RESUMEN
Hypertensive pregnancy has been associated with reduced nitric oxide (NO), bioavailability, and increased activity of matrix metalloproteinases (MMPs). However, it is unclear if MMPs activation is regulated by NO during pregnancy. To this end, we examined activity of MMP-2 and MMP-9 in plasma, placenta, uterus and aorta, NO bioavailability, oxidative stress, systolic blood pressure (SBP), and fetal-placental development at the early, middle, and late pregnancy stages in normotensive and Nω-Nitro-L-arginine methyl-ester (L-NAME)-induced hypertensive pregnancy in rats. Reduced MMP-2 activity in uterus, placenta, and aorta and reduced MMP-9 activity in plasma and placenta with concomitant increased NO levels were found in normotensive pregnant rats. By contrast, increased MMP-2 activity in uterus, placenta, and aorta, and increased MMP-9 activity in plasma and placenta with concomitant reduced NO levels were observed in hypertensive pregnant rats. Also, elevated oxidative stress was displayed by hypertensive pregnant rats at the middle and late stages. These findings in the L-NAME-treated pregnant rats were also followed by increases in SBP and associated with fetal growth restrictions at the middle and late pregnancy stages. We concluded that NO bioavailability may regulate MMPs activation during normal and hypertensive pregnancy.
Asunto(s)
Hipertensión/metabolismo , Metaloproteinasa 2 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Óxido Nítrico/sangre , Complicaciones Cardiovasculares del Embarazo/metabolismo , Animales , Biomarcadores , Presión Sanguínea/efectos de los fármacos , Activación Enzimática , Femenino , Edad Gestacional , Hipertensión/sangre , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Metabolismo de los Lípidos/efectos de los fármacos , Peroxidación de Lípido , Metaloproteinasa 2 de la Matriz/sangre , Metaloproteinasa 9 de la Matriz/sangre , NG-Nitroarginina Metil Éster/farmacología , Estrés Oxidativo , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/etiología , RatasRESUMEN
Peripartum cardiomyopathy is a type of non-ischemic cardiomyopathy with a high rate of thromboembolic events. Guiding strategies for anticoagulation in patients with peripartum cardiomyopathy and thromboembolic events are limited. Literature for all cases of peripartum cardiomyopathy with intracardiac thrombi were reviewed and summarized from twelve case reports. Based on the available literature, we conclude that patients with peripartum cardiomyopathy with ejection fraction of less than 30% should strongly consider anticoagulation therapy to avoid thromboembolic events. Future studies may be able to further elucidate the optimal indication and duration of anticoagulation.
Asunto(s)
Anticoagulantes/uso terapéutico , Coagulación Sanguínea/efectos de los fármacos , Cardiomiopatías/tratamiento farmacológico , Complicaciones Cardiovasculares del Embarazo/tratamiento farmacológico , Trombosis/tratamiento farmacológico , Adulto , Anticoagulantes/efectos adversos , Cardiomiopatías/sangre , Cardiomiopatías/diagnóstico , Cardiomiopatías/fisiopatología , Femenino , Humanos , Periodo Periparto , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Trombosis/sangre , Trombosis/diagnóstico , Trombosis/fisiopatología , Resultado del Tratamiento , Adulto JovenRESUMEN
Abstract Objective To assess maternal and perinatal outcomes in pregnancies after kidney transplantation in a tertiary center in Brazil. Methods Retrospective cohort of pregnancies in women with kidney transplantation at the Universidade Estadual de Campinas, from January 1995 until December 2017. Medical charts were reviewed, andmaternal and perinatal outcomes were described as means and frequencies. Renal function and blood pressure were evaluated during pregnancy and postpartum. Results A total of 22 women had at least 1 pregnancy during the considered timeinterval, and 3 of them had > 1 pregnancy, totalizing 25 pregnancies. The mean age at transplantation was of 24.6 ± 4.2 years old, and the mean time interval until pregnancy was of 67.8 ± 46.3months. Themost frequent complication during pregnancywas hypertension, which affected 11 (64.7%)women. The gestational age at delivery was 34.7 ± 4weeks, and 47% of these pregnancies were preterm (< 37 weeks). A total of 88.2% of the women delivered by cesarean section. Renal function, measured by serum creatinine, remained stable during pregnancy, and the systolic blood pressure increased significantly, while the diastolic blood pressure did not differ during pregnancy. Conclusion Pregnancy after kidney transplantation is a rare event. Pre-eclampsia and prematurity were frequent complications, and cesarean section rates were very high. A specialized antenatal and postpartum care with a multiprofessional approach and continuous monitoring of graft function are essential for the early diagnosis of complications and improved outcomes.
Resumo Objetivo Avaliar os resultados maternos e perinatais de gestações em mulheres transplantadas renais em um centro terciário no Brasil. Métodos Coorte retrospectiva de gestações entre mulheres transplantadas renais na Universidade Estadual de Campinas, de Janeiro de 1995 a Dezembro de 2017. Os prontuários médicos foram revisados, e os resultados maternos e perinatais foram descritos como médias e frequências. A função renal e a pressão arterial foram avaliadas durante a gravidez e o puerpério. Resultados Um total de 22 mulheres tiveram ao menos 1 gravidez durante o período avaliado, e 3 delas tiveram > 1 gestação, totalizado 25 gestações. A idade média no momento do transplante foi 24.6 ± 4.2 anos, e o tempo médio de intervalo até a gravidez foi de 67.8 ± 46.3 meses. A complicação mais frequente durante a gravidez foi a hipertensão, que acometeu 11 (64.7%) mulheres. A idade gestacional no parto foi de 34.7 ± 4 semanas, e 47% das gestações encerraram-se prematuramente (< 37 semanas). Umtotal de 88.2% das gestações terminou com uma cesárea. A função renal, avaliada pela creatinina sérica, permaneceu estável durante a gravidez, enquanto a pressão arterial sistólica aumentou significativamente. A pressão arterial diastólica não diferiu ao longo dos períodos avaliados. Conclusão Gestação após o transplante renal é um evento raro. Pré-eclâmpsia e prematuridade foram as complicações mais frequentes, e as taxas de cesárea foram muito altas. O cuidado multiprofissional no pré-natal e no puerpério e a constante monitoração da função do enxerto são fundamentais para diagnosticar precocemente complicações e melhorar os resultados.
