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Early prediction of hypertension during pregnancy in a low‐resource setting
Author(s) -
Kumar Manisha,
Gupta Usha,
Bhattacharjee Jayashree,
Singh Ritu,
Singh Shalini,
Goel Manish,
Sharma Karuna,
Rehman Mujeeb U.
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.07.021
Subject(s) - medicine , uterine artery , body mass index , pregnancy , obstetrics , blood pressure , prospective cohort study , cohort , hypertension in pregnancy , mean arterial pressure , gestational hypertension , cardiology , preeclampsia , gestation , heart rate , genetics , biology
Objective To evaluate the role of maternal factors, biomarkers, and uterine‐artery Doppler in the prediction of hypertension during pregnancy. Methods A prospective cohort study was performed between December 2012 and November 2014. All singleton pregnancies between 11 weeks and 13 weeks, 6 days of pregnancy were included. Patients had their body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), mean arterial pressure, uterine‐artery Doppler pulsatility index, and pregnancy‐associated plasma protein A (PAPP‐A) and free β‐human chorionic gonadotropin levels recorded. Any patients diagnosed with hypertension during follow‐up were assigned to the case cohort; all other patients were assigned to the control group. Results Hypertension during pregnancy was observed in 198 (9.7%) of 2042 patients that attended follow‐up. The mean BMI, mean arterial pressure, uterine‐artery Doppler pulsatility index, and the PAPP‐A level at study enrollment were all significantly correlated with the later development of hypertension ( P < 0.001 for all variables). The combined sensitivity, specificity, positive predictive value, and negative predictive value of using the investigated parameters to predict hypertension was 76%, 80%, 31%, and 93%, respectively. Conclusion Patient BMI, mean arterial pressure, PAPP‐A, and pulsatility index were found to be effective predictors of hypertension during pregnancy. Combining these predictors may be beneficial in selecting individuals for close monitoring and early intervention during pregnancy.