Early pregnancy maternal blood pressure and risk of preeclampsia: Does the association differ by parity? Evidence from 14,086 women across 7 countries

被引：0

作者：

Harris, Katie ^{[1
]}

Xu, Lily ^{[2
,3
]}

Woodward, Mark ^{[1
,4
]}

De Kat, Annelien ^{[5
]}

Zhou, Xin ^{[6
]}

Shang, Jie ^{[1
]}

Hirst, Jane E. ^{[3
,7
]}

Henry, Amanda ^{[1
,2
,3
]}

机构：

[1] Univ New South Wales, George Inst Global Hlth, Sydney, Australia

[2] UNSW Sydney, Sch Clin Med, Discipline Womens Hlth, Kensington, NSW, Australia

[3] St George Hosp, Dept Womens & Childrens Hlth, Sydney, NSW, Australia

[4] Imperial Coll London, George Inst Global Hlth, London, England

[5] Univ Med Ctr Utrecht, Reprod Med & Gynaecol, Utrecht, Netherlands

[6] Tianjin Med Univ, Gen Hosp, Dept Cardiol, Tianjin, Peoples R China

[7] Univ Oxford, Nuffield Dept Womens & Reprod Hlth, Oxford, England

来源：

PREGNANCY HYPERTENSION-AN INTERNATIONAL JOURNAL OF WOMENS CARDIOVASCULAR HEALTH | 2024年 / 37卷

基金：

比尔及梅琳达.盖茨基金会;

关键词：

Preeclampsia; Hypertensive disorders of pregnancy; Blood pressure; Women 's health; HYPERTENSIVE DISORDERS; ASPIRIN; PREVENTION; PREDICTION; DIAGNOSIS; PRETERM;

D O I：

10.1016/j.preghy.2024.101136

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective: To determine if the relationship between blood pressure (BP) before 16 weeks' gestation and subsequent onset of preeclampsia differs by parity, and by history of hypertensive disorders of pregnancy (HDP) in parous women. Study design: Data from two studies were pooled. First, routinely collected clinical data from three metropolitan hospitals in Sydney, Australia (2017-2020), where BP was measured as part of routine clinical care using validated mercury-free sphygmomanometers. Second, prospectively collected research data from the INTERBIO21st Study, conducted in six countries, investigating the epidemiology of fetal growth restriction and preterm birth, where BP was measured by dedicated research staff using an automated machine validated for use in pregnancy. Main outcome: Adjusted odds ratios (aOR) (95% confidence interval (CI)) for the association of systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) with preeclampsia were obtained from logistic regression models. Models were adjusted for age, smoking, body mass index, previous hypertension, previous diabetes, and previous preeclampsia. Interactions for parity, and history of HDP in parous women were included. Results: There were 14,086 pregnancies (Sydney = 11008, INTERBIO-21st = 3078) in the pooled analyses, 6914 (49 %) were parous, of which 414 (6.0 %) had a history of HDP. Nulliparous women had a higher risk of preeclampsia (2.6 %) compared with parous women (1.5 %): [aOR (95 %CI) 3.61 (2.67, 4.94)], as did parous women with a history of HDP (15.0 %) compared with no history (0.7 %) [12.70 (8.02, 20.16)]. MAP before 16 weeks' gestation (mean [SD] 78.8[8.6] mmHg) was more strongly associated than SBP or DBP with development of preeclampsia in parous women [2.22 (1.81, 2.74)] per SD higher MAP] compared with nulliparous women [1.58 (1.34, 1.87)] (p for interaction 0.013). There were no significant differences on the effect of blood pressure on preeclampsia in parous women by history of HDP (p for interaction 0.5465). Conclusion: The risk of preeclampsia differs according to parity and history of HDP in a previous pregnancy. Blood pressure in early pregnancy predicts preeclampsia in all groups, although more strongly associated in parous than nulliparous women, but no different in parous women by history of HDP.

引用

页数：7