Chronic hypertension: first-trimester blood pressure control and likelihood of severe hypertension, preeclampsia, and small for gestational age

There is extensive evidence that prepregnancy chronic hypertension is associated with a high risk of development of severe hypertension and preeclampsia and birth of small-for-gestational-age neonates. However, previous studies have not reported whether antihypertensive use, blood pressure control,...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2018-03, Vol.218 (3), p.337.e1-337.e7
Main Authors: Nzelu, Diane, Dumitrascu-Biris, Dan, Nicolaides, Kypros H., Kametas, Nikos A.
Format: Article
Language:English
Subjects:
Adult
Antihypertensive Agents - therapeutic use
antihypertensive drug
Blood Pressure
Chronic Disease
chronic hypertension
Female
Gestational Age
Humans
Hypertension - drug therapy
Hypertension - physiopathology
Infant, Newborn
Infant, Small for Gestational Age
London - epidemiology
Pre-Eclampsia - epidemiology
preeclampsia
Pregnancy
pregnancy outcome
Pregnancy Trimester, First
Prospective Studies
severe hypertension
small for gestational age
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Summary:There is extensive evidence that prepregnancy chronic hypertension is associated with a high risk of development of severe hypertension and preeclampsia and birth of small-for-gestational-age neonates. However, previous studies have not reported whether antihypertensive use, blood pressure control, or normalization of blood pressure during early pregnancy influences the rates of these pregnancy complications. The purpose of this study was to stratify women with prepregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first trimester of pregnancy and to examine the rates of severe hypertension, preeclampsia, and birth of small-for-gestational-age neonates according to such stratification. We conducted a prospective study of 586 women with prepregnancy chronic hypertension, in the absence of renal or liver disease, that was booked at a dedicated clinic for the management of hypertension in pregnancy. The patients had singleton pregnancies and were subdivided according to findings in their first visit: group 1 (n=199), blood pressure
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2017.12.235