Document Detail


Does advanced maternal age affect pregnancy outcome in women with mild hypertension remote from term?
MedLine Citation:
PMID:  9215179     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our purpose was to compare maternal and perinatal outcomes of mature women with those in younger women with pregnancies complicated by mild hypertension remote from term. STUDY DESIGN: A matched cohort design was used. A total of 379 mature pregnant women (> or = 35 years old) with mild hypertension remote from term were matched for race, gestational age, and proteinuria status at enrollment with 379 adult controls aged 20 to 30 years also with mild hypertension remote from term. All were enrolled in an outpatient management program that included automated blood pressure measurements and daily assessment of weight, proteinuria, and fetal movement. RESULTS: The mean gestational age at enrollment was 32.7 +/- 3.0 weeks for both groups (range 24 to 36 weeks). By matching 20.6% of patients in each group had > or = 1+ proteinuria on urinary dipstick at enrollment, and 77.3% of patients in each group were white. Chronic hypertension was more common in the mature group (22.4% vs 14.5%, p = 0.007). The mean gestational age at delivery (37.2 +/- 2.3 vs 37.2 +/- 2.2 weeks), the mean pregnancy prolongation (28.1 +/- 21.0 vs 28.4 +/- 22.0 days), and the mean birth weights (2864 +/- 770 vs 2906 +/- 788 gm) were similar between the mature and younger groups (all p > 0.05). There were no differences regarding abruptio placentae (2 vs 3 cases) or thrombocytopenia or HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome (7 vs 9 cases), and there were no cases of eclampsia. There were five stillbirths in the mature group and none in the younger group (p = 0.063). CONCLUSION: Outpatient management of mild hypertension remote from term in the mature pregnant women was associated with similar maternal outcomes but with a nonstatistically higher stillbirth rate compared with the younger pregnant woman.
Authors:
J R Barton; N K Bergauer; D I Jacques; S K Coleman; G J Stanziano; B M Sibai
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  176     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-08-04     Completed Date:  1997-08-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1236-40; discussion 1240-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Central Baptist Hospital, Memphis, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
African Continental Ancestry Group / genetics
Birth Weight / physiology
Blood Pressure / physiology
Cohort Studies
European Continental Ancestry Group / genetics
Female
Fetal Death / epidemiology
Gestational Age
Humans
Hypertension / ethnology,  genetics,  physiopathology*
Incidence
Infant, Newborn / physiology
Maternal Age*
Pregnancy
Pregnancy Complications, Cardiovascular / ethnology,  physiopathology*
Pregnancy Outcome*
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Pregnancy, High-Risk*
Proteinuria / epidemiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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