Abstract:
INTRODUCTION:Pregnancies complicated by chronic hypertension are at increased risk of adverse pregnancy outcomes. To assess whether planned early delivery might prevent some of these adverse outcomes, we studied maternal and neonatal outcomes of pregnancy in women with chronic hypertension, including gestational-age-specific outcomes. MATERIAL AND METHODS:We performed a retrospective, population-based cohort study, using data from the Netherlands Perinatal Register. We included women with chronic hypertension and normotensive controls who delivered a singleton without congenital anomalies in 2002-2007. We calculated crude and adjusted odds ratios (OR) with 95% CI, compared delivery and ongoing pregnancy using moving averages, and used multiple Cox regression to adjust for differences in baseline characteristics and to examine adverse neonatal outcomes across subgroups of hypertensive disorder. Main outcome measures were composite adverse maternal and neonatal outcomes. RESULTS:We included 3457 (0.3%) women with chronic hypertension and 984 932 normotensive controls. Women with chronic hypertension had adverse maternal outcomes more often (28.7% vs. 6.6%, adjusted OR 5.7, 95% CI 5.3-6.2). Their offspring had an increased rate of neonatal morbidity (17.4% vs. 13.2%, adjusted OR 1.2, 95% CI 1.1-1.4) but not of severe adverse neonatal outcomes (2.5% vs. 2.2%, adjusted OR 0.8, 95% CI 0.6-1.0). The increased risk of adverse maternal outcomes for ongoing pregnancy remained stable around 17% at term. The risk of severe adverse neonatal outcomes for birth was at its lowest between 38 and 40 weeks, mainly in women with iatrogenic onset of delivery. CONCLUSIONS:Women with chronic hypertension are at increased risk of adverse maternal and neonatal outcomes compared with controls throughout pregnancy, including at term. Our results suggest that the optimal timing of delivery might be between 38 and 40 weeks of gestation, but prospective randomized studies should confirm this.
journal_name
Acta Obstet Gynecol Scandjournal_title
Acta obstetricia et gynecologica Scandinavicaauthors
Broekhuijsen K,Ravelli AC,Langenveld J,van Pampus MG,van den Berg PP,Mol BW,Franssen MTdoi
10.1111/aogs.12757subject
Has Abstractpub_date
2015-12-01 00:00:00pages
1337-45issue
12eissn
0001-6349issn
1600-0412journal_volume
94pub_type
杂志文章abstract:OBJECTIVE:To evaluate the effect of early maternal feeding on maternal satisfaction and gastrointestinal complications on patients following simple and complicated caesarean delivery (CD). METHODS:A prospective, randomised study was designed including 179 women undergoing first or repeated CD. Women who were assigned ...
journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章,随机对照试验
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abstract::Ninety-six cases of ruptured uterus in labor treated in the University Teaching Hospitals, Benghazi, Libya between 1977 and 1980 are reported. An incidence of 1 in 585 deliveries remained unchanged during the period of study. Twenty uterine ruptures occurred in a previously scarred uterus. Rupture of the unscarred ute...
journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1600-0412.2002.810908.x
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abstract::Screening protocols for alloimmunization during pregnancy usually make a difference between primi- and multigravidae as well as between Rh(D) negative and Rh(D) positive pregnant women. We have evaluated a new screening program including antibody tests at 25 and 35 gestational weeks only, for all, and regardless of Rh...
journal_title:Acta obstetricia et gynecologica Scandinavica
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abstract:BACKGROUND:To elucidate the sequences of changes in bone metabolism and bone density during pregnancy, lactation and postweaning. METHODS:Women were recruited (n = 254) in early pregnancy and followed for 2 years. Markers of bone formation (osteocalcin) and resorption (NTx) were measured at five occasions. Bone minera...
journal_title:Acta obstetricia et gynecologica Scandinavica
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doi:10.1111/j.0001-6349.2004.00428.x
更新日期:2004-11-01 00:00:00
abstract::The earliest diagnosis and treatment of obstructed fetal bladder is reported. Placement of vesico-amniotic shunt at 14.5 weeks of gestation enabled preservation of bilateral renal function and maintenance of normal amniotic fluid volume with normal pulmonary development. The shunt functioned adequately for more than 1...
journal_title:Acta obstetricia et gynecologica Scandinavica
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doi:10.3109/00016348909013286
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journal_title:Acta obstetricia et gynecologica Scandinavica
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更新日期:2008-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
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更新日期:1985-01-01 00:00:00
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更新日期:2020-02-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aogs.13853
更新日期:2020-09-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
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doi:10.3109/00016348309155774
更新日期:1983-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1982-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
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更新日期:1991-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
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更新日期:2013-08-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
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更新日期:2018-09-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:10.3109/00016349709024339
更新日期:1997-09-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:10.3109/00016349109006217
更新日期:1991-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:
更新日期:2000-04-01 00:00:00
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更新日期:2010-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
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更新日期:2006-01-01 00:00:00
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journal_title:Acta obstetricia et gynecologica Scandinavica
pub_type: 杂志文章
doi:10.3109/00016349009028691
更新日期:1990-01-01 00:00:00