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299: Gestational prehypertension - An additional category of hypertensive disorder of pregnancy?

      Objective

      Adult prