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

Тільки зареєстровані користувачі можуть перекладати статті

Увійти Зареєструватися

Посилання зберігається в буфері обміну

СтатусЗавершено

Спонсори

Papa Giovanni XXIII Hospital

КЛІНІЧНЕ ДОСЛІДЖЕННЯ: NCT02982265

BioSeek: nct02982265

Ключові слова

Анотація

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.

Опис

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

Дати

Востаннє перевірено:	02/29/2020
Перший поданий:	11/13/2016
Орієнтовна реєстрація подана:	11/29/2016
Опубліковано вперше:	12/04/2016
Останнє оновлення надіслано:	03/02/2020
Останнє оновлення опубліковано:	03/03/2020
Фактична дата початку навчання:	07/31/2016
Розрахункова дата первинного завершення:	12/31/2019
Розрахункова дата завершення дослідження:	12/31/2019

Стан або захворювання

Preeclampsia/Eclampsia

Фаза

Критерії прийнятності

Вік, придатний для навчання	18 Years До 18 Years
Стать, яка підходить для вивчення	All
Метод відбору проб	Non-Probability Sample
Приймає здорових добровольців	Так
Критерії	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

Результат

Заходи первинного результату

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).

Заходи вторинного результату

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

Ключові слова

triglyceride

тестостерон

кровотеча

запалення

атрофія

ревматизм

протеїнурія

еклампсія

набряк легень

атеросклероз

цукровий діабет

інсулінорезистентність

ожиріння

pre-eclampsia

abruptio placentae

thrombophilia