Study assesses how different blood pressure guidelines identify women at risk for pregnancy complications

A pregnant woman has her blood pressure taken by a clinician in a medical office.

Researchers reviewed the electronic health records of 137,389 women who gave birth over a five-year period in California and found a lower baseline for hypertension, or high blood pressure, helped identify more women at risk for pregnancy complications. Examples of complications include severe hypertension in pregnancy, or preeclampsia, and delivering a baby early or at a low birth weight. Based on the 2017 American College of Cardiology/American Heart Association guidelines for hypertension, which starts at 130/80 mm Hg, 27,419 new women in the study were classified as having hypertension before and/or during their pregnancy. The American College of Obstetricians and Gynecologists guidelines for hypertension starts at 140/90 mm Hg and helps monitor risks for pregnancy complications.

To assess the impact of using lower guidelines for hypertension, the researchers grouped women into different groups based on how they fit into the higher and lower classifications of hypertension before and during their pregnancy. Multiple variables – including age, race, body weight, number of pregnancies, and smoking status – were accounted for in the review. The authors conclude that using the lower guidelines for hypertension independently or with the current guidelines may help identify more women at risk for pregnancy complications. This could potentially lead to closer monitoring throughout pregnancy, educational health outreach for gestational diabetes and to promote heart-healthy living, and other preventive measures. However, more research is necessary to evaluate the impact of women with newly defined hypertension taking a low dose of aspirin to prevent preeclampsia.

The research published in JAMA Network Open and was supported by the National Heart, Lung, and Blood Institute and the National Institute for Child Health and Human Development.

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