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Risk factors of pulmonary edema in women with preeclampsia from south India: a case-control study

Journal of Human Hypertension volume 34, pages 727–734 (2020)Cite this article

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Abstract

Pulmonary edema is a potentially life-threatening complication of preeclampsia, but only few studies have looked at possible risk factors. This study assessed the association between various potential risk factors and the development of pulmonary edema. An age-matched case-control design with hospital records from a tertiary care center in south India was used. A total of 55 pregnant women with preeclampsia who developed pulmonary edema were included as cases, who were 4:1 aged-matched as controls with 220 preeclamptic women, and who did not develop pulmonary edema. Multivariate conditional logistic regression was used to produce adjusted odds ratios with 95% confidence intervals for the likelihood to develop pulmonary edema (OR; 95% CI). Nulliparity (3.94; 1.44–10.7), multifetal pregnancy (5.06; 1.59–16.0), mean arterial blood pressure in mmHg (1.08; 1.03–1.13), and mild (3.25; 1.02–1.29) and moderate (4.43; 1.76–11.1) anemia showed increased odds. Multifetal pregnancy in nulliparous women had higher odds (39.5; 6.2–251) compared with those with singleton pregnancies (3.17; 1.13–8.88). While early aggressive blood pressure treatment can reduce the risk of pulmonary edema, the other risk factors are either non-modifiable or relate to disease severity; thus, continuous monitoring would be relevant for early diagnosis and management, especially among nulliparous preeclamptic women with multifetal pregnancies.

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Authors and Affiliations

  1. MSc Epidemiology, Distance Learning Programme, London School of Hygiene and Tropical Medicine, London, UK

    Anish Keepanasseril & Joel Monárrez-Espino

  2. Department of Obstetrics & Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, 605006, India

    Anish Keepanasseril, Priyadarshini Vadivelu & Dilip Kumar Maurya

  3. Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

    Joel Monárrez-Espino

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  1. Anish Keepanasseril
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  3. Priyadarshini Vadivelu
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  4. Dilip Kumar Maurya
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Correspondence to Anish Keepanasseril.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was done as per the ethical standards set by the Institute Scientific Advisory and Ethical Committee (Human Studies) in accordance with the 1964 Helsinki declaration and its later amendments. Since this was a review based on records of the patients identified from the registers, a waiver of consent was approved by the Institute Ethics Committee (Human Studies (Approval number: JIP/IEC/2016/1076)).

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Keepanasseril, A., Monárrez-Espino, J., Vadivelu, P. et al. Risk factors of pulmonary edema in women with preeclampsia from south India: a case-control study. J Hum Hypertens 34, 727–734 (2020). https://doi.org/10.1038/s41371-020-0300-1

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