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Adulto Joven , Complicaciones Cardiovasculares del Embarazo/epidemiología , Atención Prenatal , Trasplante de Riñón , Hipertensión/epidemiología , Complicaciones Cardiovasculares del Embarazo/etiología , Complicaciones Cardiovasculares del Embarazo/sangre , Brasil/epidemiología , Resultado del Embarazo , Estudios Retrospectivos , Estudios de Cohortes , Centros de Atención Terciaria , Hipertensión/etiología , Hipertensión/sangreRESUMEN
OBJECTIVE: To assess maternal and perinatal outcomes in pregnancies after kidney transplantation in a tertiary center in Brazil. METHODS: Retrospective cohort of pregnancies in women with kidney transplantation at the Universidade Estadual de Campinas, from January 1995 until December 2017. Medical charts were reviewed, and maternal and perinatal outcomes were described as means and frequencies. Renal function and blood pressure were evaluated during pregnancy and postpartum. RESULTS: A total of 22 women had at least 1 pregnancy during the considered time interval, and 3 of them had > 1 pregnancy, totalizing 25 pregnancies. The mean age at transplantation was of 24.6 ± 4.2 years old, and the mean time interval until pregnancy was of 67.8 ± 46.3 months. The most frequent complication during pregnancy was hypertension, which affected 11 (64.7%) women. The gestational age at delivery was 34.7 ± 4 weeks, and 47% of these pregnancies were preterm (< 37 weeks). A total of 88.2% of the women delivered by cesarean section. Renal function, measured by serum creatinine, remained stable during pregnancy, and the systolic blood pressure increased significantly, while the diastolic blood pressure did not differ during pregnancy. CONCLUSION: Pregnancy after kidney transplantation is a rare event. Pre-eclampsia and prematurity were frequent complications, and cesarean section rates were very high. A specialized antenatal and postpartum care with a multiprofessional approach and continuous monitoring of graft function are essential for the early diagnosis of complications and improved outcomes.
OBJETIVO: Avaliar os resultados maternos e perinatais de gestações em mulheres transplantadas renais em um centro terciário no Brasil. MéTODOS: Coorte retrospectiva de gestações entre mulheres transplantadas renais na Universidade Estadual de Campinas, de Janeiro de 1995 a Dezembro de 2017. Os prontuários médicos foram revisados, e os resultados maternos e perinatais foram descritos como médias e frequências. A função renal e a pressão arterial foram avaliadas durante a gravidez e o puerpério. RESULTADOS: Um total de 22 mulheres tiveram ao menos 1 gravidez durante o período avaliado, e 3 delas tiveram > 1 gestação, totalizado 25 gestações. A idade média no momento do transplante foi 24.6 ± 4.2 anos, e o tempo médio de intervalo até a gravidez foi de 67.8 ± 46.3 meses. A complicação mais frequente durante a gravidez foi a hipertensão, que acometeu 11 (64.7%) mulheres. A idade gestacional no parto foi de 34.7 ± 4 semanas, e 47% das gestações encerraram-se prematuramente (< 37 semanas). Um total de 88.2% das gestações terminou com uma cesárea. A função renal, avaliada pela creatinina sérica, permaneceu estável durante a gravidez, enquanto a pressão arterial sistólica aumentou significativamente. A pressão arterial diastólica não diferiu ao longo dos períodos avaliados. CONCLUSãO: Gestação após o transplante renal é um evento raro. Pré-eclâmpsia e prematuridade foram as complicações mais frequentes, e as taxas de cesárea foram muito altas. O cuidado multiprofissional no pré-natal e no puerpério e a constante monitoração da função do enxerto são fundamentais para diagnosticar precocemente complicações e melhorar os resultados.
Asunto(s)
Hipertensión/epidemiología , Trasplante de Riñón , Complicaciones Cardiovasculares del Embarazo/epidemiología , Atención Prenatal , Adulto , Brasil/epidemiología , Estudios de Cohortes , Femenino , Humanos , Hipertensión/sangre , Hipertensión/etiología , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/etiología , Resultado del Embarazo , Estudios Retrospectivos , Centros de Atención Terciaria , Adulto JovenRESUMEN
Introducción: La hemorragia obstétrica es una de las complicaciones más temidas y una de las principales causas de mortalidad materna. Objetivo: Caracterizar la hemorragia obstétrica en el servicio de Anestesiología y Reanimación del Hospital Dr. Agostinho Neto de Guantánamo. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo en el mencionado servicio de salud desde 2015 - hasta 2017. De un universo de 388 pacientes que tuvieron diagnóstico de morbilidad materna extremadamente grave, la muestra quedó constituida por las diagnosticadas con hemorragia obstétrica (n= 71). Para el procesamiento estadístico se utilizó el porcentaje, la media y la desviación estándar. Resultados: La hemorragia obstétrica se precisó en 18,2 por ciento de las pacientes; de ellas, 0,7 por ciento fallecieron. La edad media de las pacientes fue de 24,2 ± 6,2 años. La edad gestacional fue de 34,2 ± 6,2 años y la estadía en días fue de 5,9 ± 4,2 [IC 95 por ciento 5,3 - 6,5]. La atonía uterina (50,8 por ciento) fue la causa más común de la hemorragia. El 91,5 por ciento de las pacientes presentó inestabilidad hemodinámica, lo que condicionó el uso de altos volúmenes de fluidos y hemoderivados para su reanimación. La coagulación intravascular diseminada fue la causa de muerte fundamental. Conclusiones: La hemorragia obstétrica continúa una causa importante de morbilidad y mortalidad en el mencionado servicio de salud(AU)
