Background: Diagnosing hypertensive disorders in pregnancy utilizes systolic blood pressure (BP) of >140 mmHg and/or diastolic of >90 mmHg. However, since 2017, the American College of Cardiology and the American Heart Association (ACC/AHA) have been endorsing lower BP thresholds for diagnosing hypertension. Objectives: This study determines if antenatal lower threshold BP elevations under elevated BP and Stage 1 hypertension from ACC/AHA show an increased risk of gestational hypertension, preeclampsia, and adverse perinatal outcomes. Materials and Methods: This retrospective cohort study included service patients with prenatal consultations and deliveries at a private tertiary-level hospital from February 2016 to 2020. Antenatal BP measurements, categorized into “normal,” “elevated BP,” and “Stage 1 hypertension” under ACC/AHA classifications, had crude and adjusted relative risks (aRRs) and 95% confidence intervals (CIs) estimated to determine their associations with hypertensive disorders of pregnancy. Results: Stage 1 hypertension was twice more likely to develop gestational hypertension (aRR: 2.314, 95% CI: 1.08–4.98) and thrice more likely to develop preeclampsia (aRR: 3.673, 95% CI: 2.30–5.86), whether without (aRR: 3.520, 95% CI: 1.33–9.29) or with severe features (aRR: 3.717, 95% CI: 2.16–6.41). There was a slightly increased risk for adverse perinatal outcomes from Stage 1 hypertension, as well as all outcomes from elevated BP, but was not statistically significant. Majority of BP elevations were during the third trimester. Conclusion Lower threshold Stage 1 hypertension showed an increased risk of developing hypertensive disorders of pregnancy, with a three-fold increased risk for preeclampsia. There may be advantages in its application for diagnosing preeclampsia or having increased monitoring for these patients.
Gestational hypertension

Objective: The objective of the study was to determine the effectiveness of myoinositol (MI) supplementation in the prevention of gestational diabetes mellitus (GDM) among high-risk patients. Materials and Methods: Comprehensive and systemic online searches were performed on PubMed, MEDLINE, Ovid, and Cochrane. Cross-referencing from related articles was also done. Only studies published in English were included in the study. We selected all randomized controlled trials on MI and singleton pregnant women with high risk for GDM. Data Collection and Analysis: Five randomized controlled trials were evaluated by two independent reviewers. For each comparison, the quality of evidence was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Cochrane Collaboration tool. Review Manager 5.3 was used to generate the risk of bias evaluation and the analysis of the results. Main Results: The present study identified five randomized controlled trials involving 871 participants. The comparison of the studies showed a statistically significant reduction in the incidence of GDM in MI supplementation versus the control group (odds ratio [OR] = 0.32, 95% confidence interval [CI] = 0.19–0.53, P = 0.0001, Z = 4.36) by 68%. Similarly, there is a greater reduction in the incidence of fetal macrosomia among patients in the MI group than the controlled group (OR = 0.24, 95% CI = 0.07–0.78; P = 0.02, Z = 2.36) by 78%. However, there was no difference in terms of incidence of gestational hypertension (OR = 0.61, 95% CI = 0.19–2.01; P = 0.42, Z = −0.81), cesarean section (OR = 0.89, 95% CI = 0.65–1.22; P = 0.47, Z = 0.72), and neonatal hypoglycemia (OR = 0.35, 95% CI = 0.01–8.80; P = 0.53, Z = 0.63) outcomes. Conclusion MI supplementation taken at 4 g daily would decrease the incidence of GDM and fetal macrosomia. There was no statistically significant reduction in the risk of gestational hypertension, cesarean section, and neonatal hypoglycemia in the supplementation of MI.
Cesarean section ; fetal macrosomia ; gestational diabetes mellitus ; gestational hypertension ; myoinositol ; neonatal hypoglycemia

