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Latest & greatest articles for preeclampsia
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A Systematic Review of First Trimester Biochemical and Molecular Predictive Tests for Preeclampsia. Preeclampsia is a multisystem disorder affecting 5%-8% of pregnant women. Considering the ongoing debate over the predicting value of some commercial first trimester tests, the aim of this study was to compare the existing first-trimester screening tests for preeclampsia.In this systematic review, relevant articles published during 2000-2017 were extracted from PubMed, Science Direct, Scopus (...) , Cochrane Library, ISI Web of Science, and ProQuest databases. After a thorough evaluation of the 412 potentially eligible papers, only 28 papers were selected based on the inclusion criteria.From a total of 412 retrieved studies, 28 papers were found eligible. Most studies had casecontrol or nested case-control designs. A total of 15164 pregnant women were evaluated in the reviewed studies. Various tests were applied in the first trimester of pregnancy to predict the development of preeclampsia
Meta-analysis suggests that metformin may reduce pre-eclampsia compared with insulin use during pregnancy. 30108059 2019 04 01 2019 04 01 2515-4478 24 2 2019 04 BMJ evidence-based medicine BMJ Evid Based Med Meta-analysis suggests that metformin may reduce pre-eclampsia compared with insulin use during pregnancy. 72-73 10.1136/bmjebm-2018-110975 Feig Denice D 0000-0001-8561-7584 Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Department of Health Policy Management (...) and Evaluation, University of Toronto, Toronto, Ontario, Canada. eng Journal Article Review Comment 2018 08 14 England BMJ Evid Based Med 101719009 2515-446X 0 Hypoglycemic Agents 0 Insulins 9100L32L2N Metformin IM Diabet Med. 2018 Feb;35(2):160-172 29044702 Diabetes, Gestational Female Humans Hypoglycemic Agents Insulins Metformin Pre-Eclampsia Pregnancy diabetes In pregnancy maternalmedicine obstetrics Competing interests: None declared. 2018 07 24 2018 8 16 6 0 2019 4 2 6 0 2018 8 16 6 0 ppublish 30108059
. Papers were excluded if they evaluated antioxidant nutrient supplementation associated with other non-antioxidant therapies. Data were extracted and the risk of bias of each study was assessed. Heterogeneity was analyzed using the Cochran Q test, and I2 statistics and pre-specified sensitivity analyses were performed. Meta-analyses were conducted on prevention and treatment studies, separately. The primary outcome was the incidence of preeclampsia in prevention trials, and of perinatal death (...) Oral antioxidant therapy for prevention and treatment of preeclampsia: Meta-analysis of randomized controlled trials. To determine whether oral antioxidant therapies, of various types and doses, are able to prevent or treat women with preeclampsia.The following databases were searched: MEDLINE, CENTRAL, LILACS, and Web of Science. Inclusion criteria were: a) randomized clinical trials; b) oral antioxidant supplementation; c) study in pregnant women; d) control group, treated or not with placebo
Serum neopterin levels in women with preeclampsia: a systematic review. Neopterin is a pteridine that is produced following activation of human macrophages upon stimulation with the cytokine interferon-gamma. Several studies suggest its association with preeclampsia and the purpose of the present study is to evaluate this assumption.We searched the Medline (1992-2018), Scopus (1993-2018) and Google Scholar (1993-2018) databases. All articles that evaluated serum neopterin levels in patients (...) with preeclampsia were held eligible for inclusion, regardless of the trimester of pregnancy in which the measurement was performed. Case reports, animal studies and previous reviews were excluded.A total of 10 studies were finally included in the present review, with a total number of 3,529 pregnant women. Among them 446 were diagnosed with preeclampsia. The majority of included studies reported that serum neopterin was significantly higher in patients with preeclampsia, compared to normotensive pregnant women