Introduction: Obstetric hemorrhage is one of the feared complications and it is one of the main causes of maternal mortality. Objective: To characterize obstetric hemorrhage in the service of Anesthesiology and Reanimation at Dr. Agostinho Neto Hospital in Guantanamo, Cuba from 2015 to 2017. Methods: A descriptive, longitudinal and prospective study was carried out in the aforementioned health service from 2015 to 2017. Three hundred eighty eight (388) patients that had diagnostic of extremely serious maternal morbidity were the universe of this study. The sample was constituted by those diagnosed with obstetric hemorrhage (n = 71). Percentage, mean and standard deviation were used for the statistical analysis. Results: Obstetric hemorrhage occurred in 18.2 percent of the patients. 0.7 percent died. The mean age was of 24.2 ± 6.2 years; the pregnancies age was of 34.2 ± 6.2 years and hospital stay was of 5.9 ± 4.2 [IC 95 percentage 5.3 - 6.5]. Uterine atony (50.8 percent) was the most common cause of the hemorrhage. 91.5 percent of the patients had hemodynamic unsteadiness that conditioned the use of high volumes of fluids and hemoderivates for reanimation. Clotting intravascular was the main cause of death. Conclusions: Obstetric hemorrhage constitutes an important cause of morbidity and mortality in the mentioned health service(AU)
Asunto(s)
Humanos , Femenino , Embarazo , Complicaciones del Embarazo/epidemiología , Complicaciones Cardiovasculares del Embarazo/sangre , Choque/complicaciones , Coagulación Intravascular Diseminada/tratamiento farmacológico , Histerectomía/métodos , Epidemiología Descriptiva , Estudios Prospectivos , Estudios Longitudinales , Anestesiología/métodosRESUMEN
Several changes occur in lipid metabolism during gestation due to hormonal and metabolic changes, which are essential to satisfy the nutritional demands of the maternal-fetal unit development. The gestation shows two distinct periods that begin with fat accumulation, mainly in maternal adipose tissue, and the late phase, characterized by accelerated catabolism, with the increase of fatty acids in the circulation that causes hyperlipidemia, especially the one characterized as hypertriglyceridemia. Maternal hyperlipidemia may be associated with the development of maternal-fetal complications (preterm birth, preeclampsia, vascular complications) and the development of long-term cardiovascular disease. The cardiovascular risk may not only be related to lipoproteins cholesterol content, but also to the number and functionality of circulating lipoprotein particles. This review reports the major changes that occur in lipoprotein metabolism during pregnancy and that are associated with the development of dyslipidemias, lipoprotein atherogenic phenotype, and maternal-fetal unit complications.
Diversas mudanças ocorrem no metabolismo lipídico durante a gestação em função das alterações hormonais e metabólicas, que são essenciais para satisfazer a demanda nutricional ocasionada pelo desenvolvimento da unidade feto-placentária. O período da gestação apresenta dois momentos distintos que iniciam com acúmulo de gordura principalmente no tecido adiposo materno, e a fase tardia, caracterizada por catabolismo acelerado, com aumento de ácidos graxos na circulação causando hiperlipidemia, principalmente a aquela caracterizada como hipertrigliceridemia. A hiperlipidemia materna pode estar associada ao desenvolvimento de complicações materno-fetais (parto prematuro, pré-eclâmpsia, complicações vasculares) e de doenças cardiovasculares, a longo prazo. O risco pode estar relacionado não apenas ao teor de colesterol contido nas frações lipoprotéicas, mas também ao número e a funcionalidade das partículas lipoproteicas. Esta revisão aborda as principais mudanças que ocorrem no metabolismo lipoproteico durante a gravidez, e que estão associadas ao desenvolvimento de dislipidemias, fenótipo aterogênico e complicações materno-fetais.
Asunto(s)
Enfermedades Fetales/sangre , Lipoproteínas/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones del Embarazo/sangre , Biomarcadores/sangre , Femenino , Humanos , Embarazo , Complicaciones Cardiovasculares del Embarazo/epidemiología , Medición de RiesgoRESUMEN
Abstract Several changes occur in lipid metabolism during gestation due to hormonal and metabolic changes, which are essential to satisfy the nutritional demands of the maternal-fetal unit development. The gestation shows two distinct periods that begin with fat accumulation, mainly in maternal adipose tissue, and the late phase, characterized by accelerated catabolism, with the increase of fatty acids in the circulation that causes hyperlipidemia, especially the one characterized as hypertriglyceridemia. Maternal hyperlipidemia may be associated with the development of maternal-fetal complications (preterm birth, preeclampsia, vascular complications) and the development of long-term cardiovascular disease. The cardiovascular risk may not only be related to lipoproteins cholesterol content, but also to the number and functionality of circulating lipoprotein particles. This review reports themajor changes that occur in lipoprotein metabolismduring pregnancy and that are associated with the development of dyslipidemias, lipoprotein atherogenic phenotype, and maternal-fetal unit complications.
Resumo Diversas mudanças ocorrem no metabolismo lipídico durante a gestação em função das alterações hormonais e metabólicas, que são essenciais para satisfazer a demanda nutricional ocasionada pelo desenvolvimento da unidade feto-placentária. O período da gestação apresenta dois momentos distintos que iniciam com acúmulo de gordura principalmente no tecido adiposo materno, e a fase tardia, caracterizada por catabolismo acelerado, com aumento de ácidos graxos na circulação causando hiperlipidemia, principalmente a aquela caracterizada como hipertrigliceridemia. A hiperlipidemia materna pode estar associada ao desenvolvimento de complicações materno-fetais (parto prematuro, pré-eclâmpsia, complicações vasculares) e de doenças cardiovasculares, a longo prazo. O risco pode estar relacionado não apenas ao teor de colesterol contido nas frações lipoprotéicas, mas também ao número e a funcionalidade das partículas lipoproteicas. Esta revisão aborda as principais mudanças que ocorrem no metabolismo lipoproteico durante a gravidez, e que estão associadas ao desenvolvimento de dislipidemias, fenótipo aterogênico e complicações maternofetais.
