Computational protocol: Preeclampsia and Future Cardiovascular Risk: Are Women and General Practitioners Aware of This Relationship? The Experience from a Portuguese Centre

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Protocol publication

[…] The 141 cases of preeclampsia and chronic hypertension with superimposed preeclampsia with singleton births diagnosed in our institution from January 2010 to December 2013 were retrospectively reviewed. Patients with multiple pregnancy were excluded.We defined preeclampsia as the new onset of hypertension and either proteinuria or end-organ dysfunction after 20 weeks of gestation in a previously normotensive woman. Superimposed preeclampsia was defined as preeclampsia complicating chronic hypertension, according to The American College of Obstetricians and Gynecologists (ACOG) criteria. Systolic blood pressure of 160 mmHg or higher or diastolic blood pressure of 110 mmHg or higher in two occasions, thrombocytopenia (less than 100,000/microliter), impaired liver function (elevated blood concentrations of liver enzymes to twice normal), or severe refractory epigastric pain, progressive renal insufficiency (serum concentration greater than 1.1 mg/dL or a doubling concentration), pulmonary edema, or new onset cerebral/visual disturbances were considered severe features of preeclampsia. The Mississippi classification was used to define HELLP syndrome: hemolysis (increased LDH level and progressive anemia), hepatic dysfunction (LDH level > 600 IU/L, AST > 40 IU/L, ALT > 40 IU/L or both), and thrombocytopenia (platelet nadir less than 150,000 cells/mm3). The term fetal growth restriction was used to describe fetuses with an estimated weight less than the 10th percentile for gestational age.Demographic and outcome data were collected from the computerised hospital database, VCIntegrator Obscare, which records all the final diagnoses by patient, and a systematic search using preeclampsia, superimposed preeclampsia, and HELLP syndrome as keywords was carried out. Demographic variables collected included woman's age at delivery, prepregnancy maternal body mass index (BMI), parity, education, past obstetric history (including previous preeclampsia, gestational diabetes, preterm birth, and fetal death), the indication for labour induction, and the mode of delivery (vaginal birth or caesarean section). Pregnancy adverse outcomes as fetal growth restriction, gestational diabetes, preterm birth, abruption placentae, and HELLP syndrome were also collected.A standardized telephonic questionnaire was applied to 120 women who were diagnosed with preeclampsia or superimposed preeclampsia between January 2010 and October 2013. We excluded the 21 cases that delivered in the last six months, to better evaluate women lifestyle after hospital's follow-up and maternal license conclusion. Forty-two women not answering after four telephonic calls in three consecutive days were considered nonresponders. For those who were contacted successfully, the purpose of the study was explained and an invitation was given to participate in the evaluation.The questions included current age, weight, medication (including antihypertensive drugs, insulin or oral antidiabetic drugs, antidyslipidemic drugs, aspirin, or others), and contraception method (none, barrier, combined hormonal, progestin-only pills, subdermal implant, vaginal ring, intrauterine device, and female sterilization). We inquired about the mean meals per day, healthy nutrition behaviour, and attendance to nutritional counselling and to general medicine consultation and if an explanation of preeclampsia subject was addressed. Aerobic exercise practice before and after pregnancy was graded as (i) none, (ii) once per month, (iii) once per week, (iv) twice weekly, and (v) more than twice weekly. The monitoring of tensional values and glycemic levels were graded as (i) never, (ii) once per year, (iii) once per month, and (iv) once per week.Study data were collected, validated, and entered into a dedicated study database by trained personnel. A descriptive analysis was performed using SPSS 20.0 software and the STATISTICA FOR WINDOWS statistical package, version 10.0. Chi-square test was used to compare categorical variables and one-way ANOVA test was applied to compare the means BMI between women with preeclampsia with or without severe features. No adjustment for confounders was made. A P value of less than 0.05 was considered significant. […]

Pipeline specifications

Software tools SPSS, Statistica
Application Miscellaneous
Organisms Homo sapiens
Diseases Cardiovascular Diseases, Hypertension, Pre-Eclampsia