Associations between adverse pregnancy outcomes and cognitive impairment and dementia: a systematic review and meta-analysis.

Background: Individuals with adverse pregnancy outcomes have an increased risk of cerebrovascular disease, but the association between adverse pregnancy outcomes and cognitive impairment and dementia is less well established. We aimed to synthesise, combine, and assess the growing body of data examining the associations between adverse pregnancy outcomes and mild cognitive impairment and dementia in parous women.

Methods: In this systematic review and meta-analysis, we searched PubMed (MEDLINE), Web of Science, and Embase from database inception up to July 18, 2024, with no language restrictions, for observational studies or clinical trials that reported mild cognitive impairment or dementia as outcomes and included female individuals or women who had an adverse pregnancy outcome, including hypertensive disorders of pregnancy, gestational diabetes, stillbirth, fetal growth restriction, preterm birth, or placental abruption.

Continuous versus Intermittent Blood Pressure Monitoring in Postpartum Preeclampsia with Severe Features.

Objective:  In this study, we piloted the use of continuous 24-hour blood pressure (BP) monitoring in postpartum patients with preeclampsia with severe features.

Study Design:  We measured continuous BP for up to 24 hours using finger plethysmography. We also used an oscillometric device to measure brachial BP per usual clinical protocol (intermittent BP) during the same monitoring period.

Short-Acting Oral Nifedipine versus Intravenous Labetalol for the Control of Severe Hypertension in the Postpartum Period: A Retrospective Cohort Study.

Objective:  This study aimed to compare the effectiveness of oral short-acting (SA) nifedipine with intravenous (IV) labetalol for the treatment of postpartum (PP) severe hypertension.

Study Design:  We conducted a retrospective cohort study of women who delivered at a tertiary care facility between January and December 2018, had not previously received antihypertensive medication, and required treatment for PP severe hypertension defined as systolic blood pressure (SBP) ≥ 160 mm Hg and/or diastolic blood pressure (DBP) ≥110 mm Hg. Exposure groups were defined by the receipt of either oral SA nifedipine or IV labetalol.

Ischemic events are infrequent in patients with ovarian hyperstimulation syndrome.

Background: Case reports describe arterial thrombosis including ischemic stroke associated with severe ovarian hyperstimulation syndrome (OHSS), but the prevalence of major ischemic events during or shortly after OHSS is unknown.

Methods: Using publicly available administrative datasets in the United States between 2015 and 2020, we conducted two separate cross-sectional studies of patients with OHSS. We included all patients with OHSS.

Antihypertensive medication prescription dispensation among pregnant women in the United States: A cohort study.

Importance: Hypertension is increasingly common in pregnancy capable individuals, yet there is limited data on antihypertensive medication dispensation in peripartum individuals.

Objective: To describe antihypertensive medication dispensation from preconception through the first year postpartum.

Design, Setting, And Participants: This retrospective cohort study used the Truven Health Market Scan administrative data from 2008 to 2014 to identify women in the United States with commercial or government health insurance, aged 15-54, free from heart disease, who experienced a pregnancy and filled at least 1 prescription for an antihypertensive medication between 3 months prior to conception and 12 months after the end of the pregnancy.

Incident stroke in individuals with peripartum cardiomyopathy.

Background: Peripartum cardiomyopathy (PPCM), a form of heart failure with reduced ejection fraction (HFrEF) that occurs during the final month of pregnancy through the first 5 months postpartum, is associated with heightened risk for maternal morbidity and mortality. Stroke is a common complication of HFrEF but there is limited data on the incidence of stroke in PPCM.

Methods: Using statewide, nonfederal administrative data from 2000 to 2015, we analyzed age-adjusted risk of stroke within 3 years after PPCM-associated pregnancies.

Impact of adverse pregnancy outcomes on brain vascular health and cognition.

A State of the Art lecture titled "Impact of Adverse Pregnancy Outcomes on Brain Vascular Health and Cognition" was presented at the International Society on Thrombosis and Haemostasis Congress in 2023. Adverse pregnancy outcomes, encompassing conditions such as gestational hypertension, eclampsia, preeclampsia, preterm birth, fetal growth restriction, stillbirth, and gestational diabetes, may form part of an underrecognized pathway from early adulthood reproductive health factors to later-life vascular cognitive impairment and dementia in women. Adverse pregnancy outcomes are caused by dysregulated vascular and metabolic adaptations during pregnancy, and these pathophysiological changes may persist after delivery.

Smoking Modifies the Association Between Radon Exposure and Incident Ischemic Stroke: The REGARDS Study.

Background: Exposure to radon has been linked to lung cancer and other lung diseases. Although biologically plausible, research of residential radon exposure in relation to stroke risk is scarce.

Methods: Study participants were from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) cohort (n=30 239), which consisted of male and female non-Hispanic Black and White adults aged 45 and older.

Parity and Risk of Dementia in Women: The Atherosclerosis Risk in Communities Study.

Reproductive factors, including parity, may contribute to dementia risk, due to hormonal, physiological, social, and demographic factors. We hypothesized that higher parity would be associated with increased dementia risk. We utilized data from the Atherosclerosis Risk in Communities (ARIC) community-based cohort study.

Risk of Midlife Stroke After Adverse Pregnancy Outcomes: The FinnGen Study.

Background: Adverse pregnancy outcomes (APO) contribute to higher risk of maternal cerebrovascular disease, but longitudinal data that include APO and stroke timing are lacking. We hypothesized that APO are associated with younger age at first stroke, with a stronger relationship in those with >1 pregnancy with APO.

Methods: We analyzed longitudinal Finnish nationwide health registry data from the FinnGen Study.

How do guideline recommended energy targets compare with measured energy expenditure in critically ill adults with obesity: A systematic literature review.

Background: Critically ill patients with obesity have unique and complex nutritional needs, with clinical practice guidelines conflicting regarding recommended energy targets. The aim of this systematic review was to 1) describe measured resting energy expenditure (mREE) reported in the literature and; 2) compare mREE to predicted energy targets using the European (ESPEN) and American (ASPEN) guideline recommendations when indirect calorimetry is not available in critically ill patients with obesity.

Methods: The protocol was registered apriori and literature was searched until 17th March, 2022.

Association of a Mediterranean Diet Pattern With Adverse Pregnancy Outcomes Among US Women.

Importance: The Mediterranean diet pattern is inversely associated with the leading causes of morbidity and mortality, including metabolic diseases and cardiovascular disease, but there are limited data on its association with adverse pregnancy outcomes (APOs) among US women.

Objective: To evaluate whether concordance to a Mediterranean diet pattern around the time of conception is associated with lower risk of developing any APO and individual APOs.

Design, Setting, And Participants: This prospective, multicenter, cohort study, the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be, enrolled 10 038 women between October 1, 2010, and September 30, 2013, with a final analytic sample of 7798 racially, ethnically, and geographically diverse women with singleton pregnancies who had complete diet data.

Effect of Sex on Coronary Endothelial Dysfunction in People Living With HIV.

Background Impaired coronary endothelial function (CEF) predicts cardiovascular events and occurs in people living with HIV (PLWH). Women compared with men living with HIV have worse cardiovascular outcomes, but prior CEF studies included few women. The authors aimed to compare CEF in women with HIV versus without HIV, investigate sex differences in CEF and PCSK9 (proprotein convertase subtilisin/kexin type 9) (a proinflammatory biomarker), and evaluate whether increased serum levels of PCSK9 are associated with CEF in PLWH.