Home Quarantine: A Double-Edged Sword During COVID-19 Pandemic for Hypertensive Disorders of Pregnancy and the Related Complications

Figures & data

Table 1 Sociodemographic and Obstetric Histories of Patients with HDP

Variables	2018 (N=60)	2019 (N=74)	2020 (N=142)	X^2/F	P
Age (years)	31.80±5.03	29.38±4.76	30.68±4.13	1.787	0.174
Gestational age (week)	38.00±1.86	38.59±1.60	38.06±2.65	0.689	0.505
Gestational weight gain^†§	13.35±3.51	14.03±5.87	17.16±6.37	3.683	0.031*
Parity^†§	1.00(0.00, 1.00)	0.00(0.00, 1.00)	1.00(1.00, 1.25)	10.926	<0.001**
Gravidity	2.00(1.00, 3.00)	1.50(1.00, 3.00)	2.00(1.00, 3.00)	0.895	0.412
Fetal sex				2.726	0.256
Male	21(35.0%)	42(56.8%)	73(51.4%)
Female	39(65.0%)	32(43.2%)	69(48.6%)
Fetal number	1.00(1.00, 1.00)	1.00 (1.00, 1.00)	1.00 (1.00, 1.00)	1.033	0.360
Pre-pregnancy BMI (kg/m^2)				1.971	0.373
<18.5	5(8.3%)	3(4.0%)	6(4.2%)
18.5~23.9	39(65.0%)	36(48.7%)	84(59.2%)
24~27.9	9(15.0%)	24(32.4%)	35(24.6%)
>28	7(11.7%)	11(14.9%)	17(12.0%)
BMI after pregnancy (kg/m^2)^†§				6.794	0.033*
18.5~23.9	9(15.0%)	8(10.8%)	15(10.6%)
24~27.9	27(45.0%)	30(40.5%)	35(24.6%)
>28	24(40.0%)	36(48.7%)	92(64.8%)

Notes: ^†There was statistically significant difference between 2018 and 2020. ^§There was statistically significant difference between 2019 and 2020. *P<0.05, **P<0.001.

Table 2 Sociodemographic and Obstetric Histories of Patients with HDP-GDM

Variables	2018 (N=40)	2019 (N=52)	2020 (N=105)	X^2/F	P
Age (years)^†	34.90±4.36	29.81±5.22	30.68±4.13	4.496	0.015*
Gestational age (week)	37.50±2.27	38.67±1.65	38.05±2.65	0.939	0.396
Gestational weight gain^†	12.75±4.34	14.21±4.57	17.13±5.43	3.183	0.048*
Parity^§	1.00(0.00, 1.00)	0.00(0.00, 1.00)	1.00(1.00, 1.25)	7.965	0.001**
Gravidity	2.50(1.00, 4.00)	2.00(1.00, 4.00)	2.00(1.00, 3.00)	1.749	0.175
Fetal sex				3.636	0.162
Male	6(30.0%)	14(46.7%)	27(57.1%)
Female	14(70.0%)	16(53.3%)	18(42.9%)
Fetal number	1(1.00, 1.00)	1(1.00, 1.00)	1(1.00, 1.00)	2.915	0.062
Pre-pregnancy BMI (kg/m^2)				3.223	0.200
<18.5	4(10.0%)	0(0.0%)	2(1.9%)
18.5~23.9	28(70.0%)	28(53.9%)	65(61.9%)
24~27.9	4(10.0%)	18(34.6%)	22(21.0%)
>28	4(10.0%)	6(11.5%)	16(15.2%)
BMI after pregnancy (kg/m^2)^†§				6.346	0.042*
<18.5	0(0.0%)	0(0.0%)	0(0.0%)
18.5~23.9	4(10.0%)	4(7.7%)	5(4.8%)
24–27.9	24(60.0%)	20(42.3%)	26(24.8%)
>28	12(30.0%)	26(50.0%)	74(70.4%)

Notes: ^†There was statistically significant difference between 2018 and 2020. ^§There was statistically significant difference between 2019 and 2020. *P<0.05, **P<0.001.

