Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Mini Review
  • Mini review series: Current topic in Hypertension
  • Published:

Preeclampsia up to date—What’s going on?

Hypertension Research volume 46, pages 1900–1907 (2023)Cite this article

Abstract

Preeclampsia is a hypertensive disorder in pregnancy characterized by placental malperfusion and subsequent multi-organ injury. It accounts for approximately 14% of maternal deaths and 10–25% of perinatal deaths globally. In addition, preeclampsia has been attracting attentions for its association with risks for developing chronic diseases in later life for both mother and child. This mini-review discusses on latest knowledge on prediction, prevention, management, and long-term outcomes of preeclampsia and also touches on association between COVID-19 and preeclampsia.

HTN hypertension, HDP hypertensive disorders of pregnancy, PE preeclampsia, BP blood pressure, cfDNA cell-free DNA, ST2 human suppression of tumorigenesis 2, sFlt-1 soluble fms-like tyrosine kinase-1, PIGF placental growth factor, VEGF vascular endothelial growth factor, VEGFR VEGF receptor, TGFβ transforming growth factor β, ENG endoglin, sENG soluble ENG, PRES posterior reversible encephalopathy syndrome, AKI acute kidney injury, CVD cardiovascular disease, ESKD end-stage kidney disease, ACE angiotensinogen converting enzyme, Ang angiotensin.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rolnik DL, Wright D, Poon LC, O’Gorman N, Syngelaki A, de Paco Matallana C, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med. 2017;377:613–22.

    Article  CAS  PubMed  Google Scholar 

  2. Chaemsaithong P, Pooh RK, Zheng M, Ma R, Chaiyasit N, Tokunaka M, et al. Prospective evaluation of screening performance of first-trimester prediction models for preterm preeclampsia in an Asian population. Am J Obstet Gynecol. 2019;221:650.e1–650.e16.

    Article  PubMed  Google Scholar 

  3. O’Gorman N, Wright D, Syngelaki A, Akolekar R, Wright A, Poon LC, et al. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11–13 weeks gestation. Am J Obstet Gynecol. 2016;214:103.e1–103.e12.

    Article  PubMed  Google Scholar 

  4. Yue C, Gao J, Zhang C, Ni Y, Ying C. Development and validation of a nomogram for the early prediction of preeclampsia in pregnant Chinese women. Hypertens Res. 2021;44:417–25.

    Article  PubMed  Google Scholar 

  5. Duhig KE, Myers J, Seed PT, Sparkes J, Lowe J, Hunter RM, et al. Placental growth factor testing to assess women with suspected pre-eclampsia: a multicentre, pragmatic, stepped-wedge cluster-randomised controlled trial. Lancet. 2019;393:1807–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Verlohren S, Herraiz I, Lapaire O, Schlembach D, Moertl M, Zeisler H, et al. The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am J Obstet Gynecol. 2012;206:58.e1–8.

    Article  CAS  PubMed  Google Scholar 

  7. Verlohren S, Perschel FH, Thilaganathan B, Dröge LA, Henrich W, Busjahn A, et al. Angiogenic markers and cardiovascular indices in the prediction of hypertensive disorders of pregnancy. Hypertension. 2017;69:1192–7.

    Article  CAS  PubMed  Google Scholar 

  8. Levine RJ, Lam C, Qian C, Yu KF, Maynard SE, Sachs BP, et al. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med. 2006;355:992–1005.

    Article  CAS  PubMed  Google Scholar 

  9. Levine RJ, Maynard SE, Qian C, Lim K-H, England LJ, Yu KF, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350:672–83.

    Article  CAS  PubMed  Google Scholar 

  10. Cerdeira AS, O’Sullivan J, Ohuma EO, Harrington D, Szafranski P, Black R, et al. Randomized interventional study on prediction of preeclampsia/eclampsia in women with suspected preeclampsia: INSPIRE. Hypertension. 2019;74:983–90.

    Article  CAS  PubMed  Google Scholar 

  11. Zeisler H, Llurba E, Chantraine FJ, Vatish M, Staff AC, Sennström M, et al. Soluble fms-like tyrosine kinase-1 to placental growth factor ratio: ruling out pre-eclampsia for up to 4 weeks and value of retesting. Ultrasound Obstet Gynecol J Int Soc Ultrasound Obstet Gynecol. 2019;53:367–75.

