Survey of Pregnacy Induced Hypertention in Pregnant Women in Isfahan University of Medical Sciences Hospitals

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Resident, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Department of Obstetrics and Gynecology, Isfahan, Iran.

4 Ophtalmologist, Isfahan, Iran.

Abstract

Background: Pregnacy induced hypertention (PIH) is a higlly prevalent pregnancy complication with andvrese effects on maternal and fetal health. According to epidemiological studies obesity, family history, low caloric intake and… are related risk factors. The purpose of this study was to determine relationship between family history, body mass index (BMI), serum Mg, nutritiom, and PIH.Methods: In a cross sectional study 172 prognant women at 28-42 weeks getational age in two groups were studied. The cases were hypretensive pregnant women and controls were normotensive pregnant women. The controls were matched by age, gestational age, and pariety with cases. Daily caloric intake, serum Mg, BMI and family history were determind. Then data were analyzed by SPSS10 software.Finding: The risk of developing PHI tended to increase by BMI ≥ 30 (P < 0.0001), positive family history (P < 0.0001) and low caloric intake (1399.45 ± 3.1 kal/day) (P < 0.001).Conclusion: BMI ≥ 30 and low caloric intake are two risk factors that are proventable and if there was positive family history of hypertension prenatal care should be done carefully.

Keywords

References

  1. Cunningham FG, Lindheimer MD. Hypertension in pregnancy. N Engl J Med 1992; 326(14): 927-32.
  2. [No authors listed]. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol 2000; 183(1): S1-S22.
  3. Myatt L, Miodovnik M. Prediction of preeclampsia. Semin Perinatol 1999; 23(1): 45-57
  4. Saftlas AF, Olson DR, Franks AL, Atrash HK, Pokras R. Epidemiology of preeclampsia and eclampsia in the United States, 1979-1986. Am J Obstet Gynecol 1990; 163(2): 460-5.
  5. ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 2002; 77(1): 67-75.
  6. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic re-view of controlled studies. BMJ 2005; 330(7491): 565.
  7. Sibai BM, el-Nazer A, Gonzalez-Ruiz A. Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis. Am J Obstet Gynecol 1986; 155(5): 1011-6.
  8. Sibai BM, Mercer B, Sarinoglu C. Severe preeclampsia in the second trimester: recurrence risk and long-term prognosis. Am J Obstet Gynecol 1991; 165(5 Pt 1): 1408-12.
  9. Gaugler-Senden IP, Berends AL, de Groot CJ, Steegers EA. Severe, very early onset preeclampsia: subsequent pregnancies and future parental cardiovascular health. Eur J Obstet Gynecol Reprod Biol 2008; 140(2): 171-7.
  10. Dawson LM, Parfrey PS, Hefferton D, Dicks EL, Cooper MJ, Young D, et al. Familial risk of preeclampsia in Newfoundland: a population-based study. J Am Soc Nephrol 2002; 13(7): 1901-6.
  11. Nilsson E, Salonen Ros H, Cnattingius S, Lich-tenstein P. The importance of genetic and environmental effects for pre-eclampsia and gestational hypertension: a family study. BJOG 2004; 111(3): 200-6.
  12. Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol 1998; 179(5): 1359-75.
  13. Stella CL, How HY, Sibai BM. Thrombophilia and adverse maternal-perinatal outcome: controversies in screening and management. Am J Perinatol 2006; 23(8): 499-506.
  14. Conde-Agudelo A, Villar J, Lindheimer M. Maternal infection and risk of preeclampsia: systematic review and metaanalysis. Am J Obstet Gynecol 2008; 198(1): 7-22.
  15. Moran P, Lindheimer MD, Davison JM. The renal response to preeclampsia. Semin Nephrol 2004; 24(6): 588-95.
  16. Taufield PA, Ales KL, Resnick LM, Druzin ML, Gertner JM, Laragh JH. Hypocalciuria in preeclampsia. N Engl J Med 1987; 316(12): 715-8.
  17. August P, Marcaccio B, Gertner JM, Druzin ML, Resnick LM, Laragh JH. Abnormal 1,25-dihydroxyvitamin D metabolism in preeclampsia. Am J Obstet Gynecol 1992; 166(4): 1295-9.
  18. Stillman IE, Karumanchi SA. The glomerular injury of preeclampsia. J Am Soc Nephrol 2007; 18(8): 2281-4.
  19. Stubbs TM, Lazarchick J, Van Dorsten JP, Cox J, Loadholt CB. Evidence of accelerated platelet production and consumption in nonthrombocytopenic preeclampsia. Am J Obstet Gynecol 1986; 155(2): 263-5.
  20. Arias F, Mancilla-Jimenez R. Hepatic fibrinogen deposits in pre-eclampsia. Immunofluorescent evidence. N Engl J Med 1976; 295(11): 578-82.
  21. Minakami H, Oka N, Sato T, Tamada T, Yasuda Y, Hirota N. Preeclampsia: a microvesicular fat disease of the liver? Am J Obstet Gynecol 1988; 159(5): 1043-7.
  22. Shah AK, Rajamani K, Whitty JE. Eclampsia: a neurological perspective. J Neurol Sci 2008; 271(1-2): 158-67.
  23. Shah AK, Whitty JE. Brain MRI in peripartum seizures: usefulness of combined T2 and diffusion weighted MR imaging. J Neurol Sci 1999; 166(2): 122-5.
