Preeclampsia/Eclampsia

Asst Papa Giovanni Xxiii

Pre-eclampsia/Eclampsia in Italy Over the Years 2010-2016

"Pre-eclampsia/Eclampsia in Italy Over the Years 2010-2016" Retrospective Observational Multicenter Study Carried Out Through an On-line Self-administered Questionnaire

Either, or maternal and paternal: extremes of age (years), extremes of weight (BMI in kg/m2), blood group, ethnic group, level of education (primary, secondary or academic), cardiovascular predisposing factors (hypertension defined as over 140/90 mmHg BP, diabetes mellitus defined as fasting glycemia over 126 mg/dl or over 200mg/dl in a glucose tolerance test, hypercholesterolemia defined as LDL over 240mg/dl, hyperhomocysteinemia defined as homocysteinemia over 15 mol/l, cigarette smoking), family history of pre-eclampsia/eclampsia and/or of cardiovascular predisposing factors (as above), presence of rheumatological and/or immunological disorders, pre-existing thrombophilia.
Maternal only: history of pre-eclampsia, over 10 years from last pregnancy, multiple partners, assisted reproductive technology (ART), oocyte or embryo donation, weight at term (Kg).

gestational week at term; gestational diabetes (defined as fasting plasma glucose level over 126 mg/dl or a fasting glycemia over 92 mg/dl and a 1‑hour glycemia over 180 mg/dl and a 2-hour glycemia over 153 mg/dL in the 75 g oral glucose tolerance test), hypertension (defined as a diastolic blood pressure ≥ 90 mm Hg and a systolic blood pressure ≥ 140 mmHg on at least two different recordings taken at least 4-6 h apart and less than 7 days apart, using an appropriate cuff) and/or kidney failure (defined by the abrupt loss of kidney function; a serum creatinine concentration above 0.8 mg/dL during pregnancy may indicate an underlying renal dysfunction) resolved after childbirth or within 3 months from delivery or over 3 months from delivery or current.

weight at birth (grams), blood group when tested, abortion

Chiara Viviani

Papa Giovanni XXIII Hospital

Woman at high risk of pre-eclampsia:
supplements. 1500 mg Calcium and 1200 IU Vitamin D for 2 months. balanced diet.

usual follow-up in the gynecology out patient clinic, without nutrition or supplement intervention.

Pre-eclampsia

1500 mg Calcium and 1200 IU Vitamin D for 2 months

participants will get a balanced diet according to pregnancy stage

balanced diet

Dietary Intervention Program for Pre-eclampsia in Women at Risk

Testing the Effect of a Dietary Intervention Program on the Incidence of Pre-eclampsia in Women at Risk

Rambam Health Care Campus

Pregnant women who are lean with normal glucose tolerance
- Bloods will be taken at 12 - 32 weeks, at 36 weeks/ delivery

Pregnant women who are obese with normal glucose tolerance
- Bloods will be taken at 12 - 32 weeks, at 36 weeks/ delivery

Pregnant women who have Gestational Diabetes Mellitus
- Bloods will be taken at 12 - 32 weeks, at 36 weeks/ delivery

Placental tissue for epigenetic studies of the leptin gene, and cord blood for leptin and micro RNA29 (miR29) will be collected

Metabolic Syndrome X

At 12 - 32 weeks: All patients need blood sampling for OGTT + insulin + C-peptide + fasting triglyceride + NEFA At 36 weeks/ delivery: All patients need blood sampling for fasting glucose + insulin + C-peptide + fasting triglyceride + NEFA At 36 weeks/ delivery: only GDM patients need blood sampling for HbA1c + fructosamine

Blood sampling

University of Malaya

Maternal Hypertriglyceridaemia Study

Pregravid Body Mass Index (BMI), Maternal Hypertriglyceridemia During Pregnancy and Body Composition/Metabolic Health of Asian GDM Offspring

The ESTEEM dietary pattern is similar to that in a Mediterranean diet associated with reduced risk of pre-eclampsia.
The intervention will include structured meal plans and grocery lists, recipes for healthy diet and appropriate choices at restaurants

The control group will be provided the usual antenatal dietary advice. This includes advice on healthy and physical activity in women with normal weight and obesity and overweight. Folic acid and vit D supplementation are provided as per national recommendations. Participants will provide outcome data at point of delivery and food frequency questionnaire at baseline and 36 weeks or delivery depending on which is sooner.

Non-randomised cohort of women with no metabolic risk factors will be followed up to delivery to collect outcome data

Obesity

Raised Lipids

High Blood Pressure

Insulin Resistance

Gestational Diabetes

Small for Gestational Age

Stillbirth

The key components of the diet are:
High intake of vegetables, nuts, non-refined grains, legumes and fruits;Moderate to high consumption of fish;Small to moderate intake of poultry and dairy products such as yoghurt and cheese;Low consumption of red meat and processed meat and avoidance of sugary drinks, fast food and high fat food;High fibre;Intake of nuts including walnuts and almonds that are rich sources of monounsaturated and polyunsaturated fatty acids (30 g/day);Olive oil to cook and dress salads as the main source of fat (0.5 l/week)
The intervention will include structured meal plans and grocery lists, recipes for healthy diet and appropriate choices at restaurants

Targeted ESTEEM diet

Non-randomised cohort

Barts Health NHS Trust

ESTEEM - Effect of Simple, Targeted Diet in Pregnant Women With Metabolic Risk Factors on Pregnancy Outcomes

Effect of Simple, Targeted Diet in Pregnant Women With Metabolic Risk Factors on Pregnancy Outcomes (ESTEEM): A Randomised Trial

Diagnosis of pre-eclampsia defined as:
new onset hypertension after 20 weeks gestation defined as systolic BP ≥ 140 mm Hg or diastolic BP ≥ 90 mmHg, in at least two readings AND New onset proteinuria defined as spot urine Protein/creatinine ratio (PCR) test greater than 30mg/mmol or >24 hour urine 300mg/24 hours or 2+ or more on standard urinary dipstick tests after 20 weeks gestation
superimposed pre-eclampsia in women with chronic hypertension or chronic proteinuria
women with eclamptic seizures with no hypertension or proteinuria
Diagnosis of gestational diabetes defined as:
fasting venous glucose of 5·1 mmol/L or higher or
2 h venous glucose of 8·5 mmol/L or higher or
combination of these

Queen Mary University of London

Pre-Eclampsia

L-arginine

Hospital "Ospedali Riuniti", Unit of Obstetrics and Ginecology

Obstetrics and Ginecology Division

L-Arginine in Pre-Eclampsia

A Double-Blind, Randomized, Pilot Study to Explore Whether Enhancing L-Arginine Bioavailability by Oral Supplementation Increases NO Production and Prevents Peroxynitrite Generation in the Pre-Eclamptic Placenta

eclampsia/triglyceride

Pre-eclampsia/Eclampsia in Italy Over the Years 2010-2016

Dietary Intervention Program for Pre-eclampsia in Women at Risk

Maternal Hypertriglyceridaemia Study

ESTEEM - Effect of Simple, Targeted Diet in Pregnant Women With Metabolic Risk Factors on Pregnancy Outcomes

L-Arginine in Pre-Eclampsia

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