The interdependence of mid-trimester blood pressure and glucose levels in shaping fetal growth and neonatal outcomes: implications for risk–benefit assessment and co-management DOI Creative Commons
Lijuan Lv,

Jingbo Yang,

Linjie Li

et al.

BMC Medicine, Journal Year: 2025, Volume and Issue: 23(1)

Published: March 14, 2025

Maternal hypertension and hyperglycemia are closely related but have distinct impacts on fetal growth managed independently. How the interdependence of blood pressure (BP) glucose levels quantitatively influences risk patterns for abnormal neonatal complications remains unexplored. BP fasting plasma (FPG) were measured between 20 28 weeks gestation in a cohort including 56,881 singleton pregnancies. Linear quantile regression analyses used to evaluate relationship FPG. We examined dose–response relationships FPG with small-for-gestational age (SGA) large-for-gestational (LGA) by using restricted cubic spline (RCS) curves. Additionally, multivariable fractional polynomial interaction (MFPI) analysis was conducted assess effects higher versus lower across full range levels. Heatmaps created visualize contributions categorizing them into ordered groups. Quantile revealed consistent positive correlations mean arterial (MAP) FPG, steeper increase MAP coefficients above 0.5 had non-linear association SGA risk, while showed negative association. highest high (MAP ≥ 85 mmHg)/low (< mg/dL) combinations lowest low < mmHg)/high (≥ mg/dL), equivalent at both BP/high BP/low glucose. In hypertensive patients, worsened continuously as decreased. LGA not influenced Neonatal decreased approximately 47% declined from category, about 17% decreasing Based large pregnancy China, this study an interdependent maternal their combined impact SGA. It provided quantitative evidence how shapes transition SGA, complications, LGA. These findings underscore need integrated approach co-managing during pregnancy.

Language: Английский

Antenatal Physical Activity Interventions and Pregnancy Outcomes: A Systematic Review and Meta‐Analysis With a Focus on Trial Quality DOI Creative Commons
Amanda J. Poprzeczny, Andrea R. Deussen, Megan Mitchell

et al.

BJOG An International Journal of Obstetrics & Gynaecology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 3, 2025

ABSTRACT Background Guidelines recommending regular physical activity in pregnancy for improving outcomes are informed by published meta‐analyses. Inclusion of randomised trials poor methodological quality may bias effect estimates. Objectives To assess the validity these recommendations focusing on trial quality. Search Strategy Systematic search PubMed, PubMed Central, Ovid Medline, Embase, Cochrane Central Register Controlled Trials, and CINAHL from inception to 14 December 2023. Selection Criteria Randomised evaluating an antenatal intervention alone, compared with no such intervention. Data Collection Analysis Trial was assessed using Risk Bias tool. Independent this, studies were grouped based degree deviation intention treat principle. Sequential meta‐analysis performed which greater degrees potential allowed. Between group comparisons used, relative risks or mean differences 95% confidence intervals dichotomous continuous outcomes, respectively. Main Results Overall, reporting low. Only 5 (12.5%) analysed keeping When considering only those rigorously, there evidence that improves limits gestational weight gain (WMD −0.60 kg; CI −2.17, 0.98 WMD 0.98). Conclusions at no/negligible risk bias, interventions not associated improved outcomes. Most methodologically rigorous. Incorporation meta‐analyses into care guidelines result inaccurate recommendations.

Language: Английский

Citations

0
Teratogenic risks of treated and untreated maternal obesity DOI
Robert E. Jones, Chloe Zera

Seminars in Perinatology, Journal Year: 2025, Volume and Issue: unknown, P. 152081 - 152081

Published: April 1, 2025

Language: Английский

Citations

0
The interdependence of mid-trimester blood pressure and glucose levels in shaping fetal growth and neonatal outcomes: implications for risk–benefit assessment and co-management DOI Creative Commons
Lijuan Lv,

Jingbo Yang,

Linjie Li

et al.

BMC Medicine, Journal Year: 2025, Volume and Issue: 23(1)

Published: March 14, 2025

Maternal hypertension and hyperglycemia are closely related but have distinct impacts on fetal growth managed independently. How the interdependence of blood pressure (BP) glucose levels quantitatively influences risk patterns for abnormal neonatal complications remains unexplored. BP fasting plasma (FPG) were measured between 20 28 weeks gestation in a cohort including 56,881 singleton pregnancies. Linear quantile regression analyses used to evaluate relationship FPG. We examined dose–response relationships FPG with small-for-gestational age (SGA) large-for-gestational (LGA) by using restricted cubic spline (RCS) curves. Additionally, multivariable fractional polynomial interaction (MFPI) analysis was conducted assess effects higher versus lower across full range levels. Heatmaps created visualize contributions categorizing them into ordered groups. Quantile revealed consistent positive correlations mean arterial (MAP) FPG, steeper increase MAP coefficients above 0.5 had non-linear association SGA risk, while showed negative association. highest high (MAP ≥ 85 mmHg)/low (< mg/dL) combinations lowest low < mmHg)/high (≥ mg/dL), equivalent at both BP/high BP/low glucose. In hypertensive patients, worsened continuously as decreased. LGA not influenced Neonatal decreased approximately 47% declined from category, about 17% decreasing Based large pregnancy China, this study an interdependent maternal their combined impact SGA. It provided quantitative evidence how shapes transition SGA, complications, LGA. These findings underscore need integrated approach co-managing during pregnancy.

Language: Английский

Citations

0