    Article  CAS  Google Scholar 

  12. Hund M, Allegranza D, Schoedl M, Dilba P, Verhagen-Kamerbeek W, Stepan H. Multicenter prospective clinical study to evaluate the prediction of short-term outcome in pregnant women with suspected preeclampsia (PROGNOSIS): study protocol. BMC Pregnancy Childbirth. 2014;14:324.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zeisler H, Llurba E, Chantraine F, Vatish M, Staff AC, Sennström M, et al. Predictive value of the sFlt-1:PlGF ratio in women with suspected preeclampsia. N Engl J Med. 2016;374:13–22.

    Article  CAS  PubMed  Google Scholar 

  14. Ohkuchi A, Masuyama H, Yamamoto T, Kikuchi T, Taguchi N, Wolf C, et al. Economic evaluation of the sFlt-1/PlGF ratio for the short-term prediction of preeclampsia in a Japanese cohort of the PROGNOSIS Asia study. Hypertens Res J Jpn Soc Hypertens. 2021;44:822–9.

    Article  CAS  Google Scholar 

  15. Chen Y, Wang X, Hu W, Chen Y, Ning W, Lu S, et al. A risk model that combines MAP, PlGF, and PAPP-A in the first trimester of pregnancy to predict hypertensive disorders of pregnancy. J Hum Hypertens. 2022;36:184–91.

    Article  CAS  PubMed  Google Scholar 

  16. Liu L, Li H, Wang N, Song X, Zhao K, Zhang C. Assessment of plasma cell-free DNA and ST2 as parameters in gestational hypertension and preeclampsia. Hypertens Res. 2021;44:996–1001.

    Article  CAS  PubMed  Google Scholar 

  17. Zhou P, Luo X, Qi H-B, Zong W-J, Zhang H, Liu D-D, et al. The expression of pentraxin 3 and tumor necrosis factor-alpha is increased in preeclamptic placental tissue and maternal serum. Inflamm Res. 2012;61:1005–12.

    Article  CAS  PubMed  Google Scholar 

  18. Colmenares-Mejía CC, Quintero-Lesmes DC, Bautista-Niño PK, Guio Mahecha E, Beltrán Avendaño M, Díaz Martínez LA, et al. Pentraxin-3 is a candidate biomarker on the spectrum of severity from pre-eclampsia to HELLP syndrome: GenPE study. Hypertens Res. 2020;43:884–91.

    Article  PubMed  Google Scholar 

  19. Araki Y, Yanagida M. Hypertensive disorders of pregnancy: strategy to develop clinical peptide biomarkers for more accurate evaluation of the pathophysiological status of this syndrome. Adv Clin Chem. 2020;94:1–30.

    Article  CAS  PubMed  Google Scholar 

  20. Wakabayashi I, Yanagida M, Araki Y. Associations of cardiovascular risk with circulating peptides related to hypertensive disorders of pregnancy. Hypertens Res. 2021;44:1641–51.

    Article  CAS  PubMed  Google Scholar 

  21. Takagi K, Nakamoto O, Watanabe K, Tanaka K, Matsubara K, Kawabata I, et al. A review of best practice guide 2021 for diagnosis and management of hypertensive disorders of pregnancy (HDP) - misc. - researchmap. Hypertens Res Pregnancy. 2022;10:57–73.

    Article  Google Scholar 

  22. Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72:24–43.

    Article  CAS  PubMed  Google Scholar 

  23. Espinoza J, Vidaeff A, Pettker CM, Simhan H. ACOG Committee Opinion No. 743: low-dose aspirin use during pregnancy. Obstet Gynecol. 2018;132:e44–e52.

  24. Henderson JT, Vesco KK, Senger CA, Thomas RG, Redmond N. Aspirin use to prevent preeclampsia and related morbidity and mortality: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2021;326:1192–206.

    Article  PubMed  Google Scholar 

  25. Magee LA, Khalil A, Kametas N, von Dadelszen P. Toward personalized management of chronic hypertension in pregnancy. Am J Obstet Gynecol. 2022;226:S1196–210.

