Anti-hypertensive use for non-severe gestational hypertension in Botswana: A case-control study.
Anti-hypertensive use for non-severe gestational hypertension in Botswana: A case-control study.
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DOI：
10.1002/ijgo.13809
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Shapiro R
中科院分区：
文献类型：
--
作者：
Johnson KM;Zash R;Modest AM;Luckett R;Diseko M;Mmalane M;Makhema J;Ramogola-Masire D;Wylie BJ;Shapiro R
妊娠期使用抗高血压药物治疗妊娠期高血压对胎儿的风险和益处尚未得到充分研究，特别是在低收入和中等收入国家。我们对 2014 年至 2019 年博茨瓦纳产科患者的回顾性队列进行了巢式病例对照研究。我们纳入了妊娠 20 周后出现新发非严重高血压（收缩压 140-159 mmHg 或舒张压 90-109 mmHg）的单身女性。病例被定义为小于胎龄（SGA）婴儿或死产的妇女，并单独进行分析；对照组是在其他方面相似的女性，在每次分析中都没有出现不良结果。我们确定了 1932 例 SGA 病例（7925 例对照）和 316 例死产病例（9619 例对照）。与对照组相比，SGA 病例更有可能使用抗高血压药物（33% vs. 29%，调整后 OR=1.28，95% CI 1.15-1.43）。死产病例比对照组更有可能使用抗高血压药物（42% vs. 29%，调整后 OR=1.45，95% CI 1.14-1.83）。对于从未患过严重高血压的女性，使用抗高血压药物治疗新发妊娠期高血压会增加 SGA 婴儿或死产的风险。这些数据支持进行随机临床试验，以确定抗高血压药在非严重妊娠期高血压中的适当使用。
The fetal risks and benefits of antihypertensives to treat gestational hypertension in pregnancy are understudied, particularly in low- and middle-income countries. We performed a nested case-control study within a retrospective cohort of obstetric patients in Botswana from 2014 to 2019. We included women carrying singletons who developed new onset non-severe hypertension (140-159 mmHg systolic or 90-109 mmHg diastolic) after 20 weeks’ gestation. Cases were defined as women with either small for gestational age (SGA) infants or stillbirth, analyzed separately; controls were otherwise similar women without the adverse outcome in each analysis. We identified 1932 cases of SGA (7925 controls) and 316 cases of stillbirth (9619 controls). Cases with SGA were more likely to have used an anti-hypertensive than controls (33% vs. 29%, adjusted OR=1.28, 95% CI 1.15-1.43). Cases with stillbirth were more likely to have used an anti-hypertensive than controls (42% vs. 29%, adjusted OR=1.45, 95% CI 1.14-1.83). Anti-hypertensive use for new-onset gestational hypertension was associated with an increased risk of having an SGA infant or a stillbirth among women who never developed severe hypertension. These data support conduct of a randomized clinical trial to determine the appropriate use of anti-hypertensives in non-severe gestational hypertension.
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DOI：
10.1161/hypertensionaha.116.07862
发表时间：
2016-11
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Magee LA;von Dadelszen P;Singer J;Lee T;Rey E;Ross S;Asztalos E;Murphy KE;Menzies J;Sanchez J;Gafni A;Helewa M;Hutton E;Koren G;Lee SK;Logan AG;Ganzevoort W;Welch R;Thornton JG;Moutquin JM;CHIPS Study Group*
通讯作者：
CHIPS Study Group*
DOI：
10.1016/s0002-9378(12)90905-9
发表时间：
1993-01-01
影响因子：
9.8
作者：
MONTAN, S;ANANDAKUMAR, C;RATNAM, SS
通讯作者：
RATNAM, SS
影响因子：
9.8
作者：
Vigil-De Gracia, Paulino;Reyes Tejada, Osvaldo;Ludmir, Jack
通讯作者：
Ludmir, Jack
影响因子：
158.5
作者：
Magee, Laura A.;von Dadelszen, Peter;Moutquin, Jean-Marie
通讯作者：
Moutquin, Jean-Marie
DOI：
10.1016/j.preghy.2016.10.002
发表时间：
2016-10-01
影响因子：
2.2
作者：
Johnson, Katherine M.;Zash, Rebecca;Shapiro, Roger
通讯作者：
Shapiro, Roger