Evidence map›Paper›PMID 26438140›Full record

ArticleBMJ open2015

Increased planned delivery contributes to declining rates of pregnancy hypertension in Australia: a population-based record linkage study.

Christine L Roberts, Charles S Algert, Jonathan M Morris, Jane B Ford

Abstract read
In one paragraph

Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. The fetuses-at-risk approach: survival analysis from a fetal perspective.Acta obstetricia et gynecologica Scandinavica · 2018
    Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Christine L RobertsClinical and Population Perinatal Health, Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia.
Charles S AlgertClinical and Population Perinatal Health, Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia.
Jonathan M MorrisClinical and Population Perinatal Health, Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia Department of Obstetrics and Gynaecology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.
Jane B FordClinical and Population Perinatal Health, Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSince the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declining pregnancy hypertension rates in Australia.

designPopulation-based record linkage study utilising linked birth and hospital records. SETTING AND

participantsA cohort of 1,076,122 deliveries in New South Wales, Australia, 2001-2012. OUTCOME MEASURES: Pregnancy hypertension (including gestational hypertension, pre-eclampsia and eclampsia) was the main outcome; pre-eclampsia was a secondary outcome.

resultsFrom 2001 to 2012, pregnancy hypertension rates declined by 22%, from 9.9% to 7.7%, and pre-eclampsia by 27%, from 3.3% to 2.4% (trend p<0.0001). At the same time, planned deliveries increased: prelabour caesarean section by 43% (12.9-18.4%) and labour inductions by 10% (24.8-27.2%). Many maternal risk factors for pregnancy hypertension significantly increased (p<0.01) over the study period including nulliparity, age ≥35 years, diabetes, overweight and obesity, and use of assisted reproductive technologies; some risk factors decreased including multifetal pregnancies, age <20 years, autoimmune diseases and previous pregnancy hypertension. Given these changes in risk factors, the pregnancy hypertension rate was predicted to increase to 10.5%. Examination of annual gestational age distributions showed that pregnancy hypertension rates actually declined from 38 weeks gestation and were steepest from 41 weeks; at least 36% of the decrease could be attributed to planned deliveries. The risk factors for pregnancy hypertension were also risk factors for planned delivery.

conclusionsIt appears that an unanticipated consequence of increasing early planned deliveries is a decline in the incidence of pregnancy hypertension. Women with risk factors for hypertension were relatively more likely to be selected for early delivery.

Indexed as

Population SurveillanceAdultDelivery, ObstetricFemaleGestational AgeHumansHypertension, Pregnancy-InducedIncidenceNew South WalesPre-EclampsiaPregnancyPregnancy OutcomeRetrospective StudiesEPIDEMIOLOGYpreeclampsiapregnancyrecord linkage

Identifiers

PMID26438140
PMCPMC4606429

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.