OSLO, NORWAY — Gestational hypertension and preeclampsia discuss several preconception risk factors, a few of which could be modified to minimize the risk of side pregnancy outcomes, suggests a cohort study covering >13,000 pregnancies[1].
“Our findings assist the hypotheses that pregnancy unmasks predisposing familial and modifiable cardiometabolic risk,” write the authors, led by Dr Grace M Egeland (Norwegian Institute of Public Good health & University of Bergen), in their report published April 25, 2016 in Hypertension. “However, in the latest study, a better variety of risk factors predicted preeclampsia compared to gestational hypertension.”
A family history of diabetes and women’s own diabetes status prior to conception predicted the two gestational hypertension and preeclampsia among participants in the Cohort Norway (CONOR) Good health survey, which ran from 1994 to 2003.
A family history of MI prior to age 60 likewise predicted preeclampsia, yet it didn’t predict gestational hypertension. A family history of stroke predicted the combined outcome of gestational hypertension or preeclampsia.
A total cholesterol/HDL-cholesterol levels ratio exceeding 5 predicted the two gestational hypertension and preeclampsia; yet raised triglycerides (≥1.7 mmol/L) was a predictor just for preeclampsia, according to the group. Obesity turned out to be an necessary risk factor for the two side pregnancy outcomes.
Women determined to be at increased risk for an side pregnancy outcome require much more constant screening as the pregnancy progresses, to ascertain whether or not they are in the unlucky zone, observed Dr Christopher Redman (Oxford University, UK) for heartwire from Medscape.
“The question is: Could these risk factors be modified ahead of time of pregnancy?” he asked, referring the analysis findings. “And they can—obesity is the primary example—it’s not known for sure, yet every little thing points to the honest truth that if a woman can easily delivering her [body-mass index] BMI down in to the regular zone, she’ll minimize her risk of having preeclampsia and gestational hypertension.”
Redman, long a leading figure in obstetric medicine, isn’t connected along with the latest analysis.
Certainly, he said, a woman preparation a pregnancy and meeting along with her doctor would certainly incentive from being informed of necessary risks for side pregnancy outcomes. “Among the severe troubles women improve after they’ve been through preeclampsia—not so a lot gestational hypertension, which is generally a milder situation—is: Why didn’t anyone warn me? I had no pointer that this could happen.”
Preconception Risk Factors for Hypertensive Disorders of Pregnancy, Odds Ratio (95% CI)
| Risk factor | Gestational hypertension | Preeclampsia |
| Family history of diabetes | 2.1 (1.39–3.09) | 1.6 (1.12–2.25) |
| Stroke | 1.5 (0.85–2.55) | 1.5 (0.95–2.24) |
| MI prior to 60 | 1.1 (0.69–1.70) | 1.8 (1.31–2.39) |
| Prepregnancy diabetes | 3.2 (1.14–8.68) | 3.1 (1.43–6.49) |
| Weekly alcohol consumption | 0.8 (0.40–1.42) | 0.5 (0.27–0.78) |
| Binge drinking ≥6 times past year | 1.2 (0.65–2.12) | 1.8 (1.09–2.94) |
In various other findings from the study, bodily activity for 3 hrs a week or much more reasonable the risk of preeclampsia by 20% and the risk of preterm preeclampsia by 50%. yet bodily activity is not protective versus gestational hypertension, the analysis suggests.
Weekly alcohol intake emerged as similarly protective versus preeclampsia. Compared along with no alcohol intake or intake of much less compared to one serving per month, weekly alcohol intake prior to conception was associated along with a 30% reduced risk of the two preeclampsia and term preeclampsia.
On the various other hand, binge drinking increased the risk of preeclampsia virtually twofold and it increased the risk of preterm preeclampsia virtually fourfold.
Adjusted for binge drinking, weekly alcohol intake likewise reasonable the risk of preeclampsia by 50%, and its protective effect was also more powerful for preterm preeclampsia.
Redman said that pharmacologic correction of dyslipidemia is a tricky thing to recommend in the context; physicians are reluctant to prescribe a statin from concern for effects on the making fetus.
Neither the study’s authors nor Redman had conflicts to disclose.
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