000			02761 am a22002413u 4500
042			_adc
100	1	0	_aBailey, Beth _eauthor _9949
700	1	0	_aEuser, Anna G. _eauthor _9950
700	1	0	_aBol, Kirk A. _eauthor _9951
700	1	0	_aJulian, Colleen G. _eauthor _9952
700	1	0	_aMoore, Lorna G. _eauthor _9953
245	0	0	_aHigh-altitude residence alters blood-pressure course and increases hypertensive disorders of pregnancy
260			_c2022-04.
500			_a/pmc/articles/PMC7529930/
500			_a/pubmed/32228111
520			_aOBJECTIVES: To determine whether the full spectrum of hypertensive disorders of pregnancy (HDP) -- comprising gestational hypertension; preeclampsia with or without severe features; eclampsia; and Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) Syndrome -- is increased at high (≥2500 m, 8250 ft) compared with lower altitudes in Colorado independent of maternal background characteristics, and if so their relationship to neonatal well-being. METHODS: A retrospective cohort study was conducted using statewide birth-certificate data to compare the frequency of gestational hypertension, preeclampsia (with or without severe features), eclampsia, HELLP Syndrome, or all HDP combined in 617,958 Colorado women who lived at high vs. low altitude (<2500 m) and delivered during the 10-year period, 2007 - 2016. We also compared blood-pressure changes longitudinally during pregnancy and the frequency of HDP in 454 high (>2500 m)- vs. low (<1700 m)-altitude Colorado residents delivering in 2013 and 2014, and matched for maternal risk factors. Data were compared between altitudes using t-tests or chi-square, and by multiple or logistic regression analyses to adjust for risk factors and predict specific hypertensive or neonatal complications. RESULTS: Statewide, high-altitude residence increased the frequency of each HDP disorder separately or all combined by 33%. High-altitude women studied longitudinally also had more HDP accompanied by higher blood pressures throughout pregnancy. The frequency of low-birth weight infants (<2500 g), five-minute APGAR scores <7, and NICU admissions were also greater at high than low altitudes statewide, with the latter being accounted for by the increased incidence of HDP. CONCLUSIONS: Residence at high altitude constitutes a risk factor for HDP and recommends increased clinical surveillance. The increased incidence also makes high altitude a natural laboratory for evaluating the efficacy of predictive biomarkers or new therapies for HDP.
540			_a
546			_aen
690			_aArticle
655	7		_aText _2local
786	0		_nJ Matern Fetal Neonatal Med
856	4	1	_uhttp://dx.doi.org/10.1080/14767058.2020.1745181 _zConnect to this object online.
999			_c1710 _d1710