Hypertension, Pregnancy-Induced

FRIDAY, Jan. 10, 2025 -- Experiencing at least one microaggression related to race and gender during or after pregnancy is associated with increased postpartum blood pressure (BP), according to a study published online Jan. 9 in Hypertension . Teresa Janevic, Ph.D., M.P.H., from the Columbia University Mailman School of Public Health in New York City, and colleagues conducted a prospective postpartum cohort study involving 373 Asian, Black, and Hispanic participants in New York City and Philadelphia. The Gendered Racial Microaggression (GRM) in Obstetrics scale was administered at delivery. Mixed models were used to estimate the associations between GRM and mean postpartum systolic and diastolic BP, measured for three months. Overall, 4.6, 20.9, and 13.4 percent of participants had chronic hypertension, pregnancy hypertension, and preeclampsia, respectively, comprising a hypertensive disorder of pregnancy subgroup (117 participants). The researchers found that 37.5 percent of participants experienced one or more GRM. Those who experienced one or more GRM versus none had 1.88 and 2.19 mm Hg higher systolic BP from days 1 to 10 and days 11 to 85, respectively. A similar pattern was seen for associations with diastolic BP; associations were stronger in the hypertensive disorder of pregnancy subgroup. Compared with those with neither, participants experiencing GRM and a high Structural Racism Effect Index had 7.55 and 6.03 mm Hg higher systolic and diastolic BP, respectively. "This work serves as a reminder of the long-term impact that racism can have on one’s overall health," senior author Lisa Levine, M.D., from the University of Pennsylvania Perelman School of Medicine in Philadelphia, said in a statement. "The magnitude of these types of physiologic changes may become cumulative over time and lead to the inequities we see in many health outcomes."

THURSDAY, Dec. 26, 2024 -- Gestational hypertension, preeclampsia , and eclampsia are associated with an increased risk for neurological outcomes in the months or years after giving birth, according to a study published online Dec. 23 in JAMA Neurology . Therese Friis, M.D., from Uppsala University in Sweden, and colleagues examined whether gestational hypertension, preeclampsia, and eclampsia are associated with new-onset migraine, headache, epilepsy, sleep disorder, or mental fatigue within months to years after giving birth in a register-based cohort study. A total of 659,188 primiparous women with singleton pregnancies between 2005 and 2018 were identified through the Swedish Medical Birth Register; the final study population included 648,385 women. The researchers found that compared with women with normotensive pregnancies, women with gestational hypertension, preeclampsia, and eclampsia all had an association with an increased risk for a new-onset neurological disorder (adjusted hazard ratios, 1.27, 1.32, and 1.70, respectively). On examination of individual outcomes, the risk for epilepsy was increased more than fivefold for women with eclampsia (adjusted hazard ratio, 5.31). "Our findings warrant further investigations of neurological complications after gestational hypertension, preeclampsia, and eclampsia," the authors write. "They also highlight the need for follow-up regarding neurological disorders in women affected by these pregnancy complications." One author disclosed ties to the pharmaceutical industry.

OXFORD, England--( BUSINESS WIRE )--New research published in Diabetic Medicine this week found that the standard NHS procedures for processing gestational diabetes blood sugar tests were leading to more than 50% of cases being missed. If undiagnosed or untreated gestational diabetes is associated with serious complications for the mother, such as the development of preeclampsia, and for the baby an increased risk of admission to the Neonatal Intensive Care Unit for breathing difficulties, low blood sugar and in some severe cases, a risk of major complications including stillbirth and death. These risks can be reduced with timely diagnosis and intervention during the pregnancy. The study, carried out by Professor Claire Meek of the University of Leicester and colleagues at the University of Cambridge with funding from the National Institute of Health and Care Research (NIHR) found that processing the blood sugar test of mothers at risk of gestational diabetes more quickly could lead to more accurate diagnosis of this serious condition. A new world-first at-home oral glucose tolerance test (OGTT), developed by British digital clinical diagnostics company Digostics (GTT@home), analyses the blood sugar tests immediately, with results instantly shared with the requesting antenatal care team for diagnosis and clinical review. This overcomes the problems with sample processing and delayed testing carried out in hospital or community-based OGTTs as identified by Professor Meek’s study. The GTT@home test is already being successfully used by NHS trusts. Using standard NHS sample processing procedures, 9% of women in the study were diagnosed with gestational diabetes. The researchers found that when blood was processed more quickly, 22% of women in the study were found to have gestational diabetes, a difference of 13%. Without faster sample processing, more than half the women found to have gestational diabetes would have gone undiagnosed. Professor of Chemical Pathology and Diabetes in Pregnancy, Claire Meek said: “Gestational diabetes, which affects women in pregnancy, is very common in the UK and causes complications at the time of birth, affecting both mother and child. Fortunately, most complications can be prevented by accurate diagnosis and access to treatment. However, if the diagnosis is not accurate, then affected mothers cannot access the treatment they need.” The Digostics GTT@home test not only avoids the false negative results issues identified in Professor Meek’s study but is also more convenient and accessible as the patient doesn’t have to travel, especially as the test must be carried out first thing in the morning. Travelling to take the test means patients must arrange childcare, take time off work, or manage transportation, and studies have shown that women from socio-economically deprived groups, black ethnicity, or with mental health issues are less likely to attend or complete OGTT appointments. With at-home testing women who may have struggled to attend clinic-based tests can take the test in comfort on the day most convenient for them. James Jackson, Founder and CEO of Digostics, commented, “Professor Meek’s research definitively shows that in the UK standard OGTT testing is failing to diagnose more than 50% of women who have gestational diabetes during pregnancy. Without a diagnosis, the risks of gestational diabetes cannot be mitigated and mothers and babies are being left at risk of serious, lifelong, and life-threatening health complications.” “The at-home OGTT we have developed avoids the sample processing delays identified in Professor Meek’s research, and we’re identifying a higher rate of gestational diabetes than in-clinic OGTTs. Patients find the test easy to use and we’re extending access to screening to women from underserved patient groups frequently marginalised by in-clinic OGTT provision. The GTT@home test is in use across a number of NHS Trusts in England, and we are in discussions with many more to make this important new technology available to more expectant mothers who are at risk of gestational diabetes.” About Digostics UK-based Digostics' mission is to enable healthcare providers to identify everyone with diabetes and those at risk of developing diabetes by eliminating the common barriers that inhibit accurate and timely testing using the gold standard oral glucose tolerance test (OGTT).