Figure 1 Total incidence and subsets incidence of HDP. The total number of women delivered in the research center was 6166 in 2020, 7268 in 2019, and 7153 in 2018. After screening the electronic medical records according to the above inclusion and exclusion criteria, 6024 women were excluded in 2020, 7194 in 2019, and 7093 in 2018. Finally, a total of 276 HDP patients were used for subsequent analysis, including 142 HDP patients in 2020, 74 in 2019, and 60 in 2018. Additionally, a total of 197 women with HDP-GDM were included in our cohort, including 105 women in 2020, 52 women in 2019, and 40 in 2018. As for women with GH, there was 100 women in 2020, 32 women in 2018 and 34 women in 2019. Lastly, 42 women with PE/E in 2020 were enrolled in our cohort, 28 women in 2018 and 40 women in 2019.

Table 3 Pregnant Outcomes of HDP Patients

	2018				2019
	Crude OR (95%-CI)^†	P^†	Adjusted OR (95%-CI)^§	P^§	Crude OR (95%-CI)^†	P^†	Adjusted OR (95%-CI)^§	P^§
Gestational weight gain	0.88(0.79, 0.99)	0.029*	0.86(0.76, 0.98)	0.021*	0.92(0.84, 1.01)	0.064	0.89(0.77, 0.98)	0.026*
Gestational age (week)	0.99(0.77, 1.26)	0.926	1.02(0.77, 1.36)	0.869	1.14(0.89, 1.46)	0.296	1.13(0.85, 1.51)	0.406
Delivery mode	1.44(0.38, 5.47)	0.592	2.76(0.56, 13.62)	0.212	1.29(0.41, 3.99)	0.664	3.74(0.87, 16.02)	0.076
DP	4.61(1.35, 15.78)	0.015*	4.41(1.13, 17.23)	0.033*	2.25(0.83, 6.07)	0.110	2.40(0.73, 7.90)	0.150
SP	0.82(0.26, 2.62)	0.749	0.79(0.22, 2.80)	0.711	2.65(0.83, 8.40)	0.098	2.80(1.01, 7.71)	0.047*
Blood platelet	3.00(0.57, 15.87)	0.196	3.59(0.58, 22.17)	0.169	2.25(0.60, 8.42)	0.229	2.00(0.43, 9.35)	0.381
Uric Acid	2.26(0.70, 7.19)	0.169	2.59(0.73, 9.25)	0.143	3.10(1.09, 8.83)	0.034*	3.50(1.03, 11.87)	0.045*
Neonatal weight (g)	1.10(1.01, 1.22)	0.011*	1.11(1.02, 1.32)	0.004**	1.21(1.10, 1.35)	0.006**	1.21(1.10, 1.42)	0.007**
Abdominal circumference (cm)	1.02(0.99, 1.04)	0.211	1.02(0.99, 1.05)	0.135	1.03(1.01, 1.05)	0.029*	1.03(1.01, 1.06)	0.004*
Head circumference (cm)	1.03(0.99, 1.07)	0.101	1.05(1.01, 1.10)	0.024*	1.04(1.01, 1.08)	0.024*	1.06(1.01, 1.10)	0.010*
Body length (cm)	1.30(1.10, 1.69)	0.047*	1.42(1.06, 1.89)	0.017*	1.28(1.02, 1.60)	0.031*	1.34(1.04, 1.73)	0.022*
Placental weight (g)	1.02(1.01, 1.03)	0.002**	1.02(1.01, 1, 03)	0.013*	1.02(1.01, 1.03)	0.002**	1.04(1.02, 1.05)	0.033*
Placental thickness (mm)	0.24(0.04, 1.38)	0.110	0.31(0.05, 2.03)	0.221	0.93(0.31, 2.79)	0.891	1.63(0.41, 6.51)	0.491
Placental length (cm)	2.03(1.20, 3.43)	0.009**	1.92(1.08, 3.42)	0.027*	1.61(1.05, 2.49)	0.031*	1.44(0.86, 2.40)	0.164
Placental width (cm)	1.47(0.94, 2.28)	0.091	1.39(0.83, 2.33)	0.208	1.34(0.84, 2.14)	0.213	1.48(1.01, 2.19)	0.049*
Umbilical cord length (cm)	1.06(0.95, 1.19)	0.310	1.03(0.91, 1.17)	0.648	0.96(0.87, 1.06)	0.441	0.93(0.83, 1.05)	0.225
Amniotic fluid volume (mL)	1.00(0.99, 1.00)	0.262	1.00(0.99, 100)	0.446	1.00(1.00, 1.00)	0.648	1.00(1.00, 1.01)	0.931
One minute Apgar scores =9	0.20(0.06, 0.72)	0.013*	0.17(0.04, 0.70)	0.015*	0.48(0.17, 1.33)	0.155	0.47(0.14, 1.61)	0.230
One minute Apgar scores =10	Ref		Ref		Ref		Ref
Placental factors	0.55(0.10, 3.02)	0.490	0.46(0.06, 3.31)	0.437	0.94(0.18, 5.01)	0.938	0.69(0.90, 5.24)	0.716
Umbilical factors	2.04(0.48, 8.65)	0.333	1.62(0.33, 7.90)	0.552	1.56(0.48, 5.03)	0.456	1.03(0.25, 4.20)	0.965
FGR	4.93(0.56, 43.40)	0.151	3.57(1.16, 5.81)	0.037*	8.04(0.93, 69.54)	0.058	7.88(1.46, 11.93)	0.024*
Premature delivery	1.23(0.32, 4.76)	0.763	1.60(0.36, 7.13)	0.538	1.66(0.48, 5.74)	0.422	1.96(0.45, 8.50)	0.369

