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Pregnancy Outcomes in Women Who Developed Elevated Blood Pressure and Stage I Hypertension after 20 Weeks, Gestation.
- Source :
-
American journal of perinatology [Am J Perinatol] 2024 Nov; Vol. 41 (15), pp. 2135-2143. Date of Electronic Publication: 2024 Apr 03. - Publication Year :
- 2024
-
Abstract
- Objective: The American College of Obstetrics threshold for hypertension (≥140/90 mm Hg) differs from those of the American College of Cardiology (ACC) and the American Heart Association (AHA). It is unknown if ACC/AHA hypertension levels are associated with adverse pregnancy outcomes (APOs) after 20 weeks gestation. The purpose of this study is to analyze APOs in women with blood pressure (BP) in the elevated or stage 1 range after 20 weeks gestation.<br />Study Design: This was a secondary analysis of the nuMoM2b prospective cohort study of 10,038 nulliparous, singleton pregnancies between 2010 and 2014. BP was measured at three visits during the pregnancy using a standard protocol. Women without medical comorbidities, with normal BP by ACC/AHA guidelines (systolic BP [SBP] < 120 and diastolic BP [DBP] < 80 mm Hg) up to 22 weeks, were included. Exposure was BP between 22 and 29 weeks gestation: normal (SBP < 120 and DBP < 80 mm Hg), elevated (SBP: 120-129 and DBP < 80 mm Hg), and stage 1 (SBP: 130-139 or DBP: 80-89 mm Hg). The primary outcome was hypertensive disorder of pregnancy (HDP) at delivery. Secondary outcomes included fetal growth restriction (FGR), placental abruption, preterm delivery, and cesarean delivery. Multivariable-adjusted odds ratio (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models.<br />Results: Of 4,460 patients that met inclusion criteria, 3,832 (85.9%) had BP in the normal range, 408 (9.1%) in elevated, and 220 (4.9%) in stage 1 range between 22 and 29 weeks. The likelihood of HDP was significantly higher in women with elevated BP (aOR: 1.71, 95%CI: 1.18,2.48), and stage 1 BP (aOR: 2.79, 95%CI: 1.84,4.23) compared to normal BP ( p < 0.001). Stage 1 BP had twice odds of FGR (aOR: 2.33, 95%CI: 1.22,4.47) and elevated BP had three times odds of placental abruption (aOR: 3.03; 95%CI: 1.24,7.39).<br />Conclusion: Elevated or stage 1 BP >20 weeks of pregnancy are associated with HDP, FGR, and placental abruption.<br />Key Points: · Elevated and stage 1 BP increases risk for HDP.. · Elevated BP increases risk for placental abruption.. · Stage 1 BP increases risk for FGR..<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)
- Subjects :
- Humans
Female
Pregnancy
Adult
Prospective Studies
Hypertension, Pregnancy-Induced epidemiology
Blood Pressure
Pregnancy Trimester, Second
Gestational Age
Premature Birth epidemiology
Logistic Models
Young Adult
Hypertension epidemiology
Cesarean Section statistics & numerical data
Abruptio Placentae epidemiology
Pregnancy Complications, Cardiovascular
Pregnancy Outcome
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8785
- Volume :
- 41
- Issue :
- 15
- Database :
- MEDLINE
- Journal :
- American journal of perinatology
- Publication Type :
- Academic Journal
- Accession number :
- 38569509
- Full Text :
- https://doi.org/10.1055/a-2298-5347