Document Detail

Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohort.
MedLine Citation:
PMID:  24821945     Owner:  NLM     Status:  MEDLINE    
Hypertensive disorders of pregnancy are associated with intrauterine growth restriction and preterm birth. However, the associations of patterns of blood pressure change during pregnancy with these outcomes have not been studied in detail. We studied repeat antenatal blood pressure measurements of 9697 women in the Avon Longitudinal Study of Parents and Children (median [interquartile range], 10 [9-11] measurements per woman). Bivariate linear spline models were used to relate blood pressure changes to perinatal outcomes. Higher systolic, but not diastolic, blood pressure at baseline (8 weeks of gestation) and a greater increase in systolic and diastolic blood pressure between 18 and 36 weeks of gestation were associated with lower offspring birth weight and being smaller for gestational age in confounder-adjusted models. For example, the mean difference (95% confidence interval) in birth weight per 1 mm Hg/wk greater increase in systolic blood pressure between 18 and 30 weeks was -71 g (-134 to -14) and between 30 and 36 weeks was -175 g (-208 to -145). A smaller decrease in systolic and diastolic blood pressure before 18 weeks and a greater increase between 18 and 36 weeks were associated with a shorter gestation (percentage difference in gestational duration per 1 mm Hg/wk greater increase in systolic blood pressure between 18 and 30 weeks was -0.60% [-1.01 to -0.18] and between 30 and 36 weeks was -1.01% [-1.36 to -0.74]). Associations remained strong when restricting to normotensive women. We conclude that greater increases in blood pressure, from the 18-week nadir, are related to reduced fetal growth and shorter gestation even in women whose blood pressure does not cross the threshold for hypertensive disorders of pregnancy.
Corrie Macdonald-Wallis; Kate Tilling; Abigail Fraser; Scott M Nelson; Debbie A Lawlor
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2014-05-12
Journal Detail:
Title:  Hypertension     Volume:  64     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-06-12     Completed Date:  2014-08-11     Revised Date:  2014-11-05    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-44     Citation Subset:  IM    
Copyright Information:
© 2014 American Heart Association, Inc.
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MeSH Terms
Birth Weight / physiology
Blood Pressure / physiology*
Fetal Development / physiology*
Fetal Growth Retardation / etiology,  physiopathology*
Gestational Age*
Hypertension, Pregnancy-Induced / physiopathology*
Infant, Newborn
Prospective Studies
Grant Support
0701594//Medical Research Council; 092731//Wellcome Trust; G0701594//Medical Research Council; MC_UU_12013/5//Medical Research Council; MC_UU_12013/9//Medical Research Council; MR/J011932/1//Medical Research Council; R01 DK077659/DK/NIDDK NIH HHS; WT087997MA//Wellcome Trust
Comment In:
Hypertension. 2014 Jul;64(1):28-9   [PMID:  24821947 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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