Asunto(s)
Humanos , Femenino , Embarazo , Complicaciones del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Enfermedades Fetales/sangre , Lipoproteínas/sangre , Complicaciones Cardiovasculares del Embarazo/epidemiología , Biomarcadores/sangre , Medición de RiesgoRESUMEN
BACKGROUND: The genetic component related to blood pressure (BP) changes during pregnancy is still not elucidated. Thus, the aim of the study was to evaluate the association between leptin and leptin receptor polymorphisms and systolic (SBP) and diastolic BP (DBP) variation during pregnancy and the postpartum period. METHODS: Prospective cohort of 146 women followed at a Public Health Center in Rio de Janeiro, Brazil, during pregnancy and the postpartum. SBP and DBP (mm Hg) were measured using an automatic sphygmomanometer. DNA was extracted by phenol-chloroform protocol and leptin (G2548A) and leptin receptor genes (Q223R and K109R) polymorphisms were genotyped using real-time PCR method. Statistical analyses included longitudinal linear mixed-effect models. RESULTS: Adjusted longitudinal models showed that women carrying the G-allele of leptin gene's polymorphism began pregnancy with higher BP levels compared to the AA genotype and their levels remained higher throughout pregnancy and the postpartum period (ß SBP = 4.5; 95% confidence interval (CI) = 1.0-8.0; P = 0.012; ß DBP = 2.9; 95% CI = 0.1-5.8; P = 0.040). There was a significant interaction between leptin gene polymorphism and body mass index (BMI), in which the effect of BMI on increasing BP was steeper in women homozygous for the A-allele, compared with those who had at least one G-allele (ß G-allele#BMI = -0.8; 95% CI = -1.5 to -0.1; P = 0.022). We did not find significant associations between leptin receptor polymorphisms and BP changes. CONCLUSIONS: The G-allele of leptin gene polymorphism (G2548A) was associated with increased BP levels during pregnancy and the postpartum. Furthermore, leptin polymorphism genotypes seem to modify the well-known effect of BMI on BP.
Asunto(s)
Presión Sanguínea/fisiología , Índice de Masa Corporal , Leptina/genética , Polimorfismo Genético , Periodo Posparto/genética , Complicaciones Cardiovasculares del Embarazo/genética , Receptores de Leptina/genética , Adulto , Alelos , Determinación de la Presión Sanguínea , Brasil/epidemiología , Femenino , Estudios de Seguimiento , Frecuencia de los Genes , Genotipo , Humanos , Incidencia , Leptina/sangre , Persona de Mediana Edad , Periodo Posparto/sangre , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/epidemiología , Estudios Prospectivos , Reacción en Cadena en Tiempo Real de la Polimerasa , Receptores de Leptina/sangre , Factores de TiempoRESUMEN
BACKGROUND AND AIMS: Pregnancy-related hypertensive disorders are complications in which risk factors are identified such as nulliparity, age, malnutrition, obesity and social issues. Those statements are explained by theories of abnormal placentation, immunological inadequacy, genetics and oxidative stress, but all theories converge in endothelial damage, which is able to mechanically deform and hemolyze erythrocytes as they pass through the capillaries. Given the effects of endothelial damage, the aim of the study was to determine erythrocyte alterations in peripheral blood smear of patients with hypertensive disorders of pregnancy that could be used as prognostic condition. METHODS: We performed a prospective, descriptive and observational study where all patients with hypertensive disorders admitted to the obstetrics and gynecology service of a specialty hospital were recruited. Patients who provided signed informed consent underwent peripheral blood smear. Results were tabulated in percentage graphics and analyzed with Cramer's V based on χ(2). The peripheral blood smear consisted of an extended drop of peripheral blood from the patient with subsequent hematological staining done with Romanowsky stain. RESULTS: A total of 119 samples were analyzed; 74% showed abnormal morphology of erythrocytes and the most frequent abnormality was the presence of schistocytes in up to 39% of samples. Descriptive analysis showed a degree of association to independent variables with Cramer's V = 0.41 value (p <0.05). CONCLUSIONS: A high percentage of patients with hypertensive disorders of pregnancy show some morphologic alterations of erythrocytes in peripheral blood smear.
Asunto(s)
Eritrocitos/metabolismo , Hipertensión Inducida en el Embarazo/sangre , Preeclampsia/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Adulto , Eritrocitos/citología , Femenino , Humanos , Hipertensión Inducida en el Embarazo/patología , Masculino , Estrés Oxidativo , Embarazo , Complicaciones Cardiovasculares del Embarazo/patología , Estudios Prospectivos , Adulto JovenRESUMEN
OBJECTIVE: To determine if early pregnancy serum biomarkers in high-risk women who develop preeclampsia vary according to risk factor. STUDY DESIGN: We performed a secondary analysis of the Maternal-Fetal Medicine Units Network randomized controlled trial of low-dose aspirin for the prevention of preeclampsia in high-risk women. Serum biomarker levels at enrollment (before initiation of aspirin or placebo) were compared between women who did and did not develop preeclampsia, both for the group as a whole and within each of 4 high-risk groups (insulin-dependent diabetes, hypertension, multiple gestation, and previous preeclampsia) using a regression model adjusting for gestational age at collection and prepregnancy body mass index. RESULTS: 1258 women were included (233 with insulin-dependent diabetes, 387 with chronic hypertension, 315 with a multiple gestation, 323 with previous preeclampsia). Multiple early pregnancy serum biomarkers differed between women who did and did not develop preeclampsia. Each high-risk group had a unique and largely nonoverlapping pattern of biomarker abnormality. Differences between those who did and did not develop preeclampsia were noted in vascular cell adhesion molecule in the diabetes group; human chorionic gonadotropin, soluble tumor necrosis factor receptor-2, tumor necrosis factor-alpha, selectin and angiogenin in the chronic hypertension group; interleukin-6, placental growth factor, soluble fms-like tyrosine kinase plus endoglin to placental growth factor ratio in the multiple gestation group; and angiogenin in the previous preeclampsia group. CONCLUSION: Patterns of serum biomarkers vary by high-risk group. These data support the hypothesis that multiple pathogenic pathways lead to the disease recognized clinically as preeclampsia.
