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Hypertensive Disorders of Pregnancy

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1. Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy. (PubMed)

Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy. The hypertensive disorders of pregnancy include pre-eclampsia, gestational hypertension, chronic hypertension, and undefined hypertension. Pre-eclampsia is considerably more prevalent in low-income than in high-income countries. One possible explanation for this discrepancy is dietary differences, particularly calcium deficiency. Calcium supplementation in the second half (...) to be inadequate. This is an update of a review first published in 2017.To determine the effect of calcium supplementation, given before or early in pregnancy and for at least the first half of pregnancy, on pre-eclampsia and other hypertensive disorders, maternal morbidity and mortality, and fetal and neonatal outcomes.We searched the Cochrane Pregnancy and Childbirth Trials Register (31 July 2018), PubMed (13 July 2018), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP; 31

2019 Cochrane

2. Calcium supplementation commencing before or early in pregnancy, or food fortification with calcium, for preventing hypertensive disorders of pregnancy. (PubMed)

Calcium supplementation commencing before or early in pregnancy, or food fortification with calcium, for preventing hypertensive disorders of pregnancy. Pre-eclampsia is considerably more prevalent in low- than high-income countries. One possible explanation for this discrepancy is dietary differences, particularly calcium deficiency. Calcium supplementation in the second half of pregnancy reduces the serious consequences of pre-eclampsia and is recommended by the World Health Organization (WHO (...) and other hypertensive disorders, maternal morbidity and mortality, as well as fetal and neonatal outcomes.We searched the Cochrane Pregnancy and Childbirth Trials Register (10 August 2017), PubMed (29 June 2017), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (10 August 2017) and reference lists of retrieved studies.Randomised controlled trials of calcium supplementation or food fortification which include women of child bearing age not yet pregnant, or in early

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2017 Cochrane

4. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. (PubMed)

Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Pre-eclampsia and eclampsia are common causes of serious morbidity and death. Calcium supplementation may reduce the risk of pre-eclampsia, and may help to prevent preterm birth. This is an update of a review last published in 2014.To assess the effects of calcium supplementation during pregnancy on hypertensive disorders of pregnancy and related maternal and child outcomes.We searched Cochrane (...) Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (18 September 2017), and reference lists of retrieved studies.We included randomised controlled trials (RCTs), including cluster-randomised trials, comparing high-dose calcium supplementation (at least 1 g daily of calcium) during pregnancy with placebo. For low-dose calcium we included quasi-randomised trials, trials without placebo, trials with cointerventions and dose

2018 Cochrane

5. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study. (PubMed)

Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study. Objectives To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time.Design Nationwide register based cohort study.Setting Denmark.Populations 482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses (...) ), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses).Main outcome measures 10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression.Results Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies

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2017 BMJ

6. Hypertension Canada's 2018 guidelines for the management of hypertension in pregnancy

eliorerlapriseenchargedesfemmes Hypertensive disorders of pregnancy (HDP) occur in approximately 7% of all pregnancies in Canada. 1 HDP represent a broad range of conditions including: chronic hypertension (ie, preexisting hypertension), gestational hypertension (ie, hypertension that develops after 20 weeks’ gestation), and/or preeclampsia/eclampsia (gestational hyper- tension with proteinuria and/or other target organ involve- ment). 2,3 HDP have a major effect on maternal, fetal, and newborn outcomes including: fetal (...) . Heterogeneity in types of HDP included might differentially affect clinical outcomes: a. Variable severity of disease (ranging from GHTN to severe preeclampsia) b. Represent different underlying pathophysiology 3. Clinical outcomes not cardiovascular events or mortality a. Use of surrogate outcomes 4. Small sample sizes 5. Short duration of follow-up (hours to months) GHTN, gestational hypertension; HDP, hypertensive disorders of pregnancy. prevention, and treatment of hypertension in adults and children

2018 CPG Infobase

7. Hypertension in pregnancy: diagnosis and management

is it for? 5 Recommendations 6 1.1 Reducing the risk of hypertensive disorders in pregnancy 6 1.2 Assessment of proteinuria in hypertensive disorders of pregnancy 8 1.3 Management of chronic hypertension in pregnancy 9 1.4 Management of gestational hypertension 13 1.5 Management of pre-eclampsia 17 1.6 Fetal monitoring 24 1.7 Intrapartum care 26 1.8 Medical management of severe hypertension, severe pre-eclampsia or eclampsia in a critical care setting 27 1.9 Antihypertensive treatment during the postnatal (...) of birth 46 Antihypertensive treatment during the postnatal period, including during breastfeeding 48 Risk of recurrence of hypertensive disorders of pregnancy and long-term cardiovascular disease 49 Context 50 Hypertension in pregnancy: diagnosis and management (NG133) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 54Finding more information and resources 52 Update information 53 Hypertension in pregnancy

