Temporal patterns of pre- and post-natal target organ damage associated with hypertensive pregnancy: a systematic review.
Temporal patterns of pre- and post-natal target organ damage associated with hypertensive pregnancy: a systematic review.
复制标题
与高血压妊娠相关的出生前和出生后靶器官损害的时间模式：一项系统回顾。
DOI：
10.1093/eurjpc/zwad275
复制
发表时间：
2024-01-05
影响因子：
8.3
通讯作者：
Leeson, Paul
中科院分区：
文献类型：
--
作者：
Cutler, Hannah Rebecca;Barr, Logan;Sattwika, Prenali Dwisthi;Frost, Annabelle;Alkhodari, Mohanad;Kitt, Jamie;Lapidaire, Winok;Lewandowski, Adam James;Leeson, Paul
妊娠期高血压与日后发生一系列血管疾病的风险增加有关。了解高血压靶器官损害何时首次出现可以指导预防性干预的最佳时机。本文综述了从妊娠到产后不同时间点高血压对心脏、血管、脑和肾系统靶器官损害的证据。截至2023年2月（含）的奥维德/MEDLINE、EMBASE和ClinicalTrials.gov系统综述，包括参考文献列表综述。识别出的文章通过综合进行评价，而不是使用基于效应方向的投票计数方法进行荟萃分析，无论统计学意义如何。对每个结果领域的偏倚风险进行了评估，并且仅使用更高质量的研究进行最终分析。从7644篇文章中，76项研究，包括1742698例妊娠的数据，被确定为高质量，报告了高血压妊娠期间或之后的血压轨迹或靶器官损害。左心室肥大、白色病变、蛋白尿和视网膜微血管改变首先在妊娠期高血压妇女中出现。尽管产后早期血压降低，但在产后早期和晚期进行的研究中也报告了心脏、大脑和视网膜变化。认知功能障碍最早出现在产后晚期。尽管血压不同，但妊娠高血压期间报告的大多数靶器官损害在产后早期和晚期仍然很明显。早期围产期的策略可能需要预防或逆转靶器官损害的妇女谁有高血压妊娠。
Hypertensive pregnancy is associated with increased risks of developing a range of vascular disorders in later life. Understanding when hypertensive target organ damage first emerges could guide optimal timing of preventive interventions. This review identifies evidence of hypertensive target organ damage across cardiac, vascular, cerebral, and renal systems at different time points from pregnancy to postpartum. Systematic review of Ovid/MEDLINE, EMBASE, and ClinicalTrials.gov up to and including February 2023 including review of reference lists. Identified articles underwent evaluation via a synthesis without meta-analysis using a vote-counting approach based on direction of effect, regardless of statistical significance. Risk of bias was assessed for each outcome domain, and only higher quality studies were used for final analysis. From 7644 articles, 76 studies, including data from 1 742 698 pregnancies, were identified of high quality that reported either blood pressure trajectories or target organ damage during or after a hypertensive pregnancy. Left ventricular hypertrophy, white matter lesions, proteinuria, and retinal microvasculature changes were first evident in women during a hypertensive pregnancy. Cardiac, cerebral, and retinal changes were also reported in studies performed during the early and late post-partum period despite reduction in blood pressure early postpartum. Cognitive dysfunction was first reported late postpartum. The majority of target organ damage reported during a hypertensive pregnancy remains evident throughout the early and late post-partum period despite variation in blood pressure. Early peri-partum strategies may be required to prevent or reverse target organ damage in women who have had a hypertensive pregnancy.
登录
查看更多内容
影响因子：
9.8
作者：
Aukes, Annet M.;Wessel, Ineke;Zeeman, Gerda G.
通讯作者：
Zeeman, Gerda G.
DOI：
10.1136/bmj.j3078
发表时间：
2017-07-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Behrens I;Basit S;Melbye M;Lykke JA;Wohlfahrt J;Bundgaard H;Thilaganathan B;Boyd HA
通讯作者：
Boyd HA
影响因子：
7.1
作者：
Canjels, L. P. W.;Ghossein-Doha, C.;Backes, W. H.
通讯作者：
Backes, W. H.
影响因子：
7.5
作者：
Akhter, Tansim;Wikstrom, Anna-Karin;Naessen, Tord
通讯作者：
Naessen, Tord
影响因子：
5.4
作者：
Breetveld NM;Alers RJ;Geerts L;van Kuijk SMJ;van Dijk AP;van der Vlugt MJ;Heidema WM;van Neer J;van Empel VPM;Brunner-La Rocca HP;Scholten RR;Ghossein-Doha C;Spaanderman MEA
通讯作者：
Spaanderman MEA