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

Sadece kayıtlı kullanıcılar makaleleri çevirebilir

Giriş yapmak kayıt olmak

Bağlantı panoya kaydedilir

DurumTamamlandı

Sponsorlar

Papa Giovanni XXIII Hospital

KLINIK ÇALIŞMA: NCT02982265

BioSeek: nct02982265

Anahtar kelimeler

Öz

Pre-eclampsia is a heterogeneous multisystem disorder that complicates 2-8% of pregnancies and remains a leading cause of maternal and perinatal mortality and morbidity.

Pre-eclampsia is defined as new onset of 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 substantial proteinuria (defined as excretion of protein ≥300 mg in 24 h or a protein concentration ≥ 300 mg/L or ≥ "1 +" on dipstick in at least two random urine samples taken at least 4-6 h apart but no more than 7 days apart) at or after 20 weeks of gestation.

Pre-eclampsia only occurs in the presence of placenta and is resolved by delivery of the same. However, the underlying causes of the disease remain largely unknown.

Açıklama

Poor placentation is considered a powerful predisposing factor for pre-eclampsia. Recently, it has been suggested that the occurrence of pre-eclampsia requires a combination of an excessive or atypical maternal immune response to the trophoblast and/or exaggerated endothelial activation as well as a generalised hyper-inflammatory state resulting in endothelial dysfunction and associated increased vascular reactivity. Any factors (maternal and paternal constitutional, genetic and environmental risk factors) that enhance these responses would predispose to pre-eclampsia.

The list of predisposing factors includes: extremes of maternal age, black race, previous history of pre-eclampsia, family history of pre-eclampsia, multifetal gestation, ≥ 10 years from previous pregnancy, limited sperm exposure, first paternity, pregnancies after donor insemination (assisted reproductive technology), oocyte donation or embryo donation, chronic hypertension or renal disease, rheumatic disease, maternal low birth weight, obesity and insulin resistance, pre-gestational diabetes mellitus, increased testosterone, increased homocysteine concentration, atherosclerosis (increased triglycerides and LDL, decreased HDL), maternal infections, pre-existing thrombophilia, maternal susceptibility genes and hydropic degeneration of placenta. Finally, smoking seems to be inversely correlated with pre-eclampsia.

Pre-eclampsia can result in a fetal syndrome characterized by fetal growth restriction, reduced amniotic fluid, abnormal oxygenation, fetal demise and preterm birth. Moreover, women with pre-eclampsia are at increased risk for abruptio placentae, disseminated coagulopathy/HELLP syndrome, pulmonary oedema, acute renal failure, eclampsia, cerebral haemorrhage, death and cardiovascular or renal disease.

Early prediction of pre-eclampsia would allow for close surveillance and preventive strategies

Tarih

Son Doğrulandı:	02/29/2020
İlk Gönderilen:	11/13/2016
Tahmini Kayıt Gönderildi:	11/29/2016
İlk Gönderilen:	12/04/2016
Son Güncelleme Gönderildi:	03/02/2020
Son Güncelleme Gönderildi:	03/03/2020
Fiili Çalışma Başlangıç Tarihi:	07/31/2016
Tahmini Birincil Tamamlanma Tarihi:	12/31/2019
Tahmini Çalışma Tamamlanma Tarihi:	12/31/2019

Durum veya hastalık

Preeclampsia/Eclampsia

Evre

Uygunluk kriterleri

Çalışmaya Uygun Yaşlar	18 Years İçin 18 Years
Çalışmaya Uygun Cinsiyetler	All
Örnekleme yöntemi	Non-Probability Sample
Sağlıklı Gönüllüleri Kabul Ediyor	Evet
Kriterler	Inclusion Criteria: - Ability to read and understand the Italian language and fill in the questionnaire, including access to the Internet. - Ability of both parents to give informed consent to the processing of personal data, with the understanding that the consent could be withdrawn at any time Exclusion Criteria: - Inability to reach the patients by telephone and inform them about the study - Death or incapacitating illness of one or both parents following discharge from hospital - Refusal of one or both parents to disclose their email address

Sonuç

Birincil Sonuç Ölçütleri

1. Incidence of preeclampsia/eclampsia in Italy [Three months]

2. Aggregation of predisposing factors to pre-eclampsia / eclampsia in Italy measured by a novel multiple choice on-line questionnaire [Three months]

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).

İkincil Sonuç Ölçütleri

1. Maternal outcomes measured by a novel multiple choice on-line questionnaire [Three months]

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.

2. Fetal outcomes measured by a novel multiple choice on-line questionnaire [Three months]

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

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

Anahtar kelimeler

triglyceride

testosterone

kanama

enflamasyon

atrofi

romatizma

proteinuria

eklampsi

pulmoner ödem

ateroskleroz

diyabet

i̇nsülin direnci

obezite

pre-eclampsia

abruptio placentae

thrombophilia