Asunto(s)
Diabetes Mellitus Tipo 1/sangre , Hipertensión/sangre , Preeclampsia/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Embarazo en Diabéticas/sangre , Embarazo Múltiple/sangre , Adulto , Antígenos CD/sangre , Biomarcadores/sangre , Gonadotropina Coriónica/sangre , Endoglina , Femenino , Humanos , Factor de Crecimiento Placentario , Embarazo , Proteínas Gestacionales/sangre , Progesterona/sangre , Receptores de Superficie Celular/sangre , Receptores Tipo II del Factor de Necrosis Tumoral/sangre , Ribonucleasa Pancreática/sangre , Medición de Riesgo/métodos , Factores de Riesgo , Factor de Necrosis Tumoral alfa/sangre , Receptor 1 de Factores de Crecimiento Endotelial Vascular/sangre , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVE: To compare the values of the atherogenic index of plasma between preeclamptic patients and healthy pregnant women. PATIENTS AND METHOD: Seventy patients were selected. Twenty-three severe preeclamptic patients (group A), 12 mild preeclamptic patients (group B) and 35 healthy pregnant women with similar age and body mass index (group C). Blood samples for lipids and lipoproteins determination were taken and the atherogenic plasma index was calculated. RESULTS: We did not find differences in group A and B with regard to maternal age, gestational age at the time of evaluation and body mass index compared with pregnant women in group C (P=ns). Plasma concentrations of triglycerides and low-density lipoproteins were significantly higher in patients of groups A and B compared with group C (P<.05). Normotensive patients presented higher concentrations of high-density lipoproteins than patients with severe and mild preeclampsia (P<.05). There were no differences between groups in plasma cholesterol concentrations (P=ns). Patients in groups A (1.14±0.44) and in group B (0.95±0.46) presented significantly higher values of the atherogenic index of plasma compared with pregnant women in group C (0.62±0.20; P<.05). CONCLUSION: Patients with preeclampsia had higher values of the atherogenic index of plasma than healthy pregnant women.
Asunto(s)
Aterosclerosis/sangre , Preeclampsia/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Embarazo/sangre , Estudios de Casos y Controles , Femenino , Humanos , Adulto JovenRESUMEN
Endothelial dysfunction is a fundamental characteristic in the physiopathology of preeclampsia. Currently, a series of markers which explain endothelial dysfunction have been identified. The recognition of endothelial dysfunction has been used to realize an early diagnosis of preeclampsia, as soon as the classification of a possible prognosis. Nevertheless the detection of these markers is not accessible to the majority of hospitable centers that treat patients with preeclampsia. One indirect marker of endothelial dysfunction with a greater accessibility is the assessment of peripheral blood smear. Several studies had proved the presence of endothelial dysfunction by identification of red blood cells crenated in peripheral blood smear led us also to measure the impact in the evolution of the disease.
Asunto(s)
Preeclampsia/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Enfermedades Vasculares/sangre , Enfermedades Vasculares/complicaciones , Femenino , Humanos , Embarazo , Complicaciones Cardiovasculares del Embarazo/patología , Enfermedades Vasculares/patologíaRESUMEN
The nucleotide degrading enzymes, ectonucleotidases, present on the platelet surface of human pregnant with a normal (without complications) or high risk for thrombosis (hypertension and gestational diabetes) were studied. NTPDase (E.C. 3.6.1.5, CD39) and 5'-nucleotidase (E.C. 3.1.3.5, CD73) activities of four patient groups, non-pregnant (NP, n = 18), pregnant without complications (P, n = 25), pregnant with hypertension (HP, n = 15) and pregnant with gestational diabetes mellitus (GDP, n = 10), were analyzed. Increased NTPDase activities were observed in the groups P (37.0%, S.D. = 2.03 and 34.0%, S.D. = 3.19), HP (40.0%, S.D. = 3.32 and 56.0%, S.D. = 3.25) and GDP (23.0%, S.D. = 2.30 and 42.0%, S.D. = 2.26) in comparison to the control group NP (p < 0.01, S.D. = 1.92 and S.D. = 2.48) when ATP and ADP were used as substrate, respectively. AMP was used as substrate to determine the 5'-nucleotidase activities, which showed to be elevated in the groups P (45.0%, S.D. = 1.73), HP (54.0%, S.D. = 2.64) and GDP (68.0%, S.D. = 1.69) when compared to the control group NP (p < 0.01, S.D. = 1.26). However, no statistically significant differences were observed between the groups P, HP and GDP. As a consequence, the enhanced ATP, ADP and AMP hydrolysis was ascribed to the pregnancy itself, independent of a normal or high risk for thrombosis. The enhanced NTPDase and 5'-nucleotidase activities in platelets suggest that these enzymes are involved in the thromboregulation process in the pregnancy.
Asunto(s)
5'-Nucleotidasa/metabolismo , Antígenos CD/metabolismo , Apirasa/metabolismo , Plaquetas/enzimología , Complicaciones Cardiovasculares del Embarazo/enzimología , Embarazo/sangre , Trombosis/etiología , Adenosina Difosfato/sangre , Adenosina Monofosfato/sangre , Adenosina Trifosfato/sangre , Adulto , Plaquetas/metabolismo , Permeabilidad Capilar , Permeabilidad de la Membrana Celular , Femenino , Humanos , L-Lactato Deshidrogenasa/metabolismo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/metabolismo , Factores de Riesgo , Trombosis/sangre , Trombosis/enzimología , Trombosis/metabolismoRESUMEN
BACKGROUND AND OBJECTIVE: It has been shown that the circulating Renin-Angiotensin System (RAS) is activated during normal pregnancy, but little is known about RAS in pregnancies complicated by gestational diabetes (GDM). GDM is considered not merely a temporary condition, but a harbinger of hypertension and type 2 diabetes. The aim of this study was to evaluate the circulating RAS profile in normotensive women with GDM at the third trimester of pregnancy and to compare the results with healthy pregnant and non-pregnant age-matched women. METHODS: The diagnostic criteria for GDM followed the recommendations of the American Diabetes Association. Angiotensin I (Ang I), Angiotensin II (Ang II) and Angiotensin 1-7 [Ang-(1-7)] were determined in 24 pregnant patients with GDM; 12 healthy pregnant women and 12 non-pregnant women by radioimmunoassay. RESULTS: Levels of Ang I, Ang II and Ang-(1-7) were higher in pregnant women (p<0.05), but showed a different pattern in the GDM group, in which reduced Ang-(1-7) circulating levels were found (p<0.05). This observation was confirmed by the significantly lower Ang-(1-7)/Ang I ratio (p<0.05). CONCLUSION: Our data suggest that reduced levels of the vasodilator Ang-(1-7) could be implicated in the endothelial dysfunction seen in gestational diabetic women during and after pregnancy.
