open access

Vol 91, No 3 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-03-31
Get Citation

Effects of blood pressure level management on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension

Lianyun Wang, Wen Ye, Wendong Xiong, Fan Wang
DOI: 10.5603/GP.2020.0030
·
Pubmed: 32266954
·
Ginekol Pol 2020;91(3):137-143.

open access

Vol 91, No 3 (2020)
ORIGINAL PAPERS Obstetrics
Published online: 2020-03-31

Abstract

Objectives: This study aims to investigate the effects of blood pressure control level on maternal and perinatal outcomes
in pregnant women with mild to moderate gestational hypertension (GHp).
Material and methods: A total of 344 pregnant women who initially diagnosed as mild to moderate gestational hypertension
were recruited in this study. They were divided into 4 groups according to the stabilized blood pressure level (BPL)
during pregnancy. The clinical parameters and the incidence of adverse pregnancy outcomes were compared among the
four groups. The association between blood pressure levels and relative factors were analyzed using the χ2 test. Multivariate
logistic regression analysis was adopted for risk factors associated with adverse pregnancy outcomes.
Results: The results showed the prevalence of obesity was significantly associated with blood pressure levels of mild-moderate
GHp pregnant women (p = 0.029). The incidence of severe GHp, SPE in group A, group B, and group C were statistically
significant (p < 0.001, p = 0.041, respectively). In the patients who used drugs to control BPL, the incidence of severe GHp
has a significant association with the initial blood pressure levels (p = 0.004). However, no significant difference was found
in the incidence of sPE, PE + Upro, and SGA (all p > 0.05). Multivariate logistic regression analyses results showed that the
gestational factor BPL was an independent risk factor for the incidence of sGHp. The AMA, primigravida, gestational BPL, and
edema were risk factors for the incidence of preeclampsia with proteinuria. To the incidence of sPE, gestational BPL is the
independent risk factor. Finally, preeclampsia anamnesis and FGR trend are the high-risk parameters to the incidence of SGA.
Conclusions: Timely management and control of blood pressure in pregnant women with mild to moderate GHp were
beneficial to reduce the occurrence of severe GHp and sPE, but the incidence of SGA does not affected.

Abstract

Objectives: This study aims to investigate the effects of blood pressure control level on maternal and perinatal outcomes
in pregnant women with mild to moderate gestational hypertension (GHp).
Material and methods: A total of 344 pregnant women who initially diagnosed as mild to moderate gestational hypertension
were recruited in this study. They were divided into 4 groups according to the stabilized blood pressure level (BPL)
during pregnancy. The clinical parameters and the incidence of adverse pregnancy outcomes were compared among the
four groups. The association between blood pressure levels and relative factors were analyzed using the χ2 test. Multivariate
logistic regression analysis was adopted for risk factors associated with adverse pregnancy outcomes.
Results: The results showed the prevalence of obesity was significantly associated with blood pressure levels of mild-moderate
GHp pregnant women (p = 0.029). The incidence of severe GHp, SPE in group A, group B, and group C were statistically
significant (p < 0.001, p = 0.041, respectively). In the patients who used drugs to control BPL, the incidence of severe GHp
has a significant association with the initial blood pressure levels (p = 0.004). However, no significant difference was found
in the incidence of sPE, PE + Upro, and SGA (all p > 0.05). Multivariate logistic regression analyses results showed that the
gestational factor BPL was an independent risk factor for the incidence of sGHp. The AMA, primigravida, gestational BPL, and
edema were risk factors for the incidence of preeclampsia with proteinuria. To the incidence of sPE, gestational BPL is the
independent risk factor. Finally, preeclampsia anamnesis and FGR trend are the high-risk parameters to the incidence of SGA.
Conclusions: Timely management and control of blood pressure in pregnant women with mild to moderate GHp were
beneficial to reduce the occurrence of severe GHp and sPE, but the incidence of SGA does not affected.

Get Citation

Keywords

blood pressure level; pregnancy; maternal outcome; perinatal outcome; preeclampsia; hypertension in pregnancy; adverse pregnant outcomes

About this article
Title

Effects of blood pressure level management on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension

Journal

Ginekologia Polska

Issue

Vol 91, No 3 (2020)

Pages

137-143

Published online

2020-03-31

DOI

10.5603/GP.2020.0030

Pubmed

32266954

Bibliographic record

Ginekol Pol 2020;91(3):137-143.