Aspirin and heparin for the prevention of pre-eclampsia: protocol for a systematic review and network meta-analysis. Pre-eclampsia is an important cause of death and complication for pregnant women and perinatal infant. Low-dose aspirin has been most commonly used to prevent pre-eclampsia in high-risk pregnant women. Recently, heparins have also been used alone or in combination with aspirin to prevent pre-eclampsia. However, the optimal doses and combination therapy of aspirin and heparins (...) are not well established. Therefore, we aim to compare aspirin, heparins and their combination to prevent pre-eclampsia in a network meta-analysis.We will search the following electronic databases from the date of database establishment to 8 January 2019: PubMed, Embase, Cochrane Library, Web of Science and ProQuest. We will also search additional studies manually. There will be no restriction on the language of publications. Only randomised clinical trials will be eligible in our network meta-analysis. We
Inflammatory Markers and Preeclampsia: A Systematic Review. Preeclampsia (PE), a serious and variable pregnancy complication affecting 5%-10% of the obstetric population, has an undetermined etiology, yet inflammation is concomitant with its development, particularly in relation to endothelial dysfunction.The purpose of this systematic review was to examine the published evidence concerning an association between PE and inflammatory markers for their usefulness in the prediction or early
Vitamin D and risk of preeclampsia: A systematic review and meta-analysis. Human vitamin D levels have been increasingly related to a wide range of clinical
outcomes. There is a large amount of reports on its associations, especially with obstetric complications,
including preeclampsia and gestational diabetes. These results are scarcely consistent and there is still
a lack of quality intervention studies to confirm the role of vitamin D in those outcomes.
Objective: To review the available (...) review and metaanalysis suggest an inverse ratio between vitamin D
levels and the development of preeclampsia. There was heterogeneity among the studies with regard
to the design, population, geographic location, definitions of exposure, and the outcome. We excluded
randomized controlled trials from this meta-analysis.The inverse association we found suggests that the higher the levels of vitamin D the
lesser the probability of developing preeclampsia, in spite of the heterogeneity of the global
Predictive performance of the competing risk model in screening for preeclampsia The established method of screening for preeclampsia is to identify risk factors from maternal demographic characteristics and medical history; in the presence of such factors the patient is classified as high risk and in their absence as low risk. However, the performance of such an approach is poor. We developed a competing risks model, which allows combination of maternal factors (age, weight, height, race (...) , parity, personal and family history of preeclampsia, chronic hypertension, diabetes mellitus, systemic lupus erythematosus or antiphospholipid syndrome, method of conception and interpregnancy interval), with biomarkers to estimate the individual patient-specific risks of preeclampsia requiring delivery before any specified gestation. The performance of this approach is by far superior to that of the risk scoring systems.The objective of the study was to examine the predictive performance
Comprehensive analysis of oxidative stress markers and antioxidants status in preeclampsia. Preeclampsia is a hypertensive disorder in pregnant women, which can be the leading cause of maternal and neonatal death or premature birth. Although the cause of preeclampsia is still not clear, local or systemic oxidative stress may explain the pathological features associated with this complication. However, it is not clear whether oxidative stress is the cause or the result of preeclampsia (...) . For this purpose, the present meta-analysis was intended to evaluate the oxidant and antioxidant status in women with preeclampsia. Relevant studies were identified after a preliminary investigation of research articles published up to September 2017. In the overall analysis, including 2953 cases and 3621 controls, a statistically significant reduction in total antioxidant capacity, nitric oxide, superoxide dismutase, glutathione, vitamin E and C was observed in preeclampsia women. On the other hand