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

8. The association between a history of hypertensive disorders of pregnancy (HDP) (preeclampsia or gestational hypertension) and the elevated risk of postpregnancy type 2 diabetes

The association between a history of hypertensive disorders of pregnancy (HDP) (preeclampsia or gestational hypertension) and the elevated risk of postpregnancy type 2 diabetes Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2019 PROSPERO

9. Guideline supplement: Hypertensive disorders of pregnancy

Guideline supplement: Hypertensive disorders of pregnancy Maternity and Neonatal C linical G uideline Queensland Health Supplement: Hypertensive disorders of pregnancy Queensland Clinical Guideline Supplement: Hypertensive disorders of pregnancy Refer to online version, destroy printed copies after use Page 2 of 13 Table of Contents 1 Introduction 3 1.1 Funding 3 1.2 Conflict of interest 3 1.3 Guideline review 3 2 Methodology 4 2.1 Topic identification 4 2.2 Scope 4 2.3 Clinical questions 4 2.4 (...) of this licence contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline Supplement: Hypertensive disorders of pregnancy Refer to online version, destroy printed copies after use Page 3 of 13 1 Introduction This document is a supplement to the Queensland Clinical Guideline Hypertensive disorders of pregnancy. It provides supplementary information regarding guideline development, makes

2016 Queensland Health

10. Hypertensive disorders of pregnancy

Hypertensive disorders of pregnancy Maternity and Neonatal C linical G uideline Queensland Health Hypertensive disorders of pregnancy Queensland Clinical Guideline: Hypertensive disorders of pregnancy Refer to online version, destroy printed copies after use Page 2 of 32 Document title: Hypertensive disorders of pregnancy Publication date: August 2015 Document number: MN15.13-V7-R20 Document supplement: The document supplement is integral to and should be read in conjunction with this guideline (...) . For permissions beyond the scope of this licence contact: Intellectual Property Officer, Queensland Health, GPO Box 48, Brisbane Qld 4001, email ip_officer@health.qld.gov.au, phone (07) 3234 1479. Queensland Clinical Guideline: Hypertensive disorders of pregnancy Refer to online version, destroy printed copies after use Page 3 of 32 Flow Chart: Management of eclampsia Queensland Clinical Guidelines: Hypertensive disorders in pregnancy. Flowchart version: F15.13-1-V7-R20 Control Seizures Control Hypertension

2016 Queensland Health

11. Evaluating pre-pregnancy dietary diversity vs. dietary quality scores as predictors of gestational diabetes and hypertensive disorders of pregnancy. (PubMed)

Evaluating pre-pregnancy dietary diversity vs. dietary quality scores as predictors of gestational diabetes and hypertensive disorders of pregnancy. Dietary diversity scores (DDS) are considered as metrics for monitoring the implementation of the UN's Sustainable Development Goals, but they need to be rigorously evaluated.To examine two DDS, the Food Groups Index (FGI), and the Minimum Dietary Diversity-Women (MDD-W), alongside two dietary quality scores, the Alternate Healthy Eating Index (...) (AHEI-2010) and the Prime Diet Quality Score (PDQS), with risks of gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDPs).The analysis included 21,312 (GDM) and 19,917 (HDPs) singleton births reported in the Nurses' Health Study II cohort (1991-2001), among women without major chronic disease or GDM/HDPs. Scores were derived using prepregnancy diet collected by a comprehensive food frequency questionnaire. Multivariable models were utilized to calculate relative risks (RR

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2018 PLoS ONE

12. Sodium Intake during Pregnancy, but Not Other Diet Recommendations Aimed at Preventing Cardiovascular Disease, Is Positively Related to Risk of Hypertensive Disorders of Pregnancy. (PubMed)

