material and methods We used data from the Medical Birth Registry of Norway, and included all singleton births in gestational weeks 37–42 in Norway, 1999–2019 (n = 1 127 945). We calculated the prevalence of labor induction and outcome measures according to year of birth. We repeated these calculations for each gestational week at birth. Results The prevalence of labor induction increased from 9.7% to 25.9%, and the increase was particularly high in gestational week 41. A modest decline in fetal deaths was observed in all gestational weeks, except gestational week 41. The overall decline was from 0.18% in 1999–2004 to 0.13% during 2015–2019. There were no overall changes in other perinatal outcomes. The prevalence of postpartum hemorrhage ≥500 ml increased from 11.4% in 1999 to 30.1% in 2019, and operative deliveries increased slightly. The prevalence of acute cesarean section increased from 6.5% to 9.3%, whereas vacuum and/or forceps assisted deliveries increased from 7.8% to 10.4%. Conclusions A high increase in labor inductions was accompanied by a modest decline in fetal deaths, but no decline in other adverse perinatal outcomes. In settings where the prevalence of adverse perinatal outcomes is low, the beneficial effect of increased use of labor induction may not outweigh the side effects or the costs.

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“…preeclampsia [3]. Indeed, p38MAPK signal transduction pathways mediate cell injury, inflammation, and oxidative stress, and p38MAPK is significantly activated in the placenta of patients with preeclampsia [4]. Therefore, it may be speculated that the abnormal infiltration of extravillous trophoblasts caused by abnormal expression of p38MAPK is important in the pathogenesis of preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Aspirin protects against preeclampsia via p38MAPK signaling pathway

Su¹,

Zhou²,

Zhen³

et al. 2023

Trop. J. Pharm Res

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Purpose: To investigate the protective effect of aspirin against preeclampsia and the involvement of p38MAPK signaling pathway in the process.Methods: Sixty pregnant women who underwent antenatal care and delivery at Chancheng Central Hospital from September 2020 to September 2022 were selected and equally assigned to control group (CG) and experimental group (EG). From the 12th week of gestation, EG was administered 100 mg of aspirin and 1000 mg of calcium carbonate daily, while CG was given only 1000 mg of calcium carbonate daily. Both groups were treated up to the 35th week of gestation. Thereafter, blood samples were taken for measurement of serum levels of p38MAPK. In addition, the blood pressure of the women was measured. The incidence of preeclampsia and maternal-infant outcomes were assessed.Results: EG had a lower p38MAPK level at week 35 of pregnancy, and lower blood pressure levels at the 27th and 35th weeks of gestation, than CG (p < 0.05). There were 5 cases of preeclampsia (16.7 %) in EG, and 13 cases (43.3 %) of preeclampsia in CG, with a lower incidence of preeclampsia in EG than in CG (ꭓ2 = 5.079, p < 0.05). The numbers of newborns through premature delivery and cesarean section, as well as Apgar score ≤ 7 were lower in EG than in CG (p < 0.05).Conclusion: Aspirin exerts a protective effect against preeclampsia through via p38MAPK signaling pathway. Therefore, aspirin treatment may be useful in reducing the incidence of preeclampsia and improving maternal-infant outcomes. However, further clinical trials are recommended prior to application in clinical practice.

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Substantial decrease in preeclampsia prevalence and risk over two decades: A population-based study of 1,153,227 deliveries in Norway

Cited by 17 publications

References 37 publications

Metabolic profiling of pregnancies complicated by preeclampsia: A longitudinal study

Metabolic profiling of pregnancies complicated by preeclampsia: A longitudinal study

Is the increasing prevalence of labor induction accompanied by changes in pregnancy outcomes? An observational study of all singleton births at gestational weeks 37–42 in Norway during 1999–2019

Aspirin protects against preeclampsia via p38MAPK signaling pathway

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