Asunto(s)
Angiotensina II/sangre , Angiotensina I/sangre , Diabetes Gestacional/sangre , Fragmentos de Péptidos/sangre , Sistema Renina-Angiotensina/fisiología , Adulto , Estudios de Casos y Controles , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/fisiopatología , Femenino , Edad Gestacional , Humanos , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Tercer Trimestre del Embarazo , RadioinmunoensayoRESUMEN
OBJETIVO: Se ha comunicado asociación de hiperandrogenemia y preeclampsia; además de confirmarlo se pretende dilucidar si también hay esa asociación con embarazadas con hipertensión arterial crónica esencial (HACE). MÉTODOS: 45 mujeres con gestación de tercer trimestre separadas en 3 grupos: 1) 15 normotensas, 2) 16 preeclámpticas, 3) 14 HACE. Se registró edad, paridad, índice de masa corporal (IMC), presión arterial sistólica y diastólica (mm de Hg), proteinuria en 24 horas, semanas de gestación, y niveles séricos de testosterona total (Tt), RIA de testosterona libre (Tl), proteína ligante sexual (SHBG), índice de andrógenos libres (IAL). RESULTADOS: Los 3 grupos estudiados, normotensas, preeclámpticas y HACE, presentaron los siguientes valores séricos, respectivamente: Tt (nmol/L) 2,3±1,4; 5,2±3,0; 1,9±1,5 (p=0,001). IAL (pmol/L) 0,5±0,3; 1,1±0,9; 0,4±0,2 (p=0,001). No hubo diferencias significativas en Tl (pmol/L) 7,2±4,7; 7,39±4,5; 4,5±2,6; ni en SHBG (nmol/L) 468±112; 503±134; 512±96. CONCLUSIONES: Las embarazadas con HACE presentaron niveles séricos de Tt y de IAL similares a las embarazadas normotensas. En cambio, las mujeres con preeclampsia presentaron niveles de Tt sérica e IAL claramente aumentados en comparación con las embarazadas normotensas. Se concluye que existiría una asociación de hiperandrogenemia con preeclampsia; asociación que no fue encontrada en embarazadas con HACE.
OBJECTIVE: Association between hyperandrogenemia and preeclampsia was communicated. This study was designed to explain if also there is association between hyperandrogenemia and pregnant with essential chronic arterial hypertension (HACE). METHODS: To 45 women with gestation of third trimester were separated in 3 groups: 1) normal arterial pressure (n=15), 2) preeclampsia (n=16), 3) HACE (n=14). It was registered age, parity, body mass index (IMC), systolic and diastolic arterial pressure (mm of Hg), proteinuria in 24 h, weeks of gestation, and seric level of total testosterone (Tt), free testosterone (Tl), free androgen index (IAL). RESULTS: The studied groups, normal arterial pressure, preeclampsia, and HACE, displayed the following serics values, respectively: Tt (nmol/L) 2.3±1.4; 5.2±3.0; 1.9±1.5; (p=0.001). IAL (pmol/L) 0.5±0.3; 1.1±0.9; 0.4±0.2; (p=0.001). Not significant differences were found in: Tl (pmol/L) 7.2±4.7; 7.4±4.5; 4.5±2.6. SHBG (nmol/L) 468±112; 503±134; 512±96. CONCLUSIONS: The pregnant women with HACE presented similar seric level of T than pregnant women with normal arterial pressure. However, the women with preeclampsia displayed significant increased levels of seric Tt and increased IAL. We conclude that the association observed of hyperandrogenemia with preeclampsia was not found in pregnant with HACE.
Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Complicaciones Cardiovasculares del Embarazo/sangre , Testosterona/sangre , Hipertensión Esencial/sangre , Preeclampsia/sangre , Tercer Trimestre del Embarazo , Enfermedad Crónica , Análisis de Varianza , Hiperandrogenismo/sangreRESUMEN
OBJECTIVE: To compare the plasmatic levels of free testosterone (FT), total testosterone (TT), and dehydroepiandrosterone sulphate (DHEAs) obtained from women with pregnancy-induced hypertension (PIH) and from uncomplicated pregnant women in the third trimester of pregnancy. METHODS: FT, TT and DHEAs were measured by radioimmunoassay in plasma samples from 30 women with PIH (PIH group) defined as mean blood pressure > or = 105 mm Hg, and proteinuria > or = 100 mg/dL and < 300 mg/dL, and in 30 women with uncomplicated pregnancies (control group). Gestational age at the time of the study in the PIH group was 37 weeks +2 days (28+0 - 40+1), and in the control group, 37 weeks +1 day (28+0 - 41+6). The plasmatic androgen levels and the perinatal outcome were analysed in both groups. RESULTS: There was no difference in the gestational age at birth. In the PIH group there were increased number of caesarean sections due to fetal distress (PIH group; n = 10, control group; n = 2; p = 0.05), lower birthweight (PIH group 2549 g [800-3400 g], control group 3242 g [2400-4200 g]; p = 0.02) and increased number of neonatal intensive unit care admissions (PIH group; n = 3, control group; n = 0). In the PIH group, FT and TT levels were significantly higher than controls (mean, SD) (FT PIH group, 5.94 (0.9) pg/mL; FT control group, 0.44 (0.2) pg/mL; p = 0.002. TT PIH group, 5.28 (2.4) nmol/L; TT control group, 3.6 (0.6) nmol/L; p = 0.02. There was no difference in DHEAs levels between the groups (mean, SD) (PIH group, 51.13 (23.7) microg/dL; control group, 70.0 (13.5) microg/dL). CONCLUSIONS: In women complicated with PIH there is an increment in the plasmatic levels of FT and TT. This might contribute to the clinical findings and the adverse perinatal outcome observed in this patients.