    Article  CAS  PubMed  Google Scholar 

  26. Hirsch A, Rotem R, Ternovsky N, Hirsh Raccah B. Pravastatin and placental insufficiency associated disorders: a systematic review and meta-analysis. Front Pharm. 2022;13:1021548.

    Article  CAS  Google Scholar 

  27. Döbert M, Varouxaki AN, Mu AC, Syngelaki A, Ciobanu A, Akolekar R, et al. Pravastatin versus placebo in pregnancies at high risk of term preeclampsia. Circulation. 2021;144:670–9.

    Article  PubMed  Google Scholar 

  28. Espinoza J, Vidaeff A, Pettker CM, Simhan H. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, Number 222. Obstet Gynecol. 2020;135:e237–e260.

  29. American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 203: chronic hypertension in pregnancy. Obstet Gynecol. 2019;133:e26–e50.

    Article  Google Scholar 

  30. Metoki H, Iwama N, Hamada H, Satoh M, Murakami T, Ishikuro M, et al. Hypertensive disorders of pregnancy: definition, management, and out-of-office blood pressure measurement. Hypertens Res. 2022;45:1298–309.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Umemura S, Arima H, Arima S, Asayama K, Dohi Y, Hirooka Y, et al. The Japanese Society of Hypertension guidelines for the management of hypertension (JSH 2019). Hypertens Res. 2019;42:1235–481.

    Article  PubMed  Google Scholar 

  32. Nobles CJ, Mendola P, Mumford SL, Silver RM, Kim K, Andriessen VC, et al. Preconception blood pressure and its change into early pregnancy: early risk factors for preeclampsia and gestational. Hypertension. 2020;76:922–9.

    Article  CAS  PubMed  Google Scholar 

  33. Li N, An H, Li Z, Ye R, Zhang L, Li H, et al. Preconception blood pressure and risk of gestational hypertension and preeclampsia: a large cohort study in China. Hypertens Res. 2020;43:956–62.

    Article  PubMed  Google Scholar 

  34. Huai J, Lin L, Juan J, Chen J, Li B, Zhu Y, et al. Preventive effect of aspirin on preeclampsia in high‐risk pregnant women with stage 1 hypertension. J Clin Hypertens. 2021;23:1060–7.

    Article  CAS  Google Scholar 

  35. Slade LJ, Mistry HD, Bone JN, Wilson M, Blackman M, Syeda N, et al. American College of Cardiology and American Heart Association blood pressure categories—a systematic review of the relationship with adverse pregnancy outcomes in the first half of pregnancy. Am J Obstet Gynecol. 2023;228:418–29.e34.

  36. Suzuki H, Takagi K, Matsubara K, Mito A, Kawasaki K, Nanjo S, et al. Maternal and perinatal outcomes according to blood pressure levels for prehypertension: a review and meta-analysis. Hypertens Res Pregnancy. 2022;10:29–39.

  37. Ueda A, Hasegawa M, Matsumura N, Sato H, Kosaka K, Abiko K, et al. Lower systolic blood pressure levels in early pregnancy are associated with a decreased risk of early-onset superimposed preeclampsia in women with chronic hypertension: a multicenter retrospective study. Hypertens Res. 2022;45:135–45.

    Article  PubMed  Google Scholar 

  38. Committee on Obstetric Practice. Committee Opinion No. 692: emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2017;129:e90–5.

    Article  Google Scholar 

  39. Easterling T, Mundle S, Bracken H, Parvekar S, Mool S, Magee LA, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Lancet. 2019;394:1011–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Bone JN, Sandhu A, Abalos ED, Khalil A, Singer J, Prasad S, et al. Oral antihypertensives for nonsevere pregnancy hypertension: systematic review, network meta- and trial sequential analyses. Hypertension. 2022;79:614–28.

    Article  CAS  PubMed  Google Scholar 

  41. Huang Q, Hu B, Han X, Yang J, Di X, Bao J, et al. Cyclosporin A ameliorates eclampsia seizure through reducing systemic inflammation in an eclampsia-like rat model. Hypertens Res. 2020;43:263–70.

