In April 1994, Elizabeth Raymond, Sven Cnattingius, and John Kiely published “Effects of Maternal Age, Parity, and Smoking on the Risk of Stillbirth” in the British Journal of Obstetrics and Gynecology, now known as BJOG: An International Journal of Obstetrics and Gynecology. The article examines how advanced maternal age, defined as delivery at thirty-five years old or older, cigarette smoking, and nulliparity, or the state of never having given birth, can negatively impact pregnancy. At the time of publication, according to Raymond and colleagues, stillbirths comprised over half of all perinatal, or close to birth, deaths and more than one-third of total fetal and infant deaths in Europe and North America. In the article, Raymond and her coauthors demonstrate how certain risk factors may increase the risk of stillbirth at different stages of pregnancy, which helped set a foundation for future research in interventions to prevent stillbirth.

Leon Chesley studied hypertension, or high blood pressure, in pregnant women during the mid-twentieth century. Chesley studied preeclampsia and eclampsia, two hypertensive disorders found in approximately five percent of all US pregnancies. In New Jersey and New York, Chesley devoted over forty years to researching preeclampsia and eclampsia. Chesley conducted several long-term studies using the same group of women beginning from their pregnancies. Chesley’s multi-decade research led to more accurate diagnosis of preeclampsia and eclampsia in pregnant women and significantly reduced the mortality of pregnant women due to hypertensive diseases.

In the 1950s and 1960s, researchers Leon Chesley, John Annitto, and Robert Cosgrove investigated the possible familial factor for the conditions of preeclampsia and eclampsia in pregnant women. Preeclampsia and eclampsia, which are related to high blood pressure, have unknown causes and affect at least five percent of all pregnancies. The researchers, who worked at Margaret Hague Maternity Hospital in Jersey City, New Jersey, used hospital patient records to find and reexamine women who had eclampsia at the hospital, as well as their daughters, sisters, daughters-in-law, and granddaughters. Chesley and colleagues found that the daughters and granddaughters of eclamptic women were more likely than the female offspring of non-eclamptic women to have preeclampsia and eclampsia in their own pregnancies, and especially in their first pregnancies. The study provided evidence that the disorders are inherited, enabling physicians to better monitor pregnancies in women who have a known family history for preeclampsia and eclampsia.

Leon Chesley published Hypertensive Disorders in Pregnancy in 1978 to outline major and common complications that occur during pregnancy and manifest in abnormally high blood pressures in pregnant women. The book was published by Appleton-Century-Crofts in New York, New York. Chesley compiled his book as a tool for practicing obstetricians and teachers. The book focuses on preeclampsia and eclampsia, but it also describes other common and rare hypertensive diseases and disorders of pregnancy and discusses their histories, diagnoses, management plans, pathologies, and immediate and remote prognoses for mothers and fetuses. Doctors used the book and all subsequent editions to help diagnose and manage complications during pregnancy and to avoid deaths for pregnant women and fetuses.

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