OBJECTIVES: To study the effect of hypertensive disorders of pregnancy on peripheral venous blood cell count in preterm infants with a gestational age of 28-34 weeks. METHODS: A total of 227 preterm infants with a gestational age of 28-34 weeks who were admitted to the Department of Pediatrics, the First Hospital Affiliated to Kunming Medical University, from January to December 2020, and whose mothers had hypertensive disorders of pregnancy were enrolled as the study group. A total of 227 preterm infants with a gestational age of 28-34 weeks who were admitted during the same period and whose mothers did not have hypertensive disorders of pregnancy were enrolled as the control group. According to maternal blood pressure during pregnancy, the study group was divided into three subgroups: gestational hypertension (n=75), mild preeclampsia (n=81), and severe preeclampsia (n=71). According to the birth weight of the preterm infants, the study group was divided into two subgroups: small for gestational age (SGA) (n=113) and appropriate for gestational age (AGA) (n=114). Peripheral blood cell count on day 1 after birth was compared between the study and control groups, as well as between the subgroups of the study group. RESULTS: Compared with the control group, the study group had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count (P<0.05) and significantly higher incidence rates of leucopenia and neutropenia (P<0.05). The subgroup analysis showed that the mild preeclampsia and severe preeclampsia subgroups had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count than the gestational hypertension subgroup (P<0.05), and that the SGA subgroup had significantly lower white blood cell count, absolute neutrophil count, and blood platelet count than the AGA subgroup (P<0.05). CONCLUSIONS Hypertensive disorders of pregnancy can affect the peripheral venous blood cell count of preterm infants, which is more significant in infants with maternal preeclampsia and SGA infants.
Child ; Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Small for Gestational Age ; Platelet Count ; Pregnancy

Twin pregnancy is at increased risk for congenital anomalies. Although twins were relatively infrequent, they accaunted for a disproportionately large portion of adverse pregnancy outcome, primarily as a consequence of preterm delivery, gestational diabetes, and pregnancy induced hypertension. In case of twin pregnancy with a single anomalous fetus, the clinicians are faced with difficult decision-making processes regarding the route of delivery, when to deliver, how aggressively to attempt to prevent delivery. Twin pregnancy discordant for a fetal abnormality can be managed expectantly or by selective fetocide of abnormal twin. Recently we experienced two cases of twin pregnancy with a single anornalous fetus. We reported cases with concerned literatures.
Diabetes, Gestational ; Female ; Fetus* ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Twin*

PURPOSE: This study was performed to study normative blood pressure data in full-term neonates that may be used to facilitate identification of neonatal hypertension. METHODS: 383 newborns born in our hospital from May 2003 to January 2004 were enrolled in this study. Using an oscillometric device(BP-88 NEXT, COLIN Corp.), their blood pressures were measured more than one time within a week after birth. According to each clinical variable such as sex, delivery mode, birth weight, gestational age and presence of maternal disease or perinatal problems, we divided the population into groups and calculated the mean blood pressures of each group. We compared mean blood pressures between the divided groups according to each clinical variable statistically. RESULTS: Mean systolic and diastolic blood pressure of the population was 70.8+/-10.9 mmHg and 43.4+/-8.0 mmHg, respectively. There was no statistically significant difference in blood pressure according to clinical variables. Mean systolic pressure showed positive correlation with birth weight and gestational age(r=0.1420, 0.0360). CONCLUSION: Our results are almost in agreement with Zubrow's data from 695 newborns in U.S.A, 1995. Our data may be helpful for early detection and management of neonatal hypertension, thereby maintaining renal function and preventing possible complications of renal disease.
Birth Weight ; Blood Pressure* ; Gestational Age ; Humans ; Hypertension ; Infant, Newborn* ; Parturition

OBJECTIVE: This study was investigated on the relationship the degrees of proteinuria with the maternal characteristics, maternal and the neonatal outcomes. The correlation between the result of single urine protein- to-creatinine ratio and the amount of 24 hour urine protein was also investigated. METHODS: From December 1999 to June 2002, 63 patients were enrolled in this study. They were divided into two groups by the degree of proteinuria at 24 hour urine, single urine and dip stick test, respectively. Each two groups was compared with the maternal characteristics, gestational age, the maternal and the neonatal outcomes. The correlation between single urine protein-to-creatinine ratio and the amount of 24 hour urine protein was analyzed statistically. RESULTS: Each two groups of single urine and dip stick test had no differences in maternal characteristics, gestational age, maternal and the neonatal outcomes. However, in two of 24 hour urine, massive proteinuria group had poor maternal and neonatal outcomes compared with control group (p value 0.01). Single urine protein-to-creatine ratio and the amount 24 hour urine protein had borderline correlation (p value 0.064). CONCLUSION: The presence of proteinuria influences on maternal and neonatal outcomes. Moreover, the massive proteinuria group had more maternal and neonatal complication than control group. The result of single urine protein-to-creatine ratio had borderline correlation with the amount of protein in 24 hour urine collection.
Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy* ; Proteinuria* ; Urine Specimen Collection