Notes: 2020 was used as reference group. ^†Single variable logistic regression analysis. ^§Adjust: Parity, Gestational weight gain. *P<0.05, **P<0.001.

Table 4 Pregnant Outcomes of HDP with GDM Patients

	2018				2019
	Crude OR (95%-CI)^†	P^†	Adjusted OR (95%-CI)^§	P^§	Crude OR (95%-CI)^†	P^†	Adjusted OR (95%-CI)^§	P^§
Gestational weight gain	0.86(0.71, 1.04)	0.110	0.85(0.72, 0.99)	0.044*	0.88(0.76, 1.02)	0.099	0.91(0.81, 1.01)	0.080
Gestational age (week)	0.91(0.70, 1.20)	0.527	1.07(0.77, 1.49)	0.695	1.15(0.87, 1.51)	0.325	1.23(0.89, 1.71)	0.206
Delivery mode	3.24(0.36, 29.30)	0.295	2.94(0.25, 34.47)	0.391	0.90(0.27, 3.03)	0.865	1.94(0.41, 9.24)	0.406
DP	8.85(1.56, 12.58)	0.018*	14.64(1.22, 17.64)	0.034*	2.50(0.81, 7.69)	0.110	2.40(0.62, 9.25)	0.203
SP	1.54(0.37, 6.38)	0.553	1.35(0.24, 7.58)	0.732	2.86(0.90, 9.06)	0.075	3.37(0.86, 13.20)	0.080
Blood platelet	3.00(0.33, 27.50)	0.331	4.42(0.40, 49.49)	0.227	1.89(0.44, 8.18)	0.395	1.68(0.29, 9.67)	0.559
Uric Acid	2.83(0.62, 13.04)	0.181	2.21(0.39, 12.52)	0.369	3.04(0.93, 9.90)	0.066	3.15(0.79, 12.58)	0.105
0 min OGTT	1.80(0.32, 10.20)	0.507	2.20(0.30, 15.99)	0.437	1.65(0.37, 7.37)	0.512	1.79(0.34, 9.39)	0.493
60 min OGTT	1.14(0.17, 7.60)	0.890	0.75(0.08, 6.87)	0.800	1.94(0.39, 9.70)	0.420	2.17(0.34, 13.92)	0.415
120 min OGTT	0.83(0.15, 4.64)	0.835	0.76(0.10, 5.61)	0.790	0.49(0.11, 2.20)	0.349	0.38(0.07, 2.14)	0.272
Neonatal weight (g)	1.10(1.01, 1.21)	0.176	1.11(1.01, 1.21)	0.048*	1.02(1.01, 1.03)	0.015*	1.02(1.01, 1.03)	0.006**
Abdominal circumference (cm)	1.00(1.00, 1.02)	0.858	1.02(0.99, 1.05)	0.329	1.03(0.99, 1.05)	0.057	1.14(1.10, 1.17)	0.032*
