Effect of pregnancy prolongation in early-onset pre-eclampsia on postpartum maternal cardiovascular, renal and metabolic function in primiparous women: an observational study

Autor: M. Spaanderman, E G Mulder, Chahinda Ghossein-Doha, Jrw Crutsen, B. Thilaganathan, Smj van Kuijk
Přispěvatelé: Obstetrie & Gynaecologie, RS: GROW - R4 - Reproductive and Perinatal Medicine, MUMC+: KIO Kemta (9), Epidemiologie, RS: CAPHRI - R2 - Creating Value-Based Health Care, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9)
Rok vydání: 2020
Předmět:
Postnatal Care
Vascular damage Radboud Institute for Health Sciences [Radboudumc 16]
Ethnic group
DISEASE
0302 clinical medicine
Cultural dissonance
Pre-Eclampsia
early‐onset pre‐eclampsia
Pregnancy
Risk Factors
Health care
Medicine
Eclampsia
Pregnancy
Prolonged
PREDICTORS
Netherlands
Metabolic Syndrome
OUTCOMES
030219 obstetrics & reproductive medicine
early-onset pre-eclampsia
PRETERM
Postpartum Period
PROTEINURIA
Obstetrics and Gynecology
cardiovascular health
deferred delivery
Prenatal Care
3. Good health
Parity
Regression Analysis
Original Article
Female
Thematic analysis
Adult
hypertension
DISORDERS
Maternal Medicine
Language barrier
Interpersonal communication
EXPECTANT MANAGEMENT
WEEKS GESTATION
03 medical and health sciences
Nursing
Albuminuria
Humans
business.industry
DIABETES-MELLITUS
Original Articles
Puerperal Disorders
HYPERTENSIVE DISORDERS
RISK-FACTORS
business
Qualitative research
Zdroj: Bjog
Bjog-an International Journal of Obstetrics and Gynaecology, 128(1), 121-129. Wiley
BJOG: An International Journal of Obstetrics & Gynaecology
BJOG : an International Journal of Obstetrics and Gynaecology, 128, 121-129
BJOG : an International Journal of Obstetrics and Gynaecology, 128, 1, pp. 121-129
ISSN: 1471-0528
1470-0328
Popis: Objective To evaluate the association between deferred delivery in early‐onset pre‐eclampsia and offspring outcome and maternal cardiovascular, renal and metabolic function in the postpartum period. Design Observational study. Setting Tertiary referral hospital. Population Nulliparous women diagnosed with pre‐eclampsia before 34 weeks’ gestation who participated in a routine postpartum cardiovascular risk assessment programme. Women with hypertension, diabetes mellitus or renal disease prior to pregnancy were excluded. Methods Regression analyses were performed to assess the association between pregnancy prolongation and outcome measures. Main outcome measures Offspring outcome and prevalence of deviant maternal cardiovascular, renal and metabolic function. Results The study population included 564 women with a median pregnancy prolongation of 10 days (interquartile range [IQR] 4–18) who were assessed at on average 8 months (IQR 6–12) postpartum. Pregnancy prolongation after diagnosis resulted in a decrease in infant mortality (adjusted odd ratio [aOR] 0.907, 95% CI 0.852–0.965 per day prolongation). This improvement in offspring outcome was associated with an elevated risk of moderately increased albuminuria (aOR 1.025, 95% CI 1.006–1.045 per day prolongation), but not with aberrant cardiac geometry, cardiac systolic or diastolic dysfunction, persistent hypertension or metabolic syndrome. Conclusion Pregnancy prolongation in early‐onset pre‐eclampsia is associated with improved offspring outcome and survival. These effects do not appear to be deleterious to short‐term maternal cardiovascular and metabolic function but are associated with a modest increase in risk of residual albuminuria. Tweetable abstract Pregnancy prolongation in pre‐eclampsia has only a limited effect on postpartum maternal cardiovascular function.
Tweetable abstract Pregnancy prolongation in pre‐eclampsia has only a limited effect on postpartum maternal cardiovascular function.
Databáze: OpenAIRE
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