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- Title
Blood Pressure in Healthy Pregnancy and Factors Associated With No Mid-Trimester Blood Pressure Drop: A Prospective Cohort Study.
- Authors
Salles, Gil F.; Schlüssel, Michael M.; Farias, Dayana R.; Franco-Sena, Ana Beatriz; Rebelo, Fernanda; Lacerda, Elisa M. A.; Kac, Gilberto
- Abstract
Background: The well-known mid-trimester drop in blood pressure (BP) during normal pregnancy was recently questioned. Objective: To describe longitudinal changes in BP during healthy pregnancies and to investigate factors associated with no mid-trimester drop in BP. Methods: A prospective cohort with 158 healthy pregnant women was followed up in a public health care center in Rio de Janeiro, Brazil. We used linear mixed-effects models to estimate longitudinal changes in systolic BP (SBP) and diastolic BP (DBP) during pregnancy. Poisson regression models were performed to identify factors associated with no mid-trimester drop in BP. Results: Significant mid-trimester increase in SBP (5.6 mm Hg; 95% confidence interval (CI) = 4.6-6.7) and DBP (4.4 mm Hg; 95% CI = 3.4-5.3) was observed in 44.3% and 39.9% of the sample, respectively. Women (37.1%) who had not a mid-trimester SBP drop still had a DBP drop. White skin color (incidence ratio (IR): 1.71; 95% CI = 1.22-2.39), family history of hypertension (IR: 1.93; 95% CI = 1.29-2.89), early pregnancy obesity (IR: 2.29; 95% CI = 1.27-4.11), outside temperature variation (IR: 1.45; 95% CI = 1.00-2.10), and gestational weight gain from the first to second trimester (IR: 1.71; 95% CI = 1.01-2.88 and IR: 2.32; 95% CI = 1.39-3.89 for second and third tertiles) were characteristics associated with no mid-trimester drop in SBP. The same characteristics were associated with no mid-trimester drop in DBP, except family history of hypertension and outside temperature variation. Conclusions: Some women without a mid-trimester SBP drop still present a DBP drop. The different patterns of mid-trimester change in BP seem to be determined by preexisting and pregnancy-related factors.
- Publication
American Journal of Hypertension, 2015, Vol 28, Issue 5, p680
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpu204