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Blood pressure in pregnancy—A stress test for hypertension? Five‐year, prospective, follow‐up of the ROLO study
Author(s) -
Brady Michelle B.,
O’Brien Eileen C.,
Geraghty Aisling A.,
Courtney Amanda U.,
Kilbane Mark T.,
Twomey Patrick J.,
McKenna Malachi J.,
Crowley Rachel K.,
McAuliffe Fionnuala M.
Publication year - 2019
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14102
Subject(s) - blood pressure , medicine , pregnancy , gestation , diastole , prospective cohort study , odds ratio , obstetrics , genetics , biology
Objective To investigate whether maternal blood pressure (BP) below the diagnostic criteria of hypertensive disorders of pregnancy (HDP) is associated with maternal BP 5 years later. Design Prospective, observational study. Setting Dublin, Ireland (2007‐2011). Sample Three hundred twenty‐nine women from the ROLO study (Randomized cOntrol trial of LOw glycaemic index diet to prevent the recurrence of macrosomia). Methods Maternal BP measurements were taken during pregnancy (13, 28 and 34 weeks’ gestation and day 1 postpartum) and at the 5‐year follow‐up. Systolic BP (SBP) and diastolic BP (DBP) were categorized as normal (SBP < 120 and DBP < 80 mm Hg), elevated (SBP 120‐129 and DBP < 80 mm Hg), HTN stage 1 (SBP 130‐139 or DBP 80‐89 mm Hg) or HTN stage 2 (SBP ≥ 140 or DBP ≥ 90 mm Hg) at each timepoint. Main Outcome Measures Maternal blood pressure at the 5‐year follow‐up. Results Women with elevated BP at 28 and 34 weeks’ gestation had 2.68 (95% CI: 1.36‐5.26) and 2.45‐fold (95% CI: 1.22‐4.95) increased odds of HTN stage 1 respectively, at the 5‐year follow‐up, compared to those with normal BP in pregnancy. Conclusion Elevated BP at 28 and 34 weeks’ gestation was associated with an increased risk of HTN stage 1 at 5 years later. Thus, raised BP, below the diagnostic criteria of HDP, could be flagged for follow‐up postpartum.