    Article  CAS  PubMed  Google Scholar 

  42. Chen X, Huang J, Lv Y, Chen Y, Rao J. Crocin exhibits an antihypertensive effect in a rat model of gestational hypertension and activates the Nrf-2/HO-1 signaling pathway. Hypertens Res. 2021;44:642–50.

    Article  CAS  PubMed  Google Scholar 

  43. Chappell LC, Brocklehurst P, Green ME, Hunter R, Hardy P, Juszczak E, et al. Planned early delivery or expectant management for late preterm pre-eclampsia (PHOENIX): a randomised controlled trial. Lancet. 2019;394:1181–90.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Thilaganathan B, Kalafat E. Cardiovascular system in preeclampsia and beyond. Hypertension. 2019;73:522–31.

    Article  CAS  PubMed  Google Scholar 

  45. Vakhtangadze T, Gakhokidze N, Khutsishvili M, Mosidze S. The link between hypertension and preeclampsia/eclampsia-life-long cardiovascular risk for women. Vessel. 2019;3:19.

    Google Scholar 

  46. Bellamy L, Casas J-P, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335:974.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Minissian MB, Kilpatrick S, Eastwood J-A, Robbins WA, Accortt EE, Wei J, et al. Association of spontaneous preterm delivery and future maternal cardiovascular disease. Circulation. 2018;137:865–71.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Leon LJ, McCarthy FP, Direk K, Gonzalez-Izquierdo A, Prieto-Merino D, Casas JP, et al. Preeclampsia and cardiovascular disease in a large UK pregnancy cohort of linked electronic health records. Circulation. 2019;140:1050–60.

    Article  PubMed  Google Scholar 

  49. Honigberg MC, Zekavat SM, Aragam K, Klarin D, Bhatt DL, Scott NS, et al. Long-term cardiovascular risk in women with hypertension during pregnancy. J Am Coll Cardiol. 2019;74:2743–54.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Wagata M, Kogure M, Nakaya N, Tsuchiya N, Nakamura T, Hirata T, et al. Hypertensive disorders of pregnancy, obesity, and hypertension in later life by age group: a cross-sectional analysis. Hypertens Res. 2020;43:1277–83.

    Article  PubMed  Google Scholar 

  51. Wilson PWF, Polonsky TS, Miedema MD, Khera A, Kosinski AS, Kuvin JT. Systematic review for the 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73:3210–27.

    Article  PubMed  Google Scholar 

  52. Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the primary prevention of cardiovascular disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;74:1376–414.

    Article  PubMed  PubMed Central  Google Scholar 

  53. American College of Obstetricians and Gynecologists’ Presidential Task Force on Pregnancy and Heart Disease and Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 212: pregnancy and heart disease. Obstet Gynecol. 2019;133:e320–56.

    Article  Google Scholar 

  54. Brown DW, Dueker N, Jamieson DJ, Cole JW, Wozniak MA, Stern BJ, et al. Preeclampsia and the risk of ischemic stroke among young women. Stroke. 2006;37:1055–9.

    Article  PubMed  Google Scholar 

  55. Poulter NR, Chang CL, Farley TMM, Meirik O, Marmot MG. Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study. Lancet. 1996;348:505–10.

  56. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contarception. Venous thromboembolic disease and combined oral contraceptives: results of international multicentre case-control study. Lancet. 1995;346:1575–82.

  57. Samara AA, Liampas I, Dadouli K, Siokas V, Zintzaras E, Stefanidis I, et al. Preeclampsia, gestational hypertension and incident dementia: a systematic review and meta-analysis of published evidence. Pregnancy Hypertens. 2022;30:192–7.

    Article  PubMed  Google Scholar 

  58. Hubel CA, Wallukat G, Wolf M, Herse F, Rajakumar A, Roberts JM, et al. Agonistic angiotensin II type 1 receptor autoantibodies in postpartum women with a history of preeclampsia. Hypertension. 2007;49:612–7.

    Article  CAS  PubMed  Google Scholar 

  59. Zwertbroek EF, Franssen MTM, Broekhuijsen K, Langenveld J, Bremer H, Ganzevoort W, et al. Neonatal developmental and behavioral outcomes of immediate delivery versus expectant monitoring in mild hypertensive disorders of pregnancy: 2-year outcomes of the HYPITAT-II trial. Am J Obstet Gynecol. 2019;221:154.e1–154.e11.

