Defining the risk profile of women with stage 1 hypertension: a time to event analysis

Sabol, Bethany; Porcelli, Bree A.; Diveley, Emily; Meyenburg, Kaytelyn; Woolfolk, Candice; Rosenbloom, Joshua I.; Raghuraman, Nandini; Stout, Molly J.

doi:10.1016/j.ajogmf.2021.100376

Cited by 12 publications

(10 citation statements)

References 19 publications

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“…31 We created plots of SBP and DBP (x-axis) and individual predicted risks of preterm delivery with 95% confidence intervals (y-axis) (Figure S1). We estimated associations between ACC/AHA BP categories and risk of preterm delivery stratified by maternal age (<30 years vs. ≥30 years, cut-offs decided a priori) to improve comparability with other US cohorts 19,22,24,32,33 that have included samples of women younger than those included in our sample. We hypothesised that effect measure modification by maternal age may help explain heterogeneity in findings across studies.…”

Section: Discussionmentioning

confidence: 99%

“…6,12,17 The epidemiologic studies that have examined pre-pregnancy blood pressure in this range report mixed results, with risk estimates for the association between stage I hypertension and preterm delivery ranging from 1.05 to 3.8. [18][19][20][21][22][23][24][25][26] More research is needed to inform clinical decision making for this group.…”

Section: Backg Rou N Dmentioning

confidence: 99%

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Chronic hypertension and risk of preterm delivery: National Longitudinal Study of Adolescents to Adult Health

Delker

Bandoli

LaCoursiere

et al. 2022

Paediatric Perinatal Epid

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Background: Chronic hypertension during pregnancy is associated with increased risk of adverse birth outcomes. In 2017, the American College of Cardiology and American Heart Association (ACC/AHA) lowered thresholds to classify hypertension in nonpregnant adults to SBP ≥ 130 mmHg and DBP ≥ 80 mmHg (ie stage I hypertension), resulting in an additional 4.5-million reproductive-aged women meeting criteria for hypertension. Little is known about effects of pre-pregnancy blood pressure (BP) in this range. Objectives: To examine the effect of pre-pregnancy maternal BP on preterm delivery. Methods: We analysed the data from two waves of the National Longitudinal Study of Adolescent to Adult Health, including participants that had measured BP at Wave IV (2008-09) and a pregnancy that resulted in a singleton live birth between Waves IV and V (2016-18; n = 2038). We categorised BP using ACC/AHA cut-offs: normal (SBP < 120 mmHg and DBP < 80 mmHg), elevated (SBP 120-129 mmHg and DBP < 80 mmHg), hypertension stage I (SBP 130-139 mmHg or DBP 80-89 mmHg)and hypertension stage II (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg). We estimated risk ratios (RR) with log-binomial regression adjusting for maternal demographics, anthropometrics and medication use. Results:The prevalence of preterm delivery was 12.6%. A standard deviation (SD) increment in SBP (SD = 12.2 mmHg) and DBP (SD = 9.3 mmHg) was associated with a 14% (95% confidence interval [CI] 2, 27) and 20% (95% CI 4, 37) higher risk of preterm delivery. Compared to normotensive controls, stage I (RR 1.33, 95% CI 1.01, 1.74) and stage II (RR 1.34, 95% CI 0.89, 2.00) hypertension were associated with increased risk. Conclusions:We observed greater risk of preterm delivery among women with higher pre-pregnancy BP. Women with stage I hypertension during pregnancy may benefit from increased BP monitoring. Additional studies on the utility of foetal surveillance in this group are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Backg Rou N Dmentioning

confidence: 99%

Chronic hypertension and risk of preterm delivery: National Longitudinal Study of Adolescents to Adult Health

Delker

Bandoli

LaCoursiere

et al. 2022

Paediatric Perinatal Epid

View full text Add to dashboard Cite

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“…Of 52 articles selected for full-text review, further exclusions (including removal of duplicate publications 28 ) left 23 studies that reported on the association between ACC-AHA BP categories based on BP measurements before 20 weeks gestation and adverse pregnancy outcomes. 8 , 9 , 10 , 11 , 13 , 14 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 …”