Systematic review and meta-analysis regarding the association of endometriosis and preeclampsia in women conceiving spontaneously or through assisted reproductive technology. To investigate the association between endometriosis and preeclampsia and/or its severe forms (eclampsia and/or the hemolysis, elevated liver enzymes and low platelet count [HELLP] syndrome) in pregnancies conceived either spontaneously or by assisted reproductive technology (ART).Systematic review and meta-analysis (...) of observational studies. Search in PubMed-Medline, Scopus, Web of Science, Cochrane Library, Clinicaltrials.gov, the UK Clinical Trials Gateway, and the Australian New Zealand Clinical Trials Registry was conducted from inception through 21 June 2017, without language restrictions. Primary outcome was preeclampsia and/or its severe forms (eclampsia and/or HELLP syndrome) in pregnant women. Random-effects models were used for meta-analyses. Endometriosis effect was estimated as odds ratio (OR) with 95
Assessment of NICE and USPSTF guidelines for identifying women at high risk of pre-eclampsia for tailoring aspirin prophylaxis in pregnancy: An individual participant data meta-analysis. To assess the accuracy of the National Institute of Health and Care Excellence (NICE) and United States Preventive Services Task Force (USPSTF) guidelines for predicting pre-eclampsia in pregnancy to guide aspirin prophylaxis.We conducted an individual participant data meta-analysis using the Perinatal (...) Antiplatelet Review of International Studies (PARIS) dataset. This dataset includes randomised controlled trials (RCTs) of antiplatelet therapy for primary prevention of pre-eclampsia conducted in international antenatal care settings. RCTs were eligible if they enrolled pregnant women up to 28 weeks'gestation, reported risk factors, and assessed pre-eclampsia. Women assigned to the control arm (no antiplatelet agent) were included. Both guidelines recommend aspirin if ≥1 high-risk factors or ≥2 moderate
Glycated haemoglobin A1c as a predictor of preeclampsia in type 1 diabetic pregnant women: A systematic review and meta-analysis. To examine the relationship between the increase of glycated haemoglobin A1c (HbA1c) levels and the risk of preeclampsia in pregnant with type 1 diabetes mellitus; and to determine from which trimester the increase of HbA1c levels better predicts the risk of suffering preeclampsia in type 1 diabetic pregnant women.We systematically searched MEDLINE, EMBASE (...) , the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews and Web of Science databases, from inception to May 2017, for observational studies addressing the association of HbA1c levels with preeclampsia. Fixed effects models were used to compute pooled estimates of odds ratio (OR) and respective 95% confidence intervals (95% CI) for preeclampsia in type 1 diabetic pregnant women. Additionally, subgroup analyses were performed based on pregnancy trimester.Five published
Effectiveness of psycho-educational counseling on anxiety in preeclampsia. Preeclampsia is a serious complication during pregnancy that not only influences maternal and fetal physical health, but also has maternal mental health outcomes such as anxiety. Prenatal anxiety has negative short- and long-term effects on pre- and postpartum maternal mental health, delivery, and mental health in subsequent pregnancies.To investigate the effectiveness of individual psycho-educational counseling (...) on anxiety in pregnant women with preeclampsia.This was a randomized, intervention-controlled study involving two governmental hospitals in the municipality of Sirjan, Kerman, from January 30 2017 to March 31 2017. A total of 44 pregnant women with preeclampsia were assessed. The women were randomized into two groups: control (n=22) and intervention (n=22). The intervention consisted of two sessions of individual psycho-educational counseling. The level of anxiety was measured using the Spielberger State
Gestational Hypertension and Preeclampsia Gestational Hypertension and Preeclampsia | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Gestational Hypertension and Preeclampsia Practice Bulletin Number 202 January 2019 Jump to Resources Share Nonmembers: Subscribe now to access exclusive ACOG Clinical content, including: ACOG Clinical is designed for easy and convenient access to the latest clinical
Mean platelet volume values in preeclampsia: A systematic review and meta-analysis. Mean platelet volume (MPV) has been explored in several observational studies in the field of preeclampsia and current evidence seem to be conflicting. The purpose of the present meta-analysis is to evaluate the reported MPV differences in patients that develop preeclampsia and to compare them to those of otherwise healthy women.We searched the international literature using the Medline (1966-2018), Scopus (2004 (...) -2018), EMBASE (1947-2018) and Clinicaltrials.gov (2008-2018) databases. Statistical meta-analysis was performed using the RevMan 5.3 software.The meta-analysis was based on outcomes reported from 50 studies that included 14,614 women. MPV was significantly higher in preeclamptic than healthy pregnant women (7905 women, MD: 1.04 fl, 95% CI [0.76, 1.32]). The mean difference was less evident among women with mild preeclampsia (6604 women, MD: 0.65 fl, 95% CI [0.19, 1.11]), compared to the severe ones
