Geraldine Skurnik1, Shelley Hurwitz2, Thomas F McElrath3, Lawrence C Tsen4, Stacey Duey5, Aditi R Saxena2, Ananth Karumanchi6, Janet W Rich-Edwards7, Ellen W Seely2. 1. Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. Electronic address: gskurnik@partners.org. 2. Division of Endocrine, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. 3. Division of Maternal and Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. 4. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States. 5. Research Patient Data Registry/Biobank Portal, Brigham and Women's Hospital, Boston, MA, United States. 6. Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States. 7. Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Abstract
OBJECTIVES: This study aims at identifying associations between therapeutics used during labor and the occurrence of postpartum preeclampsia (PPPE), a poorly understood entity. STUDY DESIGN AND MAIN OUTCOME MEASURES: This is a case-control study of women who received an ICD-9 code for PPPE (cases) during the years 2009-2011, compared to women with a normotensive term pregnancy, delivery and postpartum period until discharge (controls), matched on age (±1year) and delivery date (±3months). Cases were defined as women having a normotensive term pregnancy, delivery and initial postpartum period (48h post-delivery) but developing hypertension between 48h and 6weeks postpartum. Single variable and multiple variable models were used to determine significant risk factors. RESULTS: Forty-three women with PPPE were compared to 86 controls. Use of vasopressors and oxytocin did not differ between cases and controls, but rate of fluids administered during labor (OR=1.68 per 100cc/h; 95% CI: 1.09-2.59, p=0.02) and an elevated pre-pregnancy/first trimester BMI (OR=1.18 per kg/m2, 95% CI: 1.07-1.3, p=0.001) were identified as significant risk factors in multivariate analysis. CONCLUSIONS: We identified two potentially modifiable risk factors for PPPE; further studies are needed to better define the role of these two variables in the development of PPPE.
OBJECTIVES: This study aims at identifying associations between therapeutics used during labor and the occurrence of postpartum preeclampsia (PPPE), a poorly understood entity. STUDY DESIGN AND MAIN OUTCOME MEASURES: This is a case-control study of women who received an ICD-9 code for PPPE (cases) during the years 2009-2011, compared to women with a normotensive term pregnancy, delivery and postpartum period until discharge (controls), matched on age (±1year) and delivery date (±3months). Cases were defined as women having a normotensive term pregnancy, delivery and initial postpartum period (48h post-delivery) but developing hypertension between 48h and 6weeks postpartum. Single variable and multiple variable models were used to determine significant risk factors. RESULTS: Forty-three women with PPPE were compared to 86 controls. Use of vasopressors and oxytocin did not differ between cases and controls, but rate of fluids administered during labor (OR=1.68 per 100cc/h; 95% CI: 1.09-2.59, p=0.02) and an elevated pre-pregnancy/first trimester BMI (OR=1.18 per kg/m2, 95% CI: 1.07-1.3, p=0.001) were identified as significant risk factors in multivariate analysis. CONCLUSIONS: We identified two potentially modifiable risk factors for PPPE; further studies are needed to better define the role of these two variables in the development of PPPE.
Authors: Lusia C Filetti; Anthony N Imudia; Zain Al-Safi; Deslyn T Hobson; Awoniyi O Awonuga; Ray O Bahado-Singh Journal: J Matern Fetal Neonatal Med Date: 2011-08-16
Authors: Arvind Goel; Manish R Maski; Surichhya Bajracharya; Julia B Wenger; Dongsheng Zhang; Saira Salahuddin; Sajid S Shahul; Ravi Thadhani; Ellen W Seely; S Ananth Karumanchi; Sarosh Rana Journal: Circulation Date: 2015-09-28 Impact factor: 29.690
Authors: Laura A Matthys; Kristin H Coppage; Donna S Lambers; John R Barton; Baha M Sibai Journal: Am J Obstet Gynecol Date: 2004-05 Impact factor: 8.661