  24. Richards A, Graham D, Bullock R. Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatry 1988; 51(3): 416-21.
  25. Lang RM, Pridjian G, Feldman T, Neumann A, Lindheimer M, Borow KM. Left ventricular mechanics in preeclampsia. Am Heart J 1991; 121(6 Pt 1): 1768-75.
  26. Tihtonen KM, Kööbi T, Vuolteenaho O, Huhtala HS, Uotila JT. Natriuretic peptides and hemodynamics in preeclampsia. Am J Obstet Gynecol 2007; 196(4): 328. e1-7.
  27. Bosio PM, McKenna PJ, Conroy R, O'Herlihy C. Maternal central hemodynamics in hypertensive disorders of pregnancy. Obstet Gynecol 1999; 94(6): 978-84.
  28. Visser W, Wallenburg HC. Central hemodynamic observations in untreated preeclamptic patients. Hypertension 1991; 17(6 Pt 2): 1072-7.
  29. Hankins GD, Wendel GD Jr, Cunningham FG, Leveno KJ. Longitudinal evaluation of hemodynamic changes in eclampsia. Am J Obstet Gynecol 1984; 150(5 Pt 1): 506-12.
  30. Mabie WC, Ratts TE, Sibai BM. The central hemodynamics of severe preeclampsia. Am J Obstet Gynecol 1989; 161(6 Pt 1): 1443-8.
  31. Nabatian S, Quinn P, Brookfield L, Lakier J. Acute coronary syndrome and preeclampsia. Obstet Gynecol 2005; 106(5 Pt 2): 1204-6.
  32. Fleming SM, O'Gorman T, Finn J, Grimes H, Daly K, Morrison JJ. Cardiac troponin I in pre-eclampsia and gestational hypertension. BJOG 2000; 107(11): 1417-20.
  33. Joyal D, Leya F, Koh M, Besinger R, Ramana R, Kahn S, et al. Troponin I levels in patients with preeclampsia. Am J Med 2007; 120(9): 819.e13-4.
  34. Benedetti TJ, Kates R, Williams V. Hemody-namic observations in severe preeclampsia complicated by pulmonary edema. Am J Obstet Gynecol 1985; 152(3): 330-4.
  35. Odegård RA, Vatten LJ, Nilsen ST, Salvesen KA, Austgulen R. Preeclampsia and fetal growth. Obstet Gynecol 2000; 96(6): 950-5.
  36. Sibai BM, Mercer BM, Schiff E, Friedman SA. Aggressive versus expectant management of severe preeclampsia at 28 to 32 weeks' gestation: a randomized controlled trial. Am J Obstet Gynecol 1994; 171(3): 818-22.
  37. Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol 2003; 102(1): 181-92.
  38. Barton JR, Sibai BM. Prediction and prevention of recurrent preeclampsia. Obstet Gynecol 2008; 112(2 Pt 1): 359-72. Review.
  39. Xiong X, Fraser WD, Demianczuk NN. History of abortion, preterm, term birth, and risk of preeclampsia: a population-based study. Am J Obstet Gynecol 2002; 187(4): 1013-8.
  40. Sibai BM, Sarinoglu C, Mercer BM. Eclampsia. VII. Pregnancy outcome after eclampsia and long-term prognosis. Am J Obstet Gynecol 1992; 166(6 Pt 1): 1757-61; discussion 1761-3.
  41. Mostello D, Kallogjeri D, Tungsiripat R, Leet T. Recurrence of preeclampsia: effects of gestational age at delivery of the first pregnancy, body mass index, paternity, and interval between births. Am J Obstet Gynecol 2008; 199(1): 55. e1-7.
  42. Punthumapol C, Kittichotpanich B. Serum cal-cium, magnesium and uric acid in preeclampsia and normal pregnancy. J Med Assoc Thai 2008; 91(7): 968-73.
  43. Sibai BM. Magnesium sulfate prophylaxis in preeclampsia: Lessons learned from recent trials. Am J Obstet Gynecol 2004; 190(6): 1520-6. Review.
  44. Fields SJ, Vainder M, Livshits G, Merlob P, Sirotta L. Obesity and the risk of toxaemia of pregnancy. Ann Hum Biol 1996; 23(5): 353-62.
  45. Parazzini F, Bortolus R, Chatenoud L, Restelli S, Ricci E, Marozio L, et al. Risk factors for pregnancy-induced hypertension in women at high risk for the condition. Italian Study of Aspirin in Pregnancy Group. Epidemiology 1996; 7(3): 306-8.
  46. Jain L. Effect of pregnancy-induced and chronic hypertension on pregnancy outcome. J Perinatol 1997; 17(6): 425-7.
  47. Zhou XL. Clinical analysis of the relation be-tween maternal body weight and high risk factors during pregnancy and delivery. Zhonghua Fu Chan Ke Za Zhi 1993; 28(7): 397-8, 441. [In Chinese].
  48. Höhn N, Junge S. The relationship of maternal obesity, excessive weight gain in pregnancy and pre-eclampsia. Geburtshilfe Frauenheilkd 1979; 39(12): 1079-82. [Article in German].
  49. Michlin R, Oettinger M, Odeh M, Khoury S, Ophir E, Barak M, et al. Maternal obesity and pregnancy outcome. Isr Med Assoc J 2000; 2(1): 10-3.
  50. Atkinson JO, Mahomed K, Williams MA, Woelk GB, Mudzamiri S, Weiss NS. Dietary risk factors for pre-eclampsia among women attending Harare Maternity Hospital, Zimbabwe. Cent Afr J Med 1998; 44(4): 86-92.
  51. Qiu C, Williams MA, Leisenring WM, Sorensen TK, Frederick IO, Dempsey JC, et al. Family history of hypertension and type 2 diabetes in relation to preeclampsia risk. Hypertension 2003; 41(3): 408-13.
Journal of Isfahan Medical School
Volume 28, Issue 123 - Serial Number 123
November and December 2011
Pages 1842-1849

Files

History

  • Receive Date: 13 December 2010
  • Revise Date:
  • Accept Date: 06 April 2022

Share

How to cite

Statistics