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

Autor:	Chengqi Xiao, Qi Ling, Xiaoyan Zhu, Jiaxiang Wang, Jieyu Liu, Zhongxiao Wan, Yumei Wang, Yingying Cao, Bing Han, Jiaojiao Fu, Jie-Yun Yin, Haoyue Teng
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Adult Gestational hypertension China medicine.medical_specialty Fetal outcome Trajectory Blood Pressure Gestational Age Maternal outcome 030204 cardiovascular system & hematology lcsh:Gynecology and obstetrics 03 medical and health sciences 0302 clinical medicine Pregnancy Risk Factors medicine Humans 030212 general & internal medicine lcsh:RG1-991 Obstetrics business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Blood Pressure Determination Hypertension Pregnancy-Induced Odds ratio Infant Low Birth Weight medicine.disease Latent class growth mixture model Confidence interval Low birth weight Blood pressure Infant Small for Gestational Age Systolic blood pressure Small for gestational age Gestation Female medicine.symptom business Research Article
Zdroj:	BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-10 (2021) BMC Pregnancy and Childbirth
ISSN:	1471-2393
Popis:	Background Associations between trajectories of systolic blood pressure (SBP) during pregnancy and pregnant outcomes remain unclear and disparate. Methods Data 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. Results Six 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. Conclusion Women 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.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3e4f05c7f2246dd802ba2523b152d0bf https://doaj.org/article/a2b2d10175b44aa794282de104d2028f Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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