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Hypertensive Disorders of Pregnancy and Long-Term Maternal Cardiovascular and Metabolic Biomarkers.
Battarbee, Ashley N; Mele, Lisa; Landon, Mark B; Varner, Michael W; Casey, Brian M; Reddy, Uma M; Wapner, Ronald J; Rouse, Dwight J; Thorp, John M; Chien, Edward K; Saade, George; Peaceman, Alan M; Blackwell, Sean C.
Afiliação
  • Battarbee AN; Departments of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
  • Mele L; George Washington University Biostatistics Center, Washington, District of Columbia.
  • Landon MB; Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio.
  • Varner MW; Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah.
  • Casey BM; Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.
  • Reddy UM; Department of Obstetrics and Gynecology, Eunice Kennedy Shriver National Institute of Child Health and Human Development.
  • Wapner RJ; Department of Obstetrics and Gynecology, Columbia University, New York, New York.
  • Rouse DJ; Department of Obstetrics and Gynecology, Brown University, Providence, Rhode Island.
  • Thorp JM; Department of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
  • Chien EK; Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio.
  • Saade G; Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.
  • Peaceman AM; Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois.
  • Blackwell SC; Department of Obstetrics and Gynecology, University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas.
Am J Perinatol ; 2023 Jun 29.
Article em En | MEDLINE | ID: mdl-37201538
ABSTRACT

OBJECTIVE:

This study aimed to measure the association between hypertensive disorders of pregnancy (HDP) and long-term maternal metabolic and cardiovascular biomarkers. STUDY

DESIGN:

Follow-up study of patients who completed glucose tolerance testing 5 to 10 years after enrollment in a mild gestational diabetes mellitus (GDM) treatment trial or concurrent non-GDM cohort. Maternal serum insulin concentrations and cardiovascular markers VCAM-1, VEGF, CD40L, GDF-15, and ST-2 were measured, and insulinogenic index (IGI, pancreatic ß-cell function) and 1/ homeostatic model assessment (insulin resistance) were calculated. Biomarkers were compared by presence of HDP (gestational hypertension or preeclampsia) during pregnancy. Multivariable linear regression estimated the association of HDP with biomarkers, adjusting for GDM, baseline body mass index (BMI), and years since pregnancy.

RESULTS:

Of 642 patients, 66 (10%) had HDP 42 with gestational hypertension and 24 with preeclampsia. Patients with HDP had higher baseline and follow-up BMI, higher baseline blood pressure, and more chronic hypertension at follow-up. HDP was not associated with metabolic or cardiovascular biomarkers at follow-up. However, when HDP type was evaluated, patients with preeclampsia had lower GDF-15 levels (oxidative stress/cardiac ischemia), compared with patients without HDP (adjusted mean difference -0.24, 95% confidence interval -0.44, -0.03). There were no differences between gestational hypertension and no HDP.

CONCLUSION:

In this cohort, metabolic and cardiovascular biomarkers 5 to 10 years after pregnancies did not differ by HDP. Patients with preeclampsia may have less oxidative stress/cardiac ischemia postpartum; however, this may have been observed due to chance alone given multiple comparisons. Longitudinal studies are needed to define the impact of HDP during pregnancy and interventions postpartum. KEY POINTS · Hypertensive disorders of pregnancy were not associated with metabolic dysfunction.. · Cardiovascular dysfunction was not consistently seen after pregnancy hypertension.. · Longitudinal studies with postpartum interventions after preeclampsia are needed..

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Am J Perinatol Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Am J Perinatol Ano de publicação: 2023 Tipo de documento: Article