Arterial stiffness after 6 weeks postdelivery in women with a history of hypertensive disorders of pregnancy: a systematic review and meta-analysis
Notice bibliographique
Résumé
Introduction: The main objective of this systematic review was to determine if the arterial stiffness remains elevated after 6 weeks post-delivery in women with a history of hypertensive disorders of pregnancy (HDP). Methods and analysis: A comprehensive systematic literature search was conducted across multiple electronic databases, including Medline, PubMed, Embase, Cochrane Library, Google Scholar, Web of Science, and CINAHL. We included studies assessing arterial stiffness in women with a history of HDP between 43 days and 10 years postdelivery, with participants under 60 years of age. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines. We extracted data on arterial stiffness indices, including carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), and heart rate adjusted augmentation index (AIx@75), along with the mean ± standard deviation for each study. A random-effects model was used to pool data, and heterogeneity was explored through sensitivity and subgroup analyses. The Newcastle Ottawa Scale (NOS) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were used to assess risk of bias and quality of evidence. Results: Out of 121 identified articles, 12 studies involving a total of 856 women were included in the final review after eliminating duplicates and irrelevant studies. The overall pooled data revealed a significantly elevated AIx and cfPWV among women with a history of HDP. Specifically, the mean difference (MD) in AIx was 11.63 (95% Confidence Interval (CI): [1.72-21.54]), and for cfPWV, the MD was 0.53 (95% CI: [0.27-0.78]). Notably, while AIx showed no significant change in women within 1 year postpartum (MD 14.85, 95% CI [-6.03-35.72]), an elevation was observed in those beyond 1 year post-delivery (MD 9.11, 95% CI [4.20-14.02]). cfPWV was also found to be elevated in HDP patients both within 1 year (MD 0.59, 95% CI [0.32-0.86]) and beyond 1 year (MD 0.45, 95% CI [0.03-0.88]). In cases of early-onset preeclampsia, AIx did not show a significant increase; however, a significant increase in cfPWV was observed, with AIx having an MD of 1.55 (95% CI: [-0.74-3.84]) and cfPWV an MD of 1.86 (95% CI: [0.25-3.47]). For late-onset preeclampsia, there was no significant difference in AIx (MD 2.44, 95% CI: [-8.82-13.70]) or cfPWV (MD 0.10, 95% CI: [-0.42-0.62]). Conclusion: This systematic review and meta-analysis suggest that arterial stiffness may remain elevated beyond 6 weeks postpartum in women with a history of HDP. However, the findings should be interpreted with caution due to heterogeneity across studies and limited number of available studies. Larger and standardized longitudinal studies are needed to confirm these results. In the meantime, regular cardiovascular monitoring for these women is recommended while awaiting more conclusive evidence. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/search, CRD42023461867.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,041 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,022 | 0,034 |
| Bibliométrie | 0,007 | 0,007 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,002 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».