Sodium Intake during Pregnancy, but Not Other Diet Recommendations Aimed at Preventing Cardiovascular Disease, Is Positively Related to Risk of Hypertensive Disorders of Pregnancy. The role of diet on hypertensive disorders of pregnancy (HDPs), including preeclampsia and gestational hypertension (GHTN), remains unclear.We evaluated whether adherence during pregnancy to dietary recommendations that reduce cardiovascular disease (CVD) in the general population is related to the risk of HDPs.We (...) followed 66,651 singleton pregnancies from 62,774 women participating in the Danish National Birth Cohort. Diet was assessed during week of gestation 25 with an FFQ from which we created 2 dietary pattern scores: 1) AHA, based on the diet recommendations from the AHA 2020 Strategic Impact Goals; and 2) the Dietary Approaches to Stop Hypertension (DASH) diet. Cases of HDPs were identified through linkage with the Danish National Patient Registry. RRs and 95% CIs of HDPs were estimated by increasing

2019 Journal of Nutrition

13. Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses' Health Study II: observational cohort study. (PubMed)

Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses' Health Study II: observational cohort study. Objectives To study the association between lifestyle risk factors and chronic hypertension by history of hypertensive disorders of pregnancy (HDP: gestational hypertension and pre-eclampsia) and investigate the extent to which these risk factors modify the association between HDP and chronic hypertension.Design Prospective cohort study.Setting Nurses (...) ' Health Study II (1991-2013).Participants 54 588 parous women aged 32 to 59 years with data on reproductive history and without previous chronic hypertension, stroke, or myocardial infarction.Main outcome measure Chronic hypertension diagnosed by a physician and indicated through nurse participant self report. Multivariable Cox proportional hazards models were used to investigate the development of chronic hypertension contingent on history of HDP and four lifestyle risk factors: post-pregnancy body

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2017 BMJ

14. Post-traumatic stress disorder and hypertensive disorders of pregnancy among military women. (PubMed)

Post-traumatic stress disorder and hypertensive disorders of pregnancy among military women. Women are more likely to develop post-traumatic stress disorder (PTSD) than men. Limited research exists evaluating the risk of hypertensive disorders of pregnancy (HDP) among military women with PTSD.We conducted a retrospective cohort study using US Department of Defense (DoD) data comprised of all active-duty women giving birth to their first, liveborn singleton infant using DoD-sponsored health (...) except among mothers whose PTSD was diagnosed ≥1 year prior to conception (RR 1.42, 95% CI 1.06, 1.90).Post-traumatic stress disorder preceding conception by at least a year appeared to confer an increased risk of HDP, but further research is needed using more thorough PTSD assessment.© 2019 John Wiley & Sons Ltd.

2019 Paediatric and perinatal epidemiology

15. Usefulness of uterine artery Doppler velocimetry as a predictor for hypertensive disorders in pregnancy in women with prehypertension before 20 weeks gestation. (PubMed)

Usefulness of uterine artery Doppler velocimetry as a predictor for hypertensive disorders in pregnancy in women with prehypertension before 20 weeks gestation. Hypertensive disorders of pregnancy (HDP) is major complication of maternal-fetal outcomes in obstetric field. Although HDP is mainly defined by high blood pressure, the information about the relationship between prehypertension (preHTN, 120-139mmHg and 80-89mmHg) and HDP development is limited. The objective of this study (...) UtA Doppler velocimetry, and the numbers of preHTN assessments were recorded. The risk of HDP was assessed in the PreHTN groups through patient history and Doppler velocimetry. Compared to normotensive patients, a total of 223 preHTN patients had a higher risk of preeclampsia (OR: 2.3; CI: 1.2-4.3), gestational hypertension (OR: 3.3; CI: 2.0-5.4) and any HDP (OR: 3.0; CI: 2.0-4.5). In the preHTN group, 134 (60.1%) patients had preHTN measured at least twice and 89 (39.9%) patients had preHTN

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2019 PLoS ONE

16. Hypertensive disorders of pregnancy and peripartum cardiomyopathy: A nationwide cohort study. (PubMed)

Hypertensive disorders of pregnancy and peripartum cardiomyopathy: A nationwide cohort study. Peripartum cardiomyopathy (PPCM) is a serious cardiac disorder occurring late in pregnancy or early in the postpartum period. We examined associations between hypertensive disorders of pregnancy (HDP: preeclampsia and gestational hypertension) and PPCM, accounting for other pregnancy-related risk factors for PPCM.Using nationwide Danish register data, we constructed a cohort of all women with ≥1 live (...) preeclampsia, RR 21.2, 95% confidence interval [CI] 12.0-37.4; moderate preeclampsia, RR 10.2, 95% CI 6.18-16.9; gestational hypertension, RR 5.16, 95% CI 2.11-12.6). The RRs for moderate preeclampsia and gestational hypertension were not significantly different from one another (p = 0.18); the RR for severe preeclampsia was significantly different from the RR for moderate preeclampsia and gestational hypertension combined (p = 0.02).Although 70% of PPCM occurred in women with normotensive pregnancies

