Objective: Exposure to high altitude (≥2500 m) is associated with increased arterial blood pressure. During pregnancy, even a mild elevation of maternal blood pressure is associated with reduced birthweight and increased prevalence of pregnancy complications. This study aimed to systematically assess the impact of altitude on maternal blood pressure at term and on the prevalence of hypertensive disorders of pregnancy.
Data Sources: PubMed, Ovid Embase, Cochrane Library, Medline, Web of Science, and ClinicalTrials.gov were searched (inception to November 11, 2020).
Study Appraisal And Synthesis Methods: Observational, cohort, or case-control studies were included if they reported a high-altitude and appropriate control pregnant population. Studies published >50 years ago were excluded; 2 reviewers independently assessed articles for eligibility and risk of bias.
Results: At high altitude, maternal systolic and diastolic blood pressure at term was higher than at low altitude (4.8±1.6 mm Hg; P<.001; 4.0±0.8 mm Hg; P<.001, respectively). Hypertensive disorders of pregnancy were more common at high altitude (odds ratio, 1.31 [1.03-1.65]; P<.05). The prevalence of gestational hypertension was nearly twice as high at high altitude (odds ratio, 1.92 [1.15-3.22]; P<.05) but the prevalence of preeclampsia was half as high (odds ratio, 0.57 [0.46-0.70]; P<.001). The likelihood of stillbirth was increased by 63% in pregnancies at high altitude compared with low altitude (odds ratio, 1.63 [1.12-2.35]; P<.01).
Conclusion: Maternal blood pressure is higher at term in pregnancies at high altitude than low altitude, accompanied with an increased risk of gestational hypertension but not preeclampsia. Risk of stillbirth at high altitude is also increased. With a growing population residing at high altitude worldwide, it is essential to clearly define the associated risk of adverse pregnancy outcomes.
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http://dx.doi.org/10.1016/j.ajogmf.2021.100400 | DOI Listing |
J Pediatr Nurs
January 2025
Faculty of Nursing, Yarmouk University, Irbid, Jordan. Electronic address:
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Department of Gastroenterology, The Affiliated People's Hospital of Ningbo University, Ningbo, China.
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View Article and Find Full Text PDFMedicine (Baltimore)
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Department of Cardiovascular Surgery, Eskisehir Osmangazi University Medical Faculty, Eskişehir, Türkiye.
This study assesses the effect of carotid sinus blockade applied with a local anesthetic on hemodynamic parameters during carotid endarterectomy (CEA) operations performed under general anesthesia. The medical records of patients who underwent CEA under general anesthesia between January 2020 and December 2022, were retrospectively reviewed. It was recorded whether the patients received carotid sinus block with 2 mL of 2% prilocaine.
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1Division of Neurosurgery, Department of Surgery.
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View Article and Find Full Text PDFAppl Physiol Nutr Metab
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Chronic Disease Innovation Centre, Winnipeg, Canada;
Risk factors contributing to cardiovascular diseases (CVD) can be addressed through behavior modification, including changes in diet and physical activity. In 2021, The Wellness Institute (WI), located at Seven Oaks General Hospital, created a virtual cardiometabolic risk reduction program in response to COVID-19 pandemic public health restrictions, encompassing virtual health coaching and lifestyle education. The objective was to evaluate the acceptability, adherence, efficacy and engagement of the WI online cardiometabolic and weight loss program.
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