Blood Pressure Changes in Adolescents with Preeclampsia: A Multicentre, Case-Control Study in Latin American Hospitals

Abstract

Objective: To determine the minimum blood pressure increases that would confirm or exclude, with the greatest predictive values, hypertensive disorders of pregnancy (HDP) in pregnant adolescents after 24 weeks gestation.Methods: We conducted a case-control study of pregnant women aged ≤19 years with and without HDP. Using systolic and diastolic blood pressure increases, a predictive analysis was performed, and the area under the curve was calculated.Results: The cases and controls had systolic blood pressure increases of 45.3 § 17.5 mm Hg and 6.4 § 7.9 mm Hg, respectively (P = 0.001) and diastolic blood pressure increases of 30.8 § 11.7 mm Hg and 3.5 § 5.7 mm Hg, respectively (P = 0.001). Systolic and diastolic increases of ≥20 mm Hg showed the greatest sensitivity and specificity. A combined analysis showed that an increase of ≥20 mm Hg had a greater positive likelihood ratio of 35.4 (95% CI 22.4−55.9) and negative likelihood ratio of 0.10 (95% CI 0.07−0.13), with an area under the curve of 0.98 (95% CI 0.96−0.99).Conclusions: Systolic and diastolic blood pressure increases of ≥20 mm Hg must be considered in the diagnostic criteria for preeclampsia and gestational hypertension among pregnant adolescents past 24 weeks gestation.