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Feature of trajectory of blood pressure among pregnant women with gestational hypertension

Mo, Minjia; Shen, Yu; Si, Shuting; Xin, Xing; Shao, Bule; Wang, Shuojia; Muyiduli, Xiamusiye; Chen, Zexin; Yu, Yunxian

doi: 10.1097/HJH.0000000000002197
ORIGINAL PAPERS: Pregnancy
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Objective: We aimed to describe the feature and the trajectory of blood pressure (BP) among pregnant women with onset of gestational hypertension.

Methods: This epidemiology cohort study of pregnant women enrolled in Zhoushan, Zhejiang, included 4050 participants from the Zhoushan Pregnant Women Cohort. Each participant contributed up to eight serial perinatal visits of BP measurements from 2001 to 2018. Segmented mixed models were utilized to identify the dramatic change points in the relationship of BP elevation and gestational week among pregnant women with onset of gestational hypertension.

Results: Despite of in which gestational week gestational hypertension developed, the SBP and DBP levels of pregnant women in each gestational hypertension category maintained the stable and normal levels (SBP <119∼130 and DBP <76∼83 mmHg) before the accelerated point. However, after the accelerated point, BP dramatically developed to gestational hypertension in a very short time period. Meanwhile, the earlier gestational hypertension onset was, the higher the baseline BP were; meanwhile, the earlier the gestational hypertension onset was, the higher the difference in BP at the gestational week of gestational hypertension onset between women with and without gestational hypertension was.

Conclusion: BP trajectories of gestational hypertension onset in different gestational week presented similar patterns. Meanwhile, the earlier gestational hypertension onset was, the higher the baseline BPs were. These findings show that BP monitoring during pregnancy is necessary, especially for women with high normal baseline BP.

Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China

Correspondence to Yunxian Yu, MD, PhD, Associate Professor, Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. Tel: +8657188208191; e-mail: yunxianyu@zju.edu.cn

Abbreviations: BP, blood pressure; EMRS, electronic medical recorder system; HDP, hypertensive disorders in pregnancy; MDDB, mean difference of DBP between at hypertension onset and at baseline level; MDDN, mean difference of DBP between women with gestational hypertension at week of hypertension level; MDSB, mean difference of SBP between at hypertension onset and at baseline onset and normotensive women at the same gestational week; MDSN, mean difference of SBP between women with gestational hypertension at week of hypertension onset and normotensive women at the same gestational week

Received 7 May, 2019

Revised 10 June, 2019

Accepted 20 June, 2019

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