OBJECTIVE: To examine the need to intensify fetal and maternal surveillance in pregnant women with mild pregnancy hypertension. METHODS: The multi-center cohort study in 2413 healthy nulliparae analyzed differences in hypertension-related adverse events (small-for-gestational age, perinatal mortality, eclampsia, abruptio placentae and HELLP syndrome) according to maximum diastolic blood pressure and proteinuria. RESULTS: Compared to the reference group (diastolic blood pressure 70-85 mmHg) (n = 1882) the relative risks of adverse fetal and maternal outcome in 34 proteinuric hypertensive women were 8.9 (95% CI 3.3-24.1) and 41.5 (95% CI 9.7-178.4), respectively. In 203 non-proteinuric women with a maximum diastolic blood pressure of > or = 95 mmHg only the relative risk of adverse maternal outcome was increased (11.6, 95% CI 3.1-42.8), but it was not increased in 230 non-proteinuric women with a maximum diastolic of 90 mmHg. CONCLUSIONS: Intensified surveillance in women with mild pregnancy hypertension is not indicated and should be reserved for groups with increased fetal and maternal risk.
OBJECTIVE: To examine the need to intensify fetal and maternal surveillance in pregnant women with mild pregnancy hypertension. METHODS: The multi-center cohort study in 2413 healthy nulliparae analyzed differences in hypertension-related adverse events (small-for-gestational age, perinatal mortality, eclampsia, abruptio placentae and HELLP syndrome) according to maximum diastolic blood pressure and proteinuria. RESULTS: Compared to the reference group (diastolic blood pressure 70-85 mmHg) (n = 1882) the relative risks of adverse fetal and maternal outcome in 34 proteinuric hypertensivewomen were 8.9 (95% CI 3.3-24.1) and 41.5 (95% CI 9.7-178.4), respectively. In 203 non-proteinuric women with a maximum diastolic blood pressure of > or = 95 mmHg only the relative risk of adverse maternal outcome was increased (11.6, 95% CI 3.1-42.8), but it was not increased in 230 non-proteinuric women with a maximum diastolic of 90 mmHg. CONCLUSIONS: Intensified surveillance in women with mild pregnancy hypertension is not indicated and should be reserved for groups with increased fetal and maternal risk.
Authors: Tracey L Weissgerber; James M Roberts; Arun Jeyabalan; Robert W Powers; Minjae Lee; Saul A Datwyler; Robin E Gandley Journal: Am J Obstet Gynecol Date: 2012-01-13 Impact factor: 8.661
Authors: Tracey L Weissgerber; Augustine Rajakumar; Ashley C Myerski; Lia R Edmunds; Robert W Powers; James M Roberts; Robin E Gandley; Carl A Hubel Journal: J Clin Endocrinol Metab Date: 2013-12-11 Impact factor: 5.958
Authors: Tracey L Weissgerber; Robin E Gandley; Paula L McGee; Catherine Y Spong; Leslie Myatt; Kenneth J Leveno; John M Thorp; Brian M Mercer; Alan M Peaceman; Susan M Ramin; Marshall W Carpenter; Philip Samuels; Anthony Sciscione; Margaret Harper; Jorge E Tolosa; George Saade; Yoram Sorokin Journal: PLoS One Date: 2013-04-03 Impact factor: 3.240