Preconception blood pressure and its change into early pregnancy

By Nobles CJ, Mendola P, Mumford SL, et al
Published August 17, 2020

Key Takeaways

In view of the association of preeclampsia and gestational hypertension, the common complications of pregnancy, with significant maternal and infant morbidity, researchers here evaluated the value of preconception blood pressure and its change during early pregnancy as novel risk markers for development of a hypertensive disorder of pregnancy. In the EAGeR (Effects of Aspirin in Gestation and Reproduction) trial (2007–2011), randomization of 1,228 healthy women with a history of pregnancy loss was done to receive preconception-initiated low-dose aspirin vs placebo. The participants were followed for up to 6 menstrual cycles attempting pregnancy and throughout pregnancy if they became pregnant. Among 586 assessed women with a pregnancy > 20 weeks’ gestation, they observed higher preconception blood pressure levels for preterm preeclampsia (87.3±6.7 mm Hg mean arterial pressure), term preeclampsia (88.3±9.8 mm Hg), and gestational hypertension (87.9±9.1 mm Hg) relative to no hypertensive disorder of pregnancy (83.9±8.6 mm Hg). Development of preeclampsia, particularly preterm preeclampsia were noted to be associated with change in blood pressure from preconception into very early pregnancy. No alteration in blood pressure trajectory or risk of hypertension in pregnancy was observed in correlation with randomization to aspirin. Although underexplored, preconception blood pressure and longitudinal changes during early pregnancy are suggested as crucial windows in the detection and prevention of hypertensive disorders of pregnancy.

Read the full article on Hypertension.

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