Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women
Abstract 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 extr...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-03599-7 |
| _version_ | 1818328628986904576 |
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| author | Haoyue Teng Yumei Wang Bing Han Jieyu Liu Yingying Cao Jiaxiang Wang Xiaoyan Zhu Jiaojiao Fu Qi Ling Chengqi Xiao Zhongxiao Wan Jieyun Yin |
| author_facet | Haoyue Teng Yumei Wang Bing Han Jieyu Liu Yingying Cao Jiaxiang Wang Xiaoyan Zhu Jiaojiao Fu Qi Ling Chengqi Xiao Zhongxiao Wan Jieyun Yin |
| author_sort | Haoyue Teng |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-13T12:35:12Z |
| format | Article |
| id | doaj.art-a2b2d10175b44aa794282de104d2028f |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-13T12:35:12Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-a2b2d10175b44aa794282de104d2028f2022-12-21T23:45:53ZengBMCBMC Pregnancy and Childbirth1471-23932021-02-0121111010.1186/s12884-021-03599-7Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese womenHaoyue Teng0Yumei Wang1Bing Han2Jieyu Liu3Yingying Cao4Jiaxiang Wang5Xiaoyan Zhu6Jiaojiao Fu7Qi Ling8Chengqi Xiao9Zhongxiao Wan10Jieyun Yin11Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversityDepartment of Obstetrics, The First People’s Hospital of TaiCangDepartment of Obstetrics and Gynecology, First Hospital of Soochow UniversityJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversityWomen and Children Health Care Center of TaicangJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversitySuzhou Center for Disease Prevention and ControlJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversityDepartment of Obstetrics, The First People’s Hospital of TaiCangJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversityJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversityJiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow UniversityAbstract 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.https://doi.org/10.1186/s12884-021-03599-7Systolic blood pressureTrajectoryFetal outcomeMaternal outcomeLatent class growth mixture model |
| spellingShingle | Haoyue Teng Yumei Wang Bing Han Jieyu Liu Yingying Cao Jiaxiang Wang Xiaoyan Zhu Jiaojiao Fu Qi Ling Chengqi Xiao Zhongxiao Wan Jieyun Yin Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women BMC Pregnancy and Childbirth Systolic blood pressure Trajectory Fetal outcome Maternal outcome Latent class growth mixture model |
| title | Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women |
| title_full | Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women |
| title_fullStr | Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women |
| title_full_unstemmed | Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women |
| title_short | Gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in Chinese women |
| title_sort | gestational systolic blood pressure trajectories and risk of adverse maternal and perinatal outcomes in chinese women |
| topic | Systolic blood pressure Trajectory Fetal outcome Maternal outcome Latent class growth mixture model |
| url | https://doi.org/10.1186/s12884-021-03599-7 |
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