Abstract:
INTRODUCTION:The importance of cardiovascular health in relation to pregnancy outcome is increasingly acknowledged. Women who develop certain pregnancy complications, in particular preeclampsia, are at higher risk for future cardiovascular disease. Independent of its outcome, pregnancy requires a substantial adaptive response of the maternal cardiovascular system. In the Hemodynamic Adaptation to Pregnancy and Placenta-related Outcome (HAPPO) study, we aim to examine longitudinal maternal haemodynamic adaptation to pregnancy from the preconception period onwards. We hypothesise that women who will develop adverse pregnancy outcomes have impaired cardiovascular health before conception, leading to haemodynamic maladaptation to pregnancy and diminished uteroplacental vascular development. METHODS AND ANALYSIS:In this prospective cohort study embedded in the Rotterdam periconception cohort, 200 women with a history of placenta-related pregnancy complications (high-risk group) and 100 women with an uncomplicated obstetric history (low-risk group) will be included. At five moments (preconception, first, second and third trimester and postdelivery), women will undergo an extensive examination of the macrocirculatory and microcirculatory system and uteroplacental vascular development. The main outcome measures are differences in maternal haemodynamic adaptation to pregnancy between women with and without placenta-related pregnancy complications. In a multivariate linear mixed model, the relationship between maternal haemodynamic adaptive parameters, (utero)placental vascularisation indices and clinical outcomes (occurrence of pregnancy complications, embryonic and fetal growth trajectories, miscarriage rate, gestational age at delivery, birth weight) will be studied. Subgroup analysis will be performed to study baseline and trajectory differences between high-risk and low-risk women, independent of subsequent pregnancy outcome. ETHICS AND DISSEMINATION:This study protocol was approved by the Medical Ethics Committee of the Erasmus MC, Rotterdam, the Netherlands (MEC 2018-150). Results will be disseminated to the medical community by publications in peer-reviewed journals and presentations at scientific congresses. Also, patient associations will be informed and the public will be informed by dissemination through (social) media. TRIAL REGISTRATION NUMBER:NL7394 (www.trialregister.nl).
journal_name
BMJ Openjournal_title
BMJ openauthors
Bijl RC,Cornette JMJ,van den Bosch AE,Duvekot JJ,Molinger J,Willemsen SP,Koning AHJ,Roos-Hesselink JW,Franx A,Steegers-Theunissen RPM,Koster MPHdoi
10.1136/bmjopen-2019-033083subject
Has Abstractpub_date
2019-11-10 00:00:00pages
e033083issue
11issn
2044-6055pii
bmjopen-2019-033083journal_volume
9pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVES:This study aims to identify the sources of funding for investigator-initiated clinical trials (IICTs) in Portugal, and to recommend ways to improve the quality of information collected from clinical trial databases about funding. DESIGN AND METHODS:A systematic search of trial registrations over the last 13...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023394
更新日期:2019-05-14 00:00:00
abstract:OBJECTIVES:To identify vulnerable cardiovascular patients in the hospital using a self-reported function-based screening tool. PARTICIPANTS:Prospective observational cohort study of 445 individuals aged ≥ 65 years admitted to a university medical centre hospital within the USA with acute coronary syndrome and/or decom...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008122
更新日期:2015-08-27 00:00:00
abstract:INTRODUCTION:Type 2 diabetes (T2D) is a significant problem, and lifestyle modifications including self-management are important. We have developed a structured individual-based lifestyle education (SILE) programme for T2D. With attention now being paid to techniques to change behaviour, we recently developed a behavio...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-017838
更新日期:2017-10-24 00:00:00
abstract:OBJECTIVES:The aim of the study was to assess whether gastrostomy placement before 18 months of age results in a greater increase in z-score for weight and to assess whether admission rates were reduced postgastrostomy in this age group. DESIGN:Retrospective cross-sectional study. SETTING:Single-centre secondary care...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001793
更新日期:2012-11-21 00:00:00
abstract:OBJECTIVE:The development of cynicism in medicine, defined as a decline in empathy and emotional neutralisation during medical training, is a significant concern for medical educators. We sought to use online medical student discussion groups to provide insight into how cynicism in medicine is perceived, the consequenc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-022883
更新日期:2018-10-18 00:00:00
abstract:INTRODUCTION:Our group previously demonstrated the feasibility of the HuCare Quality Improvement Strategy (HQIS), aimed at integrating into practice six psychosocial interventions recommended by international guidelines. This trial will assess whether the introduction of the strategy in oncology wards improves patient'...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-016347