Asunto(s)
Andrógenos/sangre , Sulfato de Deshidroepiandrosterona/sangre , Hipertensión/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Adolescente , Adulto , Cesárea/estadística & datos numéricos , Femenino , Sufrimiento Fetal/epidemiología , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Recién Nacido de Bajo Peso , Recién Nacido , Enfermedades del Recién Nacido/epidemiología , México/epidemiología , Trabajo de Parto Prematuro/epidemiología , Preeclampsia/sangre , Preeclampsia/epidemiología , Preeclampsia/fisiopatología , Embarazo , Complicaciones Cardiovasculares del Embarazo/epidemiología , Complicaciones Cardiovasculares del Embarazo/fisiopatología , Resultado del EmbarazoRESUMEN
Objective. To compare the plasmatic levels of free testosterone (FT), total testosterone (TT), and dehydroepiandrosterone sulphate (DHEAs) obtained from women with pregnancy-induced hypertension (PIH) and from uncomplicated pregnant women in the third trimester of pregnancy. Methods. FT, TT and DHEAs were measured by radioimmunoassay in plasma samples from 30 women with PIH (PIH group) defined as mean blood pressure > 105 mm Hg, and proteinuria > 100 mg/dL and < 300 mg/dL, and in 30 women with uncomplicated pregnancies (control group). Gestational age at the time of the study in the PIH group was 37 weeks +2 days (28+0 - 40+1), and in the control group, 37 weeks +1 day (28+0 - 41+6). The plasmatic androgen levels and the perinatal outcome were analysed in both groups. Results. There was no difference in the gestational age at birth. In the PIH group there were increased number of caesarean sections due to fetal distress (PIH group; n = 10, control group; n = 2; p = 0.05), lower birthweight (PIH group 2549 g [800-3400 g], control group 3242 g [2400-4200 g]; p = 0.02) and increased number of neonatal intensive unit care admissions (PIH group; n = 3, control group; n = 0). In the PIH group, FT and TT levels were significantly higher than controls (mean, SD) (FT PIH group, 5.94 (0.9) pg/mL; FT control group, 0.44 (0.2) pg/mL; p = 0.002. TT PIH group, 5.28 (2.4) nmol/L; TT control group, 3.6 (0.6) nmol/L; p = 0.02. There was no difference in DHEAs levels between the groups (mean, SD) (PIH group, 51.13 (23.7) µg/dL; control group, 70.0 (13.5) /igldL). Conclusions. In women complicated with PIH there is an increment in the plasmatic levels of FT and TT. This might contribute to the clinical findings and the adverse perinatal outcome observed in this patients.
Objetivo. Comparar los valores plasmáticos de testosterona libre (TL), testosterona total (TT) y sulfato de dehidroepiandrosterona (DHEAs) entre mujeres con hipertensión asociada al embarazo (HAE) y mujeres con embarazos normales en el tercer trimestre de la gestación. Mátodos. Se midieron TL, TT y DHEAs en el plasma de 30 mujeres con diagnóstico de HAE (grupo HAE), definida como tensión arterial media > 105 mm Hg y proteínas en orina >100 mg/dL y < 300 mg/ dL, y en 30 mujeres embarazadas sin HAE (grupo control) y los valores obtenidos se compararon entre ambos grupos. La edad gestacional de las pacientes del grupo control fue lo más similar posible a las pacientes del grupo con HAE. Resultados. TL y TT resultaron significativamente más altas en el grupo con HAE (media, DS). TL grupo HAE 5.94 (0.9) pg/mL; TL grupo control 0.44 (0.2) pg/mL; p = 0.002. TT grupo HAE 5.28 (2.4) nmol/L; TT grupo control 3.6 (0.6) nmol/L; p = 0.02. No hubo diferencias significativas en los valores de DHEAs (media, DS) grupo HAE 51.13 (23.7) µg/dL; grupo control 70.0 (13.5) µg/dL. La edad gestacional al momento del estudio en el grupo HAE fue de 37 semanas + 2 días (28 + 0 -40+1) y en el grupo control de 37 semanas +1 día (28+0 - 41+6). No hubo diferencia en la edad gestacional al nacimiento. El grupo con HAE presentó un mayor número de cesáreas por indicación fetal (grupo HAE n = 10; grupo control n = 2; p = 0.05), menor peso al nacimiento (grupo HAE 2549 g [800-3400 g]; grupo control 3242 g [2400-4200 g]; p = 0.02) y mayor número de ingresos a la unidad de cuidados intensivos neonatales (grupo HAE n = 3; grupo control n = 0). Conclusiones. En embarazadas con HAE, TL y TT están elevadas, pudiendo contribuir en las manifestaciones clínicas y en el peor resultado perinatal que tienen estas pacientes.
Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Recién Nacido , Embarazo , Andrógenos/sangre , Sulfato de Deshidroepiandrosterona/sangre , Hipertensión/sangre , Complicaciones Cardiovasculares del Embarazo/sangre , Cesárea/estadística & datos numéricos , Sufrimiento Fetal/epidemiología , Hipertensión/epidemiología , Hipertensión/fisiopatología , Recién Nacido de Bajo Peso , Enfermedades del Recién Nacido/epidemiología , México/epidemiología , Trabajo de Parto Prematuro/epidemiología , Resultado del Embarazo , Preeclampsia/sangre , Preeclampsia/epidemiología , Preeclampsia/fisiopatología , Complicaciones Cardiovasculares del Embarazo/epidemiología , Complicaciones Cardiovasculares del Embarazo/fisiopatologíaRESUMEN
BACKGROUND: The impact and clinical relevance of pregnancy-related heart failure (HF) on humoral immunity are not known. Heart failure is often characterized by immunoglobulins (Ig) that differ in subclass profile with etiology. Subclass immunoglobulins differ in the biologic information they confer in disease. Therefore, given that progressive gestation is associated with immunologic incompetence, we sought to study the relative impact of pregnancy-related onset of HF on humoral immunity. METHODS: Immunoglobulins (class G and subclasses G1, G2, G3) against cardiac myosin were evaluated in 47 patients with peripartum cardiomyopathy (PPCM) from different global regions: South Africa (n = 15), Mozambique (n = 9), and Haiti (n = 23) and compared with healthy mothers and patients with idiopathic dilated cardiomyopathy (DCM). C-reactive protein, tumor necrosis factor-alpha, and Fas-Apo-1 were also studied in PPCMs. RESULTS: All PPCM groups were similar in Ig profiles. The immunoglobulins, frequencies and reactivities, were markedly and nonselectively raised in PPCM patients compared with DCM. Immunoglobulin frequencies in PPCMs, Haiti: G1 58%, G2 66%, G3 54%; Mozambique: G1 77%, G2 66%, G3 66%; and South Africa: G1 47%, G2 53%, G3 53%, were higher compared with DCMs from South Africa (n = 24): G1 8%, G2 8%, G3 21%, or the United Kingdom (n = 68): G1 10%, G2 8.8%, G3 22% (P < .0001). Hence, unlike the selective up-regulation of immunoglobulins of the G3 subclass (IgG3s) in DCM, class G and all subclass immunoglobulins were raised in PPCM. Of the serological variables, IgG3s (immunoglobulins with proinflammatory characteristics) discriminated NYHA functional status at diagnosis. IgG3-positive patients were in a higher NYHA class at initial presentation (P < .05). CONCLUSIONS: Immunoglobulin subclass profiles in patients with HF differ with etiology. Unlike DCM, the impact of pregnancy-related HF on humoral immunity is not subclass-restricted. However, raised levels of IgG3s may be of prognostic value in clinical PPCM.
