Elevated diastolic blood pressure until mid-gestation is associated with preeclampsia and small-for-gestational-age birth: a population-based register study

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Gunnarsdóttir, Jóhanna,1978-Uppsala universitet,Klinisk obstetrik (författare)

Elevated diastolic blood pressure until mid-gestation is associated with preeclampsia and small-for-gestational-age birth : a population-based register study

Artikel/kapitelEngelska2019

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2019-05-28
Springer Science and Business Media LLC,2019
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-320672
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-320672URI
https://doi.org/10.1186/s12884-019-2319-2DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:141037222URI

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Språk:engelska
Sammanfattning på:engelska

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Background: Gestational hemodynamic adaptations, including lowered blood pressure (BP) until mid-gestation, might benefit placental function. We hypothesized that elevated BP from early to mid-gestation increases risks of preeclampsia and small-for-gestational-age birth (SGA), especially in women who also deliver preterm (< 37 weeks). Methods: In 64,490 healthy primiparous women, the change in systolic and diastolic BP from early to midgestation was categorized into lowered (≥ 0 mmHg decreased), and elevated (≥ 1 mmHg increase). Women with chronic hypertension, chronic renal disease, pre-gestational diabetes and systemic lupus erythematosus were excluded. Risks of preeclampsia and SGA birth were estimated by logistic regression, presented with adjusted odds ratio (aOR) and 95% confidence intervals (CI). Further, the effect of BP change in combination with stage 1 hypertension (systolic BP 130–139 mmHg or diastolic BP 80–89 mmHg) in early gestation was estimated. Results: Compared to women with lowered diastolic BP from early to mid-gestation, those with elevated diastolic BP had increased risks of preeclampsia (aOR: 1.8 [1.6–2.0]) and SGA birth (aOR: 1.3 [1.2–1.5]). The risk estimates were higher for preeclampsia and SGA when combined with preterm birth (aORs: 2.2 [1.8–2.8] and 2.3 [1.8–3.0], respectively). The highest rate of preeclampsia (9.9%) was seen in women with stage 1 hypertension in early gestation and a diastolic BP that was elevated until mid-gestation. This was three times the risk, compared to women with normal BP in early gestation and a diastolic BP that was decreased until mid-gestation. The association between elevated systolic BP from early to mid-gestation and preeclampsia was weak, and no significant association was found between changes in systolic BP and SGA births. Conclusion: Elevated diastolic BP from early to mid-gestation was associated with increased risks of preeclampsia and SGA, especially for women also delivering preterm. The results may imply that the diastolic BP starts to increase around mid-gestation in women later developing placental dysfunction disorders

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Reproduktionsmedicin och gynekologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Obstetrics, Gynaecology and Reproductive Medicine hsv//eng
Blood pressure
Preeclampsia
Foetal growth restriction
Small-for-gestational-age

Biuppslag (personer, institutioner, konferenser, titlar ...)

Akhter, Tansim,1967-Uppsala universitet,Klinisk obstetrik(Swepub:uu)tanak729 (författare)
Högberg, Ulf,1949-Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning(Swepub:uu)ulfho102 (författare)
Cnattingius, SvenKarolinska Institutet (författare)
Wikström, Anna-Karin,1965-Karolinska Institutet,Uppsala universitet,Klinisk obstetrik,Department of Clinical Sciences, Danderyds sjukhus, Karolinska Institutet(Swepub:uu)annwi179 (författare)
Uppsala universitetKlinisk obstetrik (creator_code:org_t)

Sammanhörande titlar

Ingår i:BMC Pregnancy and Childbirth: Springer Science and Business Media LLC19, s. 1-81471-23931471-2393

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Av författaren/redakt...: Gunnarsdóttir, J ...; Akhter, Tansim, ...; Högberg, Ulf, 19 ...; Cnattingius, Sve ...; Wikström, Anna-K ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Reproduktionsmed ...

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Av lärosätet: Uppsala universitet; Karolinska Institutet

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