Keywords

blood pressure level
pregnancy
maternal outcome
perinatal outcome
preeclampsia
hypertension in pregnancy
adverse pregnant outcomes

Authors

Lianyun Wang
Wen Ye
Wendong Xiong
Fan Wang

References (29)
  1. Berg C, Callaghan W, Henderson Z, et al. Pregnancy-Related Mortality in the United States, 1998 to 2005. Obstet Gynecol. 2011; 117(5): 1230.
  2. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005; 365(9461): 785–799.
  3. Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000; 183(1): s1–s22.
  4. Ye C, Ruan Y, Zou L, et al. The 2011 survey on hypertensive disorders of pregnancy (HDP) in China: prevalence, risk factors, complications, pregnancy and perinatal outcomes. PLoS One. 2014; 9(6): e100180.
  5. Sibai BM, Gordon T, Thom E, et al. Risk factors for preeclampsia in healthy nulliparous women: a prospective multicenter study. The National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol. 1995; 172(2 Pt 1): 642–648.
  6. Buchbinder A, Sibai BM, Caritis S, et al. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol. 2002; 186(1): 66–71.
  7. Ankumah NA, Cantu J, Jauk V, et al. Risk of adverse pregnancy outcomes in women with mild chronic hypertension before 20 weeks of gestation. Obstet Gynecol. 2014; 123(5): 966–972.
  8. Mudjari NS, Samsu N. Management of hypertension in pregnancy. Acta Med Indones. 2015; 47(1): 78–86.
  9. Collier AC, Sato BLM, Milam KA, et al. Methamphetamine, smoking, and gestational hypertension affect norepinephrine levels in umbilical cord tissues. Clin Exp Obstet Gynecol. 2015; 42(5): 580–585.
  10. Zhou DX, Bian XY, Cheng XY, et al. Late gestational liver dysfunction and its impact on pregnancy outcomes. Clin Exp Obstet Gynecol. 2016; 43(3): 417–421.
  11. Chen YS, Shen L, Mai RQ, et al. Levels of microRNA-181b and plasminogen activator inhibitor-1 are associated with hypertensive disorders complicating pregnancy. Exp Ther Med. 2014; 8(5): 1523–1527.
  12. American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013; 122(5): 1122–1131.
  13. Magee LA, Pels A, Helewa M, et al. SOGC Hypertension Guideline Committee, Canadian Hypertensive Disorders of Pregnancy Working Group, Canadian Hypertensive Disorders of Pregnancy (HDP) Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014; 4(2): 105–145.
  14. Pfaff NF. The new hypertensive guidelines for pregnancy: what every nurse should know. J Perinat Neonatal Nurs. 2014; 28(2): 91–93.
  15. Kildea S, Gao Yu, Rolfe M, et al. Remote links: Redesigning maternity care for Aboriginal women from remote communities in Northern Australia - A comparative cohort study. Midwifery. 2016; 34: 47–57.
  16. Chinese Medical Association, Hypertensive Disorders in Pregnancy Subgroup Chinese Society of Obstetrics and Gynecology Chinese Medical Association. Diagnosis and treatment guideline of hypertensive disorders in pregnancy. Zhonghua Fu Chan Ke Za Zhi. 2015.
  17. American Diabetes Association. Executive summary: Standards of medical care in diabetes--2012. Diabetes Care. 2012; 35 Suppl 1: S4–SS10.
  18. Fauser BC, Tarlatzis BC, Rebar RW, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012; 97(1): 28–38.e25.
  19. Abalos E, Cuesta C, Carroli G, et al. WHO Multicountry Survey on Maternal and Newborn Health Research Network. Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014; 121 Suppl 1: 14–24.
  20. Madazli R, Yuksel MA, Imamoglu M, et al. Comparison of clinical and perinatal outcomes in early- and late-onset preeclampsia. Arch Gynecol Obstet. 2014; 290(1): 53–57.
  21. Schokker SAM, Van Oostwaard MF, Melman EM, et al. Cerebrovascular, cardiovascular and renal hypertensive disease after hypertensive disorders of pregnancy. Pregnancy Hypertens. 2015; 5(4): 287–293.
  22. Choi DJ, Yoon CH, Lee H, et al. The Association of Family History of Premature Cardiovascular Disease or Diabetes Mellitus on the Occurrence of Gestational Hypertensive Disease and Diabetes. PLoS One. 2016; 11(12): e0167528.
  23. Abalos E, Duley L, Steyn DW, et al. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2001; 10(2): CD002252.
  24. Molvi SN, Mir S, Rana VS, et al. Role of antihypertensive therapy in mild to moderate pregnancy-induced hypertension: a prospective randomized study comparing labetalol with alpha methyldopa. Arch Gynecol Obstet. 2012; 285(6): 1553–1562.
  25. Scantlebury DC, Schwartz GL, Acquah LA, et al. The treatment of hypertension during pregnancy: when should blood pressure medications be started? Curr Cardiol Rep. 2013; 15(11): 412.
  26. Gaillard R, Bakker R, Steegers EAP, et al. Associations of maternal obesity with blood pressure and the risks of gestational hypertensive disorders. The Generation R Study. J Hypertens. 2011; 29(5): 937–944.
  27. Macdonald-Wallis C, Tilling K, Fraser A, et al. Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery: findings from a prospective cohort. Hypertension. 2014; 64(1): 36–44.
  28. Macdonald-Wallis C, Lawlor DA, Fraser A, et al. Blood pressure change in normotensive, gestational hypertensive, preeclamptic, and essential hypertensive pregnancies. Hypertension. 2012; 59(6): 1241–1248.
  29. Chen Z, Liu W, Sun X, et al. Clinical study on the association between pregnancy-induced hypertension and insulin resistance. Exp Ther Med. 2017; 13(5): 2065–2070.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl