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Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women

Authors
  • Teng, Haoyue1, 2
  • Wang, Yumei3
  • Han, Bing4
  • Liu, Jieyu1
  • Cao, Yingying5
  • Wang, Jiaxiang1
  • Zhu, Xiaoyan6
  • Fu, Jiaojiao1, 2
  • Ling, Qi3
  • Xiao, Chengqi1
  • Wan, Zhongxiao1, 7
  • Yin, Jieyun1, 2
  • 1 Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, China , Suzhou (China)
  • 2 Medical College of Soochow University, Suzhou, China , Suzhou (China)
  • 3 The First People’s Hospital of TaiCang, Suzhou, Jiangsu Province, China , Jiangsu Province (China)
  • 4 First Hospital of Soochow University, Suzhou, China , Suzhou (China)
  • 5 Women and Children Health Care Center of Taicang, Suzhou, Jiangsu Province, China , Jiangsu Province (China)
  • 6 Suzhou Center for Disease Prevention and Control, Suzhou, Jiangsu, 215004, China , Suzhou (China)
  • 7 Soochow University, Suzhou, China , Suzhou (China)
Type
Published Article
Journal
BMC Pregnancy and Childbirth
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Feb 22, 2021
Volume
21
Issue
1
Identifiers
DOI: 10.1186/s12884-021-03599-7
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundAssociations between trajectories of systolic blood pressure (SBP) during pregnancy and pregnant outcomes remain unclear and disparate.MethodsData of 20,353 mothers without chronic hypertension and who delivered live singletons between January, 2014 and November, 2019, was extracted from Taicang register-based cohort. Based on SBP measured during 10 to 40 weeks of gestation, SBP trajectories were explored using latent class growth mixture model, and their associations with maternal and neonatal outcomes were assessed by logistic regression analyses.ResultsSix heterogeneous SBP trajectories were identified: low delayed-increasing (7.47%), low reverse-increasing (21.88%), low-stable (19.13%), medium-stable (21.64%), medium reverse-increasing (16.47%), and high stable (13.41%) trajectories. The high-stable trajectory had SBP around 125 mmHg in the 10th gestational week, and increased slightly onwards. When compared with the low-stable trajectory, the high-stable trajectory had maximally adjusted odds ratio (95% confidence interval) of 5.28 (2.76–10.10), 1.30 (1.13–1.50), 1.53 (1.12–2.08), 1.32 (1.06–1.65) and 1.64 (1.08–2.48) for gestational hypertension (GH), early-term delivery (ETD), preterm delivery (PTD), small for gestational age and low birth weight (LBW), respectively. Besides, the medium reverse-increasing trajectory showed significantly increased risk of GH and ETD, while the medium-stable trajectory had significantly elevated risk of ETD and PTD. Notably, SBP trajectories slightly but significantly improved risk discrimination of GH, ETD and LBW, over traditional risk factors.ConclusionWomen with different SBP trajectories were at varied risk of adverse maternal and fetal outcomes. Meanwhile, our study suggested that BP monitoring during pregnancy is necessary, especially for women with high SBP in early pregnancy or upward trajectory.

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