China: Study on PIHS Treatment

A combination of magnesium sulfate and nifedipine has a powerful clinical efficacy for patients with pregnancy-induced hypertension syndrome (PIHS) by lowering the incidence of adverse pregnancy outcomes and blood pressure, in addition to improving lipid and glucose metabolism, a recent study has shown.

The study findings were published in the American Journal of Translational Research on September 30, 2023.

Introduction

Pregnancy-induced hypertension syndrome is the most common complication in pregnancy, which can lead to insufficient blood supply to the fetus and lower the immunity and antioxidant capacity of pregnant women, resulting in adverse pregnancy outcomes.

These pregnant women face higher risks of:

• Cesarean section
• Pre-eclampsia
• Premature delivery before 37 weeks of pregnancy
• Neonatal birth weight below 2500 g
• Perinatal death
• Neonatal hospitalization
• Higher risk of cardiovascular disease in later life

Study Details

Xiaolin Zhang, Department of Obstetrics, Jiangxi Jiujiang Maternal and Child Care Centers, Jiujiang, Jiangxi, China, and colleagues aimed to investigate the efficacy of magnesium sulfate combined with nifedipine for PIHS and its impact on glucose and lipid metabolism.

For this purpose, the researchers collected and retrospectively analyzed the clinical data on 124 cases of PIHS treated in Jiangxi Jiujiang Maternal and Child Care Centers from 2020 to 2022. Among them, 58 patients who received magnesium sulfate alone were enrolled (control group), and the other 66 received magnesium sulfate combined with nifedipine (study group).

Results

A comparison was drawn between the two groups for low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), fasting blood glucose (FBG), and blood pressure for treatment efficacy. To analyze the factors affecting outcome, multivariate logistic regression analysis was performed.

• The study group showed a significantly higher total effective rate than the control group.
• After treatment, the study group showed significantly lower systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels than the control group.
• After treatment, the study group showed lower levels of TC, FBG, TG, and LDL-C and a higher HDL-C level than the control group.
• The incidences of postpartum haemorrhage and cesarean section were lower in the study group than those in the control group.
• The two groups were not significantly different in premature delivery or low neonatal birth weight, and the incidence of adverse reactions of the two groups was also not greatly different.

According to multivariate logistic regression analysis, higher BMI (OR: 3.087) and higher SBP (OR: 1.220) at admission were independent risk factors for poor efficacy, while a combined therapeutic regimen (OR: 0.018) was an independent protective factor.

Limitations

The limitations of the study include its retrospective nature, limited follow-up time of the study, and the study has not collected data on the baby's postnatal growth.

"We hope to explore the effects of this therapeutic regimen on the baby in the future," the researchers concluded.

Reference

Zhang, Xiaolin, et al. "Efficacy of Magnesium Sulfate Combined With Nifedipine for Pregnancy-induced Hypertension Syndrome and Its Relation to Glucose and Lipid Metabolism." American Journal of Translational Research, vol. 15, no. 9, 2023, pp. 5940-5948.