Pregnancy Outcomes and Blood Pressure Visit-to-Visit Variability and Level in Three Less-Developed Countries
Hypertension
; 77(5): 1714-1722, 29 mai 2021. Ilus, Tab
Article
in English
| RSDM
| ID: biblio-1526350
Responsible library:
MZ1.1
ABSTRACT
In pregnancy in well-resourced settings, limited data suggest that higher blood pressure (BP) visit-to-visit variability may be associated with adverse pregnancy outcomes. Included were pregnant women in 22 intervention clusters of the CLIP (Community-Level Interventions for Preeclampsia) cluster randomized trials, who had received at least 2 prenatal contacts from a community health worker, including standardized BP measurement. Mixed-effects adjusted logistic regression assessed relationships between pregnancy outcomes and both BP level (median [interquartile range]) and visit-to-visit variability (SD and average real variability [ARV], adjusted for BP level), among all women and those who became hypertensive. The primary outcome was the CLIP composite of maternal and perinatal mortality and morbidity. Among 17 770 pregnancies, higher systolic and diastolic BP levels were associated with increased odds of the composite outcome per 5 mm Hg increase in BP (odds ratio [OR], 1.05 [95% CI, 1.031.07] and OR, 1.08 [1.061.11], respectively). Higher BP visit-to-visit variability was associated with increased odds, per a SD increase in BP variability measure, of (1) hypertension (systolic OR, 2.09 [1.982.21] for SD and 1.52 [1.451.60] for ARV; diastolic OR, 2.70 [2.542.87] for SD and 1.86 [1.761.96] for ARV); and (2) the composite outcome (systolic OR, 1.10 [1.061.14] for SD and 1.06 [1.021.10] for ARV; diastolic OR, 1.07 [1.031.11] for SD and 1.06 [1.021.09] for ARV). In 3 less-developed countries, higher BP level and visit-to-visit variability predicted adverse pregnancy outcomes, providing an opportunity for high-definition medicine.
Full text:
Available
Collection:
National databases
/
MZ
Database:
RSDM
Main subject:
Pregnancy Outcome
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Hypertension, Pregnancy-Induced
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Arterial Pressure
Limits:
Female
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Humans
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Pregnancy
Country/Region as subject:
Africa
Language:
English
Journal:
Hypertension
Year:
2021
Document type:
Article
Institution/Affiliation country:
1DepartameCentro de Excelência, Divisão de Saúde da Mulher e da Criança, Universidade Aga Khan (RNQ, ZAB)/PK
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Centro de Avaliação de Saúde e Ciências de Resultados, Providence Health Care Research Institute (JS, TL), Universidade da Colúmbia Britânica/CA
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Centro de Excelência, Divisão de Saúde da Mulher e da Criança, Universidade Aga Khan/PK
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Centro de Investigação em Saúde de Manhiça (SEM, ES, AV)/MZ
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Departamento de Medicina, Universidade de Toronto (AGL)/CA
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Departamento de Obstetrícia e Ginecologia, BC Children's Hospital Research Institute (LAM, JB, MV, PvD)/CO
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Departamento de Saúde da Mulher e da Criança, Escola de Ciências da Vida, Faculdade de Ciências da Vida e Medicina (LAM, HLN, AHS, PvD), ââKing's College London/GB
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Escola de Ciências Biomédicas GKT (SBO), King's College London/GB
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JN Medical College da KLE Academy of Higher Education and Research (MBB, SSG)/IN
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JN Medical College da KLE Academy of Higher Education and Research, (MBB, SSG)/IN