Hypertension during pregnancy is known to be one of the leading causes of maternal mortality worldwide.
The latest Nutrition, metabolism and cardiovascular diseases The study discusses the course of systolic blood pressure (SPB) in pregnant women and its relationship with demographics, anthropometric data, health-related characteristics, fetal and weight gain trajectories.
Research: Blood pressure levels and weight gain in pregnant women: a cohort-based approach. Image credit: James Ogden / Shutterstock.com
The Brazilian Society of Cardiology defines high blood pressure during pregnancy as systolic blood pressure (SBP) greater than or equal to 140 mm Hg, diastolic blood pressure (DBP) greater than or equal to 90 mm Hg, and the presence of headache or swelling after the twentieth week of pregnancy.
Gestational hypertension syndromes are classified as gestational hypertension, mild or severe preeclampsia, eclampsia, chronic arterial hypertension, and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome.
Previous studies have shown that mean arterial blood pressure (BP) tends to decrease until the twentieth week of pregnancy; Then it increases until birth. Women who do not have normal BP levels during pregnancy may experience hypertensive disorders.
Hormones produced by the placenta have a direct effect on the BP track. In addition, moderately elevated BP levels may increase the risk of prenatal and postnatal complications.
About the study
In the last decade, high rates of obesity and high blood pressure have been observed in the Brazilian population. In addition, 25 percent of maternal deaths in Brazil are related to arterial hypertension.
The present longitudinal, cross-sectional study of SBP during pregnancy. This study included pregnant women of all risk levels who received antenatal care at the Public Health Service in Paraná, Brazil, between March 2018 and November 2019.
In phase one of the study, participants were asked about demographics, birth history, socioeconomic status, and smoking and dietary status. Phase II was conducted six months after Phase 1, during which researchers obtained relevant data related to gestational age, SBP and DBP measurements, weight measurements during prenatal care, medications, and the pregnant women’s physical/electronic medical records. .
604 pregnant women participated in the first survey. In this study, 460 pregnant women were considered and all missing data were removed. Interestingly, pregnant women with higher education are more likely to participate in the survey.
63% of the survey participants were between 20 and 29. In this study group, 42% had used antihypertensive drugs during their first pregnancy, 3.5% reported smoking, 48.5% had a eutrophic pregestational body mass index (BMI), and 28.8% were obese.
A new strategy was adopted using a combination of statistical techniques and a traffic model based on groups to study BP monitoring patterns in pregnant women. Mean SBP and DBP values of 110 mmHg and 70 mmHg were observed, respectively. These values indicate a decrease in the second trimester, then the BP level increases until the end of pregnancy.
Three distinct SBP patterns were identified and classified as transient, moderate pattern, and slight change in peak BP direction. Women who started pregnancy were more likely to be overweight, taking antihypertensive drugs, or women with higher education to be classified in higher BP levels. However, when the pattern of weight gain during pregnancy was examined, there was no significant tendency to belong to the higher SBP trajectory groups.
The relationship between higher prevalence of SBP and higher education can be attributed to older pregnant women. However, these women are more likely to provide complete information, which indicates greater compliance with prenatal recommendations.
One of the key limitations of this study was loss to follow-up, which was mainly due to the conversion of physical records to electronic records that occurred during the study. Despite this limitation, the present study showed that education, obesity and blood pressure were significantly associated with higher SBP during pregnancy.
In the future, it is necessary to better monitor the blood pressure of pregnant women with trained and standardized indicators. Better documentation of these data allows health professionals to access and analyze data. In addition, it is important to evaluate how different BP trace patterns affect pregnancy outcomes.
- Beltrame, TB, de Oliveira, AC, Wei, F., inter alia. (2023) Blood pressure levels and trajectory of weight gain in pregnant women: a cohort-based approach. Nutrition, metabolism and cardiovascular diseases. doi:10.1016/j.numecd.2023.06.006.