更新日期:2017-10-06 00:00:00
abstract:OBJECTIVE:To test the association between use of medicines with anticholinergic or sedative properties and physical function, cognitive function, appetite and frailty. DESIGN, SETTING AND PARTICIPANTS:This cross-sectional study analysed baseline data collected as part of the Australian Longitudinal Study of Ageing, a ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029221
更新日期:2019-09-04 00:00:00
abstract:OBJECTIVES:Although successful airway management is essential for emergency trauma care, comprehensive studies are limited. We sought to characterise current trauma care practice of airway management in the emergency departments (EDs) in Japan. DESIGN:Analysis of data from a prospective, observational, multicentre reg...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2014-006623
更新日期:2015-02-04 00:00:00
abstract:OBJECTIVES:Compared with controls, multiple sclerosis (MS) patients die, on average, 7-14 years prematurely. Previously, we reported that, 21 years after their participation in the pivotal randomised, controlled trial (RCT) of interferon β-1b, mortality was reduced by 46-47% in the two groups who received active therap...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001972
更新日期:2012-11-30 00:00:00
abstract:OBJECTIVES:National guidelines for identifying physiological deterioration and sepsis in hospitals depend on thresholds for blood pressure that do not account for age or sex. In populations outside hospital, differences in blood pressure are known to occur with both variables. Whether these differences remain in the ho...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033618
更新日期:2020-05-05 00:00:00
abstract:INTRODUCTION:Surgery is the standard curative treatment for lung cancer but is only possible in patients with local tumour and preserved exercise capacity. Improving fitness before surgery can reduce postoperative complications and mortality. However, preoperative rehabilitation remains difficult to implement for sever...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-017307
更新日期:2017-11-12 00:00:00
abstract:OBJECTIVES:Medical and healthcare organisations-including the national cancer support and helpline organisation that is the subject of this study-are expected to collect and monitor information about the ethnicity of their client populations. Information about ethnicity is important for a variety of reasons, including ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002676
更新日期:2013-06-28 00:00:00
abstract:INTRODUCTION:Clinical practice guidelines facilitate optimal clinical practice. Point of care access, interpretation and application of such guidelines, however, is inconsistent. Informatics-based tools may help clinicians apply guidelines more consistently. We have developed a novel clinical decision support tool that...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-019087
更新日期:2017-12-04 00:00:00
abstract:INTRODUCTION:Diabetic foot ulcer represents a major health problem globally. Preliminary studies have indicated that systemic treatment of diabetic foot ulcer patients with hyperbaric oxygen therapy have beneficial effects on wound healing, risk of amputation, glycaemic control, atherosclerosis, inflammatory markers an...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031708
更新日期:2020-06-29 00:00:00
abstract:OBJECTIVES:Apolipoprotein C3 (ApoC3) polymorphisms have been suggested to be associated with risk of coronary heart disease (CHD). However, the results of relevant studies were inconsistent. We aimed to systematically evaluate this issue. DESIGN:PubMed, EMBASE and Cochrane library databases (up to March 2013) were sys...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2013-004156
更新日期:2014-01-14 00:00:00
abstract:INTRODUCTION:Tobacco smoking is one of the leading causes of preventable death. This is not inevitable as tobacco control tools have become more powerful and more effective. Among these, warnings on cigarette packs have proven to be somewhat effective. Our objective is to increase the efficacy of antismoking warnings b...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036166
更新日期:2020-06-28 00:00:00
abstract:OBJECTIVES:To investigate an association between fatty liver disease (FLD) and erosive oesophagitis. DESIGN AND SETTING:This was a cross-sectional study of subjects selected from examinees who underwent health check-up, including oesophagogastroduodenoscopy in one hospital between 2004 and 2011. Erosive oesophagitis w...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023585
更新日期:2019-01-30 00:00:00
abstract:INTRODUCTION:Innovations with sensor-augmented pump therapy (SAPT) to reduce hypoglycaemia in patients with type 1 diabetes are an ongoing area of research. The predictive low glucose management (PLGM) system incorporates continuous glucose sensor data into an algorithm and suspends basal insulin before the occurrence ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2016-011589