Association of vitamin D level and vitamin D deficiency with risk of preeclampsia: A systematic review and updated meta-analysis. Because of the immune modulatory effects of vitamin D3 in preeclampsia, we intend to have a systematic review and meta-analysis on association of both 25-hydroxy vitamin D (25-OHD) level (parametric approach) and 25-OHD deficiency (non-parametric approach) with preeclampsia. As well, for the parametric part, we used receiver operating characteristic (ROC) curve (...) model.We used Web of Science, PubMed and Science Direct data bases through searching in titles. Google Scholar search engine was used in order to find missing papers. Finally 23 studies were imported. Both random and fixed models were reported.Based on the forest plot, lower levels of 25-OHD were significantly associated with risk of preeclampsia (fixed and random P < 0.001). Based on the forest plot, vitamin D deficiency (25-OHD < 20 ng/ml) was significantly associated with risk of preeclampsia (fixed
Torsemide for Prevention of Persistent Postpartum Hypertension in Women With Preeclampsia: A Randomized Controlled Trial To evaluate whether torsemide reduces the rate of persistent postpartum hypertension in women with preeclampsia.We conducted a randomized, double-blind, placebo-controlled trial of women with preeclampsia at a tertiary center from August 2016 to September 2017. Those with gestational hypertension or renal or cardiopulmonary failure were excluded. Within 24 hours of delivery (...) , women were randomized one to one to oral torsemide, 20 mg/d, or placebo, for 5 days. Our primary outcome was blood pressure greater than or equal to 150 mm Hg systolic or 100 mm Hg diastolic (or both) on two occasions at least 4 hours apart by postpartum day 5 or by the time of hospital discharge. Assuming a 50% rate of persistent hypertension in women with preeclampsia, 118 participants were required to detect a 50% rate reduction. Analyses were by intention to treat.From August 2016 to September
Esomeprazole to treat women with preterm preeclampsia: a randomized placebo controlled trial Preterm preeclampsia has a high rate of fetal death or disability. There is no treatment to slow the disease, except delivery. Preclinical studies have identified proton pump inhibitors as a possible treatment.The purpose of this study was to examine whether esomeprazole could prolong pregnancy in women who have received a diagnosis of preterm preeclampsia.We performed a double-blind, randomized (...) controlled trial at Tygerberg Hospital in South Africa. Women with preterm preeclampsia (gestational age 26 weeks+0 days to 31 weeks+6 days) were assigned randomly to 40-mg daily esomeprazole or placebo. The primary outcome was a prolongation of gestation of 5 days. Secondary outcomes were maternal and neonatal outcomes. We compared circulating markers of endothelial dysfunction that was associated with preeclampsia and performed pharmacokinetic studies.Between January 2016 and April 2017, we recruited
Pre-eclampsia and risk of dementia later in life: nationwide cohort study. To explore associations between pre-eclampsia and later dementia, overall and by dementia subtype and timing of onset.Nationwide register based cohort study.Denmark.All women with at least one live birth or stillbirth between 1978 and 2015.Hazard ratios comparing dementia rates among women with and without a history of pre-eclampsia, estimated using Cox regression.The cohort consisted of 1 178 005 women with 20 352 695 (...) person years of follow-up. Women with a history of pre-eclampsia had more than three times the risk of vascular dementia (hazard ratio 3.46, 95% confidence interval 1.97 to 6.10) later in life, compared with women with no history of pre-eclampsia. The association with vascular dementia seemed to be stronger for late onset disease (hazard ratio 6.53, 2.82 to 15.1) than for early onset disease (2.32, 1.06 to 5.06) (P=0.08). Adjustment for diabetes, hypertension, and cardiovascular disease attenuated