Section: Resultsmentioning

confidence: 99%

“…Overall, 16 studies reported adjustment for maternal covariates, most commonly maternal age, prepregnancy BMI, parity, and/or race and ethnicity 8 , 9 , 10 , 11 , 14 , 30 , 31 , 33 , 35 , 36 , 37 , 38 , 42 , 43 , 44 , 46 ; 7 of these studies reported both adjusted and unadjusted analyses. 8 , 9 , 31 , 42 , 43 , 46 , 47 In all analyses, adjustment for maternal confounders reduced the association between BP categories and adverse outcomes, most significantly for stage 2 hypertension when reported.…”

Section: Resultsmentioning

confidence: 99%

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American College of Cardiology and American Heart Association blood pressure categories—a systematic review of the relationship with adverse pregnancy outcomes in the first half of pregnancy

Slade¹,

Mistry²,

Bone³

et al. 2023

American Journal of Obstetrics and Gynecology

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Maternal Hypertensive Disorder in Pregnancy and Childhood Strabismus in Offspring

Zhu,

You,

Jing

et al. 2024

JAMA Netw Open

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ImportanceMaternal hypertensive disorder in pregnancy (HDP) might affect ocular health in offspring; however, its association with strabismus remains unclear.ObjectiveTo examine the association of maternal HDP with overall and type-specific strabismus in offspring.Design, Setting, and ParticipantsIn the Jiangsu Birth Cohort study, a population-based study in China, pregnant women were recruited from April 24, 2014, to November 30, 2018. A total of 6195 offspring had maternal HDP diagnosis information, of whom 3078 were excluded due to having no information on ocular alignment or due to having ocular diseases other than strabismus or refractive error. Offspring underwent ocular examinations at 3 years of age, completed May 21, 2022. Data were analyzed from May 28, 2022, through December 15, 2023.ExposureMaternal HDP, categorized into hypertension and preeclampsia or with blood pressure (BP) well controlled (systolic BP, &lt;130; diastolic BP, &lt;80 mm Hg) and poorly controlled (systolic BP, ≥130; diastolic BP, ≥80 mm Hg).Main Outcomes and MeasuresThe primary outcome was the incidence of strabismus in offspring. Poisson generalized linear mixed models were used to estimate the association between maternal HDP and strabismus.ResultsAmong the included 3117 children (mean [SD] age, 36.30 [0.74] months; 1629 boys [52.3%]), 143 (4.6%) were exposed to maternal HDP and 368 (11.8%) had strabismus. Offspring exposed to maternal HDP had an 82% increased risk of overall strabismus (relative risk [RR], 1.82 [95% CI, 1.21-2.74]), an 82% increased risk of exophoria (RR, 1.82 [95% CI, 1.11-3.00]), and a 136% increased risk of intermittent exotropia (RR, 2.36 [95% CI, 1.13-4.93]) compared with unexposed offspring. When considering the type of maternal HDP, the risk for all strabismus was high for offspring exposed to preeclampsia (RR, 2.38 [95% CI, 1.39-4.09]) compared with unexposed offspring. When considering the BP control level of maternal HDP, the risk for all strabismus was high for offspring born to mothers with HDP and poorly controlled BP (RR, 2.07 [95% CI, 1.32-3.24]) compared with unexposed offspring.Conclusions and RelevanceThese findings suggest that maternal HDP is associated with an increased risk of offspring strabismus. Early screening of strabismus might be recommended for offspring with maternal HDP. Further exploration of the underlying mechanism of the association between HDP and strabismus is warranted.

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Defining the risk profile of women with stage 1 hypertension: a time to event analysis

Cited by 12 publications

References 19 publications

Chronic hypertension and risk of preterm delivery: National Longitudinal Study of Adolescents to Adult Health

Chronic hypertension and risk of preterm delivery: National Longitudinal Study of Adolescents to Adult Health

American College of Cardiology and American Heart Association blood pressure categories—a systematic review of the relationship with adverse pregnancy outcomes in the first half of pregnancy

Maternal Hypertensive Disorder in Pregnancy and Childhood Strabismus in Offspring

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