    Article  PubMed  Google Scholar 

  60. Burton GJ, Redman CW, Roberts JM, Moffett A. Pre-eclampsia: pathophysiology and clinical implications. BMJ. 2019;366:l2381.

    Article  PubMed  Google Scholar 

  61. Davis EF, Lazdam M, Lewandowski AJ, Worton SA, Kelly B, Kenworthy Y, et al. Cardiovascular risk factors in children and young adults born to preeclamptic pregnancies: a systematic review. Pediatrics. 2012;129:e1552–61.

    Article  PubMed  Google Scholar 

  62. Davisson RL, Hoffmann DS, Butz GM, Aldape G, Schlager G, Merrill DC, et al. Discovery of a spontaneous genetic mouse model of preeclampsia. Hypertension. 2002;39:337–42.

    Article  CAS  PubMed  Google Scholar 

  63. Allotey J, Fernandez S, Bonet M, Stallings E, Yap M, Kew T, et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020;370:m3320.

  64. Kalafat E, Prasad S, Birol P, Tekin AB, Kunt A, Di Fabrizio C, et al. An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women. Am J Obstet Gynecol. 2022;226:403.e1–403.e13.

    Article  CAS  PubMed  Google Scholar 

  65. Vivanti AJ, Vauloup-Fellous C, Prevot S, Zupan V, Suffee C, Do Cao J, et al. Transplacental transmission of SARS-CoV-2 infection. Nat Commun. 2020;11:3572.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Wei SQ, Bilodeau-Bertrand M, Liu S, Auger N. The impact of COVID-19 on pregnancy outcomes: a systematic review and meta-analysis. Can Med Assoc J. 2021;193:E540–E548.

    Article  CAS  Google Scholar 

  67. Papageorghiou AT, Deruelle P, Gunier RB, Rauch S, García-May PK, Mhatre M, et al. Preeclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study. Am J Obstet Gynecol. 2021;225:289.e1–289.e17.

    Article  CAS  PubMed  Google Scholar 

  68. Chmielewska B, Barratt I, Townsend R, Kalafat E, van der Meulen J, Gurol-Urganci I, et al. Effects of the COVID-19 pandemic on maternal and perinatal outcomes: a systematic review and meta-analysis. Lancet Glob Health. 2021;9:e759–e772.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Mendoza M, Garcia-Ruiz I, Maiz N, Rodo C, Garcia-Manau P, Serrano B, et al. Pre-eclampsia-like syndrome induced by severe COVID-19: a prospective observational study. BJOG Int J Obstet Gynaecol. 2020;127:1374–80.

    Article  CAS  Google Scholar 

  70. Wu J, Deng W, Li S, Yang X. Advances in research on ACE2 as a receptor for 2019-nCoV. Cell Mol Life Sci CMLS. 2021;78:531–44.

    Article  CAS  PubMed  Google Scholar 

  71. Giardini V, Carrer A, Casati M, Contro E, Vergani P, Gambacorti-Passerini C. Increased sFLT-1/PlGF ratio in COVID-19: a novel link to angiotensin II-mediated endothelial dysfunction. Am J Hematol. 2020;95:E188–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Soldavini CM, Di Martino D, Sabattini E, Ornaghi S, Sterpi V, Erra R, et al. sFlt-1/PlGF ratio in hypertensive disorders of pregnancy in patients affected by COVID-19. Pregnancy Hypertens. 2022;27:103–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology and Hypertension, Tokyo Women’s Medical University, Tokyo, Japan

    Kanako Bokuda & Atsuhiro Ichihara

Authors
  1. Kanako Bokuda
    View author publications

    Search author on:PubMed Google Scholar

  2. Atsuhiro Ichihara
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Kanako Bokuda.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bokuda, K., Ichihara, A. Preeclampsia up to date—What’s going on?. Hypertens Res 46, 1900–1907 (2023). https://doi.org/10.1038/s41440-023-01323-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41440-023-01323-w

Keywords

This article is cited by

Search

Advanced search

Quick links