Asunto(s)
Autoanticuerpos/inmunología , Autoantígenos/inmunología , Miosinas Cardíacas/inmunología , Cardiomiopatías/inmunología , Insuficiencia Cardíaca/inmunología , Inmunoglobulina G/biosíntesis , Isotipos de Inmunoglobulinas/biosíntesis , Complicaciones Cardiovasculares del Embarazo/inmunología , Trastornos Puerperales/inmunología , Adulto , Proteína C-Reactiva/análisis , Cardiomiopatías/sangre , Cardiomiopatías/diagnóstico por imagen , Cardiomiopatías/etiología , Cardiomiopatía Dilatada/sangre , Cardiomiopatía Dilatada/diagnóstico por imagen , Cardiomiopatía Dilatada/inmunología , Estudios de Cohortes , Femenino , Haití , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/diagnóstico por imagen , Insuficiencia Cardíaca/etiología , Humanos , Inmunocompetencia , Inmunoglobulina G/sangre , Inmunoglobulina G/clasificación , Inmunoglobulina G/inmunología , Isotipos de Inmunoglobulinas/sangre , Isotipos de Inmunoglobulinas/inmunología , Mozambique , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/diagnóstico por imagen , Índice de Severidad de la Enfermedad , Sudáfrica , Factor de Necrosis Tumoral alfa/análisis , Ultrasonografía , Receptor fas/análisisRESUMEN
OBJECTIVE: Haitian women have a high relative incidence of clinical presentation with peripartum cardiomyopathy (PPCM): an incidence estimated at one case per three hundred live births, a ten-fold occurrence compared to American women. Our objective has been to test the hypothesis that some Haitian women may have a forme fruste of PPCM while still without clinical symptoms. METHOD: A preliminary case-control study was conducted at the Hospital Albert Schweitzer (HAS), Deschapelles, Haiti, in which 25 apparently healthy postpartum women, without cardiovascular symptoms and with a normal cardiovascular clinical examination, were selected from a consecutive list of obstetrical deliveries and screened by echocardiography for left ventricular dysfunction. RESULT: Four out of 25 patients (16%) had asymptomatic left ventricular dysfunction that subsequently evolved towards either improvement or deterioration. Supporting evidence for the existence of asymptomatic left ventricular dysfunction or forme fruste PPCM is presented. A hypothetical schema of the pathophysiology of PPCM explains how a latent phase of variable duration may exist prior to onset of detectable clinical heart failure. CONCLUSION: Screening Haitian women during the last month of pregnancy or in the early postpartum period may help to detect asymptomatic left ventricular dysfunction. Early detection and treatment of PPCM in a known high risk population could lead to improvements in maternal and fetal mortality and morbidity.
Asunto(s)
Cardiomiopatías/diagnóstico , Complicaciones Cardiovasculares del Embarazo/diagnóstico , Adulto , Análisis de Varianza , Biomarcadores/análisis , Cardiomiopatías/sangre , Cardiomiopatías/epidemiología , Estudios de Casos y Controles , Ecocardiografía , Ensayo de Inmunoadsorción Enzimática , Femenino , Haití/epidemiología , Humanos , Incidencia , Embarazo , Complicaciones Cardiovasculares del Embarazo/sangre , Complicaciones Cardiovasculares del Embarazo/epidemiología , Factores de Riesgo , Disfunción Ventricular Izquierda/diagnóstico , Disfunción Ventricular Izquierda/etiologíaRESUMEN
PURPOSE: To evaluate the evolution of glycemic levels in newborns of hypertensive mothers according to maternal treatment. METHODS: Prospective randomized study, including 93 newborns of mothers treated with isradipine (n = 39), atenolol (n = 40), or low sodium diet (control group - n=14). Glycemia was determined at birth (mother and newborn by the oxidase glucose method) and in the 1st, 3rd, 6th, 12th, and 24th hours after birth (newborn by a test strip method). The evolution of glycemia was analyzed in each group (Friedman test). The groups were compared regarding glycemia (Kruskall-Wallis test), and linear regression models were constructed for the analyses (independent variable = maternal glycemia; dependent variables = umbilical cord, 3rd, and 6th hour glycemia). RESULTS: There were no statistically significant differences among the mean blood glucose levels of the 3 groups in any of the assessments. There was a correlation between maternal and umbilical cord blood glucose in the isradipine (r = 0.61; P <.05) and control (r = 0.84; P <.05) groups. Regarding glycemia levels of the mothers and newborns in the third and sixth hours postpartum, this correlation was present only in the control group (maternal x third hour: r = 0.65; P <.05; maternal x sixth hour: r = 0.68; P <.05). There were no correlations in the atenolol group. Hypoglycemia was detected in 51.3% of the isradipine group, 60% of the atenolol group, and 35.7% of the control group, and it was more frequent in the first hour postpartum in all groups. CONCLUSIONS: The results suggest a similar effect of the 3 types of treatment upon newborn glycemia. The correlation analysis suggests that isradipine could have effects upon newborn glycemia only after birth (correlation only in umbilical cord blood), whereas atenolol could act earlier (there was no correlation at any moment). The results also point to the need for glycemic control from the first hour postpartum of newborns of hypertensive mothers whether they have or have not undergone treatment with antihypertensive drugs.