{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T06:52:29Z","timestamp":1781679149608,"version":"3.54.5"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbidity. Traditional management often lacks systematic integration of preventive and therapeutic measures. This study evaluated the efficacy of a cluster management strategy in high-risk HDP pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study was conducted on 103 pregnant women with HDP risk factors admitted between January 2024 and February 2025. Patients were categorized into an Observation Group (cluster management,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955) and a Control Group (routine care,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948). The cluster management strategy integrated early aspirin prophylaxis, dynamic blood pressure thresholds, and precise volume management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Despite having significantly higher pre-pregnancy BMI (26.64\u2009\u00b1\u20094.33 vs. 24.14\u2009\u00b1\u20094.92\u2005kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), the Observation Group exhibited a delayed onset of proteinuria compared to the Control Group (34.67\u2009\u00b1\u20095.06 vs. 31.50\u2009\u00b1\u20097.69 weeks,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.021). The incidence of pleural\/peritoneal effusion (25.5% vs. 52.1%) and hypoproteinemia (18.2% vs. 37.5%) was significantly reduced in the Observation Group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). Crucially, the mean gestational age at delivery was prolonged to 37.51\u2009\u00b1\u20091.94 weeks in the Observation Group, compared to 34.57\u2009\u00b1\u20092.90 weeks in the Control Group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Consequently, neonatal outcomes improved, evidenced by lower NICU admission rates (52.7% vs. 85.1%) and reduced hospitalization costs (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A cluster management strategy based on early pharmacological prevention and comprehensive monitoring effectively delays disease progression and prolongs expectant management duration in high-risk pregnancies, offering significant clinical and health-economic benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgwh.2026.1776715","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:55:30Z","timestamp":1781675730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a cluster management strategy on maternal and neonatal outcomes in high-risk pregnancies with hypertensive disorders: a retrospective cohort study"],"prefix":"10.3389","volume":"7","author":[{"given":"Longhua","family":"Zhang","sequence":"first","affiliation":[{"name":"Wuxi Maternity and Child Health Care Hospital, Affiliated Women\u2019s Hospital of Jiangnan University","place":["Wuxi, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilin","family":"Wang","sequence":"additional","affiliation":[{"name":"Wuxi Maternity and Child Health Care Hospital, Affiliated Women\u2019s Hospital of Jiangnan University","place":["Wuxi, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Affiliated Hospital 2 of Nantong University","place":["Nantong City, Jiangsu Province, China"]},{"name":"Southeast University Affiliated Nantong First People\u2019s Hospital","place":["Nantong City, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Gu","sequence":"additional","affiliation":[{"name":"Wuxi Maternity and Child Health Care Hospital, Affiliated Women\u2019s Hospital of Jiangnan University","place":["Wuxi, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaokang","family":"Deng","sequence":"additional","affiliation":[{"name":"Wuxi Maternity and Child Health Care Hospital, Affiliated Women\u2019s Hospital of Jiangnan University","place":["Wuxi, Jiangsu Province, China"]},{"name":"School of Biotechnology, Jiangnan University","place":["Wuxi, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.preghy.2021.09.008","article-title":"The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice","volume":"27","author":"Magee","year":"2022","journal-title":"Pregnancy Hypertens"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e237","DOI":"10.1097\/AOG.0000000000003891","article-title":"Gestational hypertension and preeclampsia: ACOG practice bulletin, number 222","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1056\/NEJMoa1704559","article-title":"Aspirin versus placebo in pregnancies at high risk for preterm 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