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Diastolic blood pressure increase is a risk indicator for pre-eclampsia

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

A previous study demonstrated that the increase in diastolic blood pressure during pregnancy was reduced by supplementation with magnesium. The present study was undertaken to explore if increases in diastolic blood pressure could be useful for early identification of pre-eclampsia.

Study design

Hospital records of nulliparous, singleton normal pregnancies (n = 100) and those diagnosed with pre-eclampsia (n = 109) were obtained from a register at an antenatal health care unit. Data on blood pressure at the regular visits to the unit were collected and analysed.

Results

The systolic and diastolic blood pressures were significantly higher at pregnancy week 12 among those who developed pre-eclampsia (p = 0.046 and 0.001, resp). An increase in diastolic blood pressure ≥15 mmHg occurred more frequently among women with pre-eclampsia. In 93 % of the cases, this increase was present before and at the same time as the clinical diagnosis of pre-eclampsia was established.

Conclusion

The results suggest that a base-line diastolic blood pressure of ≥80 mmHg and an increase in diastolic blood pressure of ≥15 mmHg could be used to identify women at risk of pre-eclampsia (sensitivity 92 %, specificity 44 %) and as a selection criterion in treatment or prevention assays.

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References

  1. Gifford RW, August PA, Cunningham G et al (2000) Report of the national high blood pressure program working group on high blood pressure in pregnancy. Am J Obstet Gynecol 183:S1–S22

  2. Backes CH, Markham K, Moorehead P, Cordero L, Nankervis CA, Giannone PJ (2011) Maternal preeclampsia and neonatal outcomes. J Pregnancy. doi:10.1155/2011/214365

  3. Duley L (2009) The global impact of pre-eclampsia and eclampsia. Semin Perinatol 33:130–137

    Article  PubMed  Google Scholar 

  4. Tranquilli AL, Brown MA, Zeeman GG, Dekker G, Sibai BM (2013) The definition of severe and early-onset preeclampsia. Statements from the international society for the study of hypertension in pregnancy (ISSHP). Pregn Hyperten 3:44–47

    Google Scholar 

  5. Roberts JM, Cooper DW (2001) Pathogenesis and genetics of pre-eclampsia. Lancet 357:53–56

    Article  CAS  PubMed  Google Scholar 

  6. Gilstrap LC III, Ramin SM (2002) Diagnosis and management of preeclampsia and eclampsia. ACOG Pract Bull 33:1–9

    Google Scholar 

  7. Tranquilli AL, Landi B, Giannubilo SR, Sibai BM (2012) Preeclampsia: No longer solely a pregnancy disease. Pregn Hyperten 2:350–357

    Google Scholar 

  8. Fayyad AM, Harrington KF (2005) Prediction and prevention of preeclampsia and IUGR. Early Human Dev 81:865–876

    Article  Google Scholar 

  9. Page EW, Christianson R (1976) The impact of mean arterial pressure in the middle trimester upon the outcome of pregnancy. Am J Obstet Gynecol 125:740–745

    CAS  PubMed  Google Scholar 

  10. Khalil A (2011) First trimester screening for pre-eclampsia. Pregn Hyperten 1:243

    Google Scholar 

  11. Thangaratinam S, Langenveld J, Mol BW, Khan KS (2011) Prediction and primary prevention of pre-eclampsia. Best Pract Res Clin Obstet Gynaecol 25:419–433

    Article  PubMed  Google Scholar 

  12. Coomarasamy A, Honest H, Papaioannuo et al (2003) Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review. Obstet Gynecol 101:1319–1332

  13. Hofmeyr GJ, Atllah AN, Duley L (2006) Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 3:CD0011059

    Google Scholar 

  14. Mello G, Parretti E, Fatini C et al (2005) Low molecular-weight heparin lowers the recurrence rate of preeclampsia and restores the physiological vascular changes in angiotensin-converting enzyme DD women. Hypertension 45:86–91

    Article  CAS  PubMed  Google Scholar 

  15. Duley L, Henderson-Smart D, Meher S, King JF (2007) Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. doi:10.1002/14651858.CD004659.pub2

    Google Scholar 

  16. Bullarbo M, Ödman N, Nestler A, Nielsen Y, Kolisek M, Vormann J, Rylander R (2013) Magnesium supplementation to prevent high blood pressure in pregnancy—a randomised placebo control trial. Arch Obstet Gynecol 288:1269–1274

    Article  CAS  Google Scholar 

  17. Nakamoto O, Tasaka R, Motohisa C (2012) Eclampsia with progressing disease correlates to severe diastolic blood pressure. Pregn Hypertens 2:180

    Google Scholar 

  18. Levine RJ, Ewell MG, Hauth JC et al (2000) Should the definition of preeclampsia include a rise in diastolic blood pressure of ≥15 mm Hg to a level of <90 mm Hg in association with proteinuria? Am J Obstet Gynecol 183:787–792

    Article  CAS  PubMed  Google Scholar 

  19. Gifford RW (2000) Report of the National High Blood Pressure Education Program working group on high blood pressure in pregnancy. Am J Obstet Gynecol 183:S1–S22

    Article  Google Scholar 

  20. Li S, Tian H (1997) Oral low dose magnesium gluconate preventing pregnancy induced hypertension. Chin J Obstet Gynaecol 32:613–615

    CAS  Google Scholar 

  21. D’Almeida A, Carter JP, Anatol A, Prost C (1992) Effects of a combination of evening primrose oil (gamma linolenic acid) and fish oil (eicosapentaenoic + doca hexaenoic acid) versus magnesium, and versus placebo in preventing pre-eclampsia. Women Health 19:117–131

    Article  PubMed  Google Scholar 

  22. Sibai BM, Villar MA, Brazy E (1989) Magnesium supplementation during pregnancy: a double-blind randomized controlled clinical trial. Am J Obstet Gynecol 161:115–119

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The study was funded by Stiftelsen Swedbank, Sjuhärad, Borås, Sweden.

Conflict of interest

None of the authors has a conflict of interest.

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Correspondence to Ragnar Rylander.

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Bullarbo, M., Rylander, R. Diastolic blood pressure increase is a risk indicator for pre-eclampsia. Arch Gynecol Obstet 291, 819–823 (2015). https://doi.org/10.1007/s00404-014-3476-1

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  • DOI: https://doi.org/10.1007/s00404-014-3476-1

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