Preeclampsia is represented by hypertension and proteinuria in pregnancy. It usually occurs after 20 gestational weeks. There are few reports on preeclampsia before 20 gestational weeks. In this case, we report a patient with chronic hypertension superimposed with preeclampsia at 13 gestational weeks.
Adult ; Female ; Gestational Age ; Humans ; Hypertension ; physiopathology ; Pre-Eclampsia ; physiopathology ; Pregnancy ; Pregnancy Complications

Infant born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature and metabolic alterations in later life. The result of SGA followed by rapid weight gain during early postnatal life has been associated with increased long-term risks for central obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes, hypertension, increased fat mass, and cardiovascular disease. We should carefully monitor their weight during infancy and childhood to prevent excessive rates of weight gain. ‘Healthy catch up growth’ may decreased the risk of obesity-related comorbidities in SGA. Establishing the optimal growth patterns in SGA to minimize short- and long-term risks is important, and further studies will be needed. This review discusses recent studies concentrating on obesity-related morbidities in SGA infants that may provide insight into growth monitoring.
Cardiovascular Diseases ; Comorbidity* ; Gestational Age* ; Glucose ; Humans ; Hypertension ; Infant ; Insulin Resistance ; Obesity* ; Obesity, Abdominal ; Weight Gain

OBJECTIVE: To study the clinical features and prognosis of bronchopulmonary dysplasia (BPD) complicated by pulmonary hypertension (PH) in preterm infants. METHODS: A retrospective analysis was performed on the clinical data of 191 preterm infants with BPD. RESULTS: In the 191 preterm infants with BPD, 37 (19.4%), all with moderate or severe BPD, developed PH beyond 36 weeks' corrected age. The incidence rates of PH in infants with moderate and severe BPD were 5.7% (5/87) and 47.8% (32/67) respectively. Gestational age and birth weight were lower in infants with PH than in those without PH (P<0.01). Infants with PH had higher incidence rates of small for gestational age (SGA), severe BPD, surgical ligation of patent ductus arteriosus (PDA), neonatal respiratory distress syndrome, hemodynamically significant PDA, and pneumonia than those without PH (P<0.01). Durations of oxygen therapy, intubation, and positive pressure ventilation were longer in infants with PH than in those without PH (P<0.01). Infants with PH had higher incidence rates of retinopathy of prematurity and extrauterine growth retardation, a higher mortality, and a longer length of hospital stay compared with those without PH (P<0.01). In the 37 infants with PH (6 with mild PH, 14 with moderate PH, and 17 with severe PH), those with mild or moderate PH all survived; 15(88%) out of 17 infants with severe PH died. CONCLUSIONS The incidence of PH is high in preterm infants with moderate or severe BPD. Regular screening of pulmonary artery pressure is recommended for infants with BPD. Infants with low gestational age and birth weight, SGA, and severe BPD are more likely to develop PH. Infants with BPD complicated by PH have relatively high incidence rates of complications, high mortality, and poor prognosis.
Bronchopulmonary Dysplasia ; Gestational Age ; Humans ; Hypertension, Pulmonary ; Infant ; Infant, Newborn ; Infant, Premature ; Prognosis ; Retrospective Studies

OBJECTIVE: To obtain etiology and obstetric outcome of women who had a history of recurrent miscarriage. METHODS: From 1 June 1998 to 30 June 2000, 82 patients who attended infertility & current miscarriage clinic at Samsungcheil hospital and progressed beyond 24 weeks gestation following pregnancy were included in this study. The control population was 154 pregnancies considering age and parity over the same period. Retrospectively, we analyse the etiology of recurrent miscarriage and compare obstetric outcomes of two groups. RESULTS: The etiology of recurrent miscarriage was immunologic factor (36.6%), unexplained (30.4%), anatomic cause (13.4%), endocrinologic abnormality (13.4%) and chromosomal abnormality (5.6%). The rate of preterm delivery (11%) and incidence of pregnancy induced hypertention (8.5%) were significantly higher than those of control group (3.2% and 2.5% respectively). There was no significant difference in the rate of small for gestational age, oligohydroamnios, cesarean section, perinatal loss and the incidence of gestational diabetes mellitus. CONCLUSION: The pregnancy with a history of recurrent miscarriage is associated with increased risk of pregnancy induced hypertension and preterm delivery and represent a population at high risk of obstetric problems. Therefore, close surveillance during antenatal period is required.
Abortion, Habitual* ; Abortion, Spontaneous ; Cesarean Section ; Chromosome Aberrations ; Diabetes, Gestational ; Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infertility ; Parity ; Pregnancy ; Retrospective Studies