Head circumference (cm)	1.02(0.97, 1.06)	0.514	1.04(0.99, 1.10)	0.110	1.04(1.00, 1.08)	0.060	1.07(1.01, 1.12)	0.015*
Body length (cm)	1.13(0.84, 1.50)	0.426	1.58(1.00, 2.48)	0.047*	1.35(1.02, 1.78)	0.037*	1.91(1.21, 3.01)	0.006**
Placental weight (g)	1.12(1.10, 1.14)	0.007**	1.13(1.11, 1.15)	0.006**	1.12(1.11, 1.13)	0.002**	1.13(1.11, 1.15)	0.010*
Placental thickness (mm)	0.18(0.01, 2.28)	0.184	0.39(0.02, 7.56)	0.532	0.66(0.18, 2.46)	0.532	2.77(0.48, 16.01)	0.256
Placental length (cm)	1.92(0.93, 3.97)	0.079	2.24(0.94, 5.36)	0.069	1.59(0.94, 2.69)	0.082	1.53(0.80, 2.96)	0.202
Placental width (cm)	1.34(0.74, 2.42)	0.329	1.72(0.77, 3.87)	0.187	1.74(1.05, 2.89)	0.033*	2.07(1.04, 4.12)	0.039*
Umbilical cord length (cm)	1.06(0.92, 1.22)	0.428	1.04(0.89, 1.23)	0.627	1.00(0.90, 1.11)	0.997	0.96(0.85, 1.10)	0.532
Amniotic fluid volume (mL)	1.00(1.00, 1.00)	0.663	1.00(1.00, 1.01)	0.920	1.00(1.00, 1.00)	0.613	1.00(0.99, 1.01)	0.835
One minute Apgar scores =9	0.19(0.04, 0.92)	0.039*	0.19(0.10, 0.73)	0.025*	0.23(0.07, 0.75)	0.015*	0.20(0.04, 0.94)	0.042*
One minute Apgar scores =10	Ref		Ref		Ref		Ref
Placental factors	0.87(0.08, 9.43)	0.919	1.06(0.05, 22.86)	0.969	0.92(0.14, 6.01)	0.930	0.54(0.05, 6.28)	0.619
Umbilical factors	3.24(0.36, 29.30)	0.295	10.23(0.63, 16.34)	0.102	1.53(0.41, 5.78)	0.531	1.83(0.35, 9.54)	0.473
FGR	2.33(2.52, 21.63)	0.456	13.08(0.65, 26.73)	0.093	5.19(0.59, 10.58)	0.138	4.29(1.01, 10.49)	0.049*
Premature delivery	0.46(0.10, 2.05)	0.310	0.60(0.11, 3.38)	0.566	1.85(0.43, 7.92)	0.409	2.23(0.40, 12.35)	0.360

Notes: 2020 was used as reference group. ^†Single variable logistic regression analysis. ^§Adjust: Parity, Age. *P<0.05, **P<0.001.