更新日期:2016-04-15 00:00:00
abstract:OBJECTIVES:To establish a database network for the study of alpha-1 antitrypsin deficiency (AATD) and compare the results to CT lung density as the most direct measure of emphysema. DESIGN:A central electronic database was established to permit the upload of anonymised patient data from remote sites. Prospectively col...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036045
更新日期:2020-06-30 00:00:00
abstract:OBJECTIVES:There is growing evidence that antihypertensive agents, particularly centrally acting ACE inhibitors (CACE-Is), which cross the blood-brain barrier, are associated with a reduced rate of cognitive decline. Given this, we compared the rates of cognitive decline in clinic patients with dementia receiving CACE-...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002881
更新日期:2013-07-25 00:00:00
abstract:INTRODUCTION:Spondyloarthritis (SpA) is a heterogeneous spectrum of rheumatic diseases with either predominantly axial inflammatory symptoms of the spine and sacroiliac joints or predominantly peripheral arthritis. The two main entities of axial SpA (axSpA) are ankylosing spondylitis or non-radiographic axSpA (nr-axSpA...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015536
更新日期:2017-07-10 00:00:00
abstract:OBJECTIVE:To study the incidence of de novo multimorbidity across all ages in a geographically defined population with an emphasis on sex and ethnic differences. DESIGN:Historical cohort study. SETTING:All persons residing in Olmsted County, Minnesota, USA on 1 January 2000 who had granted permission for their record...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006413
更新日期:2015-02-03 00:00:00
abstract:INTRODUCTION:Psychosocial factors are increasingly recognised as important determinants of cardiovascular disease risk. The North Texas Heart Study aims to understand the mechanisms responsible for this association with a focus on social vigilance (ie, scanning the environment for social threats). There is also growing...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017345
更新日期:2017-08-14 00:00:00
abstract:OBJECTIVE:Self-reported recall data are often used in wireless phone epidemiological studies, which in turn are used to indicate relative risk of health outcomes from extended radiofrequency exposure. We sought to explain features commonly observed in wireless phone recall data and to improve analytical procedures. SE...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-000887
更新日期:2012-09-04 00:00:00
abstract:OBJECTIVES:To conduct a systematic review to identify studies that describe factors and interventions at primary care practice level that impact on levels of utilisation of unscheduled secondary care. SETTING:Observational studies at primary care practice level. PARTICIPANTS:Studies included people of any age of eith...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2013-004746
更新日期:2014-05-23 00:00:00
abstract:OBJECTIVES:To estimate the clinical and economic impact of intensive care unit-acquired bloodstream infections in Taiwan. DESIGN:Retrospective cohort study. SETTING:Nationwide Taiwanese population in the National Health Insurance Research Database and the Taiwan Nosocomial Infections Surveillance (2007-2015) dataset....
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037484
更新日期:2020-11-26 00:00:00
abstract:OBJECTIVES:Malignant melanoma has high morbidity and mortality rates. Early diagnosis improves prognosis. Clinical prediction rules (CPRs) can be used to stratify patients with symptoms of suspected malignant melanoma to improve early diagnosis. We conducted a systematic review of CPRs for melanoma diagnosis in ambulat...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2016-014096
更新日期:2017-03-06 00:00:00
abstract:INTRODUCTION:Capsular group B Neisseria meningitidis (MenB) is the most common cause of invasive meningococcal disease (IMD) in many parts of the world. A MenB vaccine directed against the polysaccharide capsule remains elusive due to poor immunogenicity and safety concerns. The vaccines licensed for the prevention of ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037358
更新日期:2020-10-22 00:00:00
abstract:OBJECTIVE:To investigate feasibility of multiple sclerosis (MS) exercise guidelines for inactive people with MS (PwMS) and to examine preliminary efficacy for walking. To investigate effect of augmenting that intervention with education based on social cognitive theory (SCT). DESIGN:Pilot multicentre, double-blind, ra...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-016336
更新日期:2017-10-12 00:00:00
abstract:OBJECTIVE:This study was aimed to explore parents' experience of assisting children affected by tuberous sclerosis complex (TSC) with subependymal giant-cell astrocytoma (SEGA) manifestation, in order to understand their caring needs and expectation of support. SETTING AND PROCEDURE:The study was designed according to...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003707
更新日期:2013-12-06 00:00:00