Mulder, EG; Ghossein-Doha, C; Crutsen, J; Van Kuijk, S; Thilaganathan, B; Spaanderman, M
(2020)
Effect of pregnancy prolongation in early-onset pre-eclampsia on postpartum maternal cardiovascular, renal and metabolic function in primiparous women: an observational study.
BJOG, 128 (1).
pp. 121-129.
ISSN 1471-0528
https://doi.org/10.1111/1471-0528.16435
SGUL Authors: Thilaganathan, Baskaran
Abstract
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.
Item Type: |
Article
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Additional Information: |
© 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists
This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
Keywords: |
Albuminuria, cardiovascular health, deferred delivery, early-onset pre-eclampsia, hypertension, metabolic syndrome, 11 Medical and Health Sciences, Obstetrics & Reproductive Medicine |
SGUL Research Institute / Research Centre: |
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) |
Journal or Publication Title: |
BJOG |
ISSN: |
1471-0528 |
Language: |
eng |
Dates: |
Date | Event |
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11 December 2020 | Published | 13 August 2020 | Published Online | 19 July 2020 | Accepted |
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Publisher License: |
Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 |
Projects: |
Project ID | Funder | Funder ID |
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765274 | H2020 Marie Skłodowska-Curie Actions | UNSPECIFIED |
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PubMed ID: |
32725713 |
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Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/112400 |
Publisher's version: |
https://doi.org/10.1111/1471-0528.16435 |
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