Women with blood pressure that increases or shows little or no decline during the first half of pregnancy are at substantially higher risk for developing a hypertensive disorder in the second half of pregnancy, according to a study published in the March issue of Hypertension.
Erica P. Gunderson, from Kaiser Permanente Northern California in Oakland, and colleagues assessed distinct blood pressure trajectories from 0 to 20 weeks of gestation and their relationship with subsequent pregnancy-related hypertension in a retrospective cohort of 174,925 women with no prior hypertension or history of preeclampsia, prenatal care entry ≤14 weeks, and a stillborn or live singleton birth between 2009 and 2019.
The researchers found that for low-increasing, moderate-stable, and elevated-stable blood pressure groups, there was elevated risk for preeclampsia/eclampsia (adjusted odds ratios, 3.25, 5.3, and 9.2, respectively) and gestational hypertension (adjusted odds ratios, 6.4, 13.6, and 30.2, respectively), compared with an ultra-low-declining blood pressure group (referent). The associations for preeclampsia/eclampsia were modified by race/ethnicity and prepregnancy obesity, with the highest risks seen for Black women, followed by Hispanic and Asian women for all blood pressure trajectories and with increasing obesity class.
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