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2019 PLoS ONE

17. Perinatal outcomes of hypertensive disorders in pregnancy at a referral hospital, Southern Ethiopia. (PubMed)

Perinatal outcomes of hypertensive disorders in pregnancy at a referral hospital, Southern Ethiopia. Hypertensive Disorders in Pregnancy (HDP) complicate about 10% of pregnancies. It accounts to 50% of maternal death in sub-Saharan Africa and precedes 15% of perinatal deaths worldwide. In this study, we looked at the perinatal outcomes and factors associated with unfavorable perinatal outcomes among women with hypertensive disorders in pregnancy at Wolaita Sodo teaching and referral hospital (...) , southern Ethiopia.A hospital based retrospective cross-sectional study design was employed among women hospitalized for hypertensive disorders in pregnancy. Socio-demographic, obstetrics, clinical laboratory, pregnancy complications and outcome were checked from patient records. Descriptive statistics were used to describe parameters collected from patient records. Bivariate and multiple logistic regressions were done to determine factors associated with unfavorable perinatal outcome. A P-value of less

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2019 PLoS ONE

18. Cardiovascular risk model performance in women with and without hypertensive disorders of pregnancy

Cardiovascular risk model performance in women with and without hypertensive disorders of pregnancy Compare the predictive performance of Framingham Risk Score (FRS), Pooled Cohort Equations (PCEs) and Systematic COronary Risk Evaluation (SCORE) model between women with and without a history of hypertensive disorders of pregnancy (hHDP) and determine the effects of recalibration and refitting on predictive performance.We included 29 751 women, 6302 with hHDP and 17 369 without. We assessed

2018 EvidenceUpdates

19. Hypertensive Disorders of Pregnancy and Maternal Cardiovascular Disease Risk Factor Development: An Observational Cohort Study. (PubMed)

Hypertensive Disorders of Pregnancy and Maternal Cardiovascular Disease Risk Factor Development: An Observational Cohort Study. Women with a history of hypertensive disorders of pregnancy (HDP) are nearly twice as likely to develop cardiovascular disease (CVD) as those who are normotensive during pregnancy. However, the emergence of CVD risk factors after HDP is less well-understood.To identify associations between HDP and maternal CVD risk factors and chart the trajectory of risk factor (...) ratios (HRs) and 95% CIs, with adjustment for prepregnancy confounders.Compared with women who were normotensive during pregnancy, those with gestational hypertension (2.9%) or preeclampsia (6.3%) in their first pregnancy had increased rates of chronic hypertension (HRs, 2.8 [95% CI, 2.6 to 3.0] and 2.2 [CI, 2.1 to 2.3], respectively), T2DM (HRs, 1.7 [CI, 1.4 to 1.9] and 1.8 [CI, 1.6 to 1.9], respectively), and hypercholesterolemia (HRs, 1.4 [CI, 1.3 to 1.5] and 1.3 [CI, 1.3 to 1.4], respectively

2018 Annals of Internal Medicine

20. Vitamin D and risk of pregnancy related hypertensive disorders: mendelian randomisation study. (PubMed)

Vitamin D and risk of pregnancy related hypertensive disorders: mendelian randomisation study. To use mendelian randomisation to investigate whether 25-hydroxyvitamin D concentration has a causal effect on gestational hypertension or pre-eclampsia.One and two sample mendelian randomisation analyses.Two European pregnancy cohorts (Avon Longitudinal Study of Parents and Children, and Generation R Study), and two case-control studies (subgroup nested within the Norwegian Mother and Child Cohort (...) Study, and the UK Genetics of Pre-eclampsia Study).7389 women in a one sample mendelian randomisation analysis (751 with gestational hypertension and 135 with pre-eclampsia), and 3388 pre-eclampsia cases and 6059 controls in a two sample mendelian randomisation analysis.Single nucleotide polymorphisms in genes associated with vitamin D synthesis (rs10741657 and rs12785878) and metabolism (rs6013897 and rs2282679) were used as instrumental variables.Gestational hypertension and pre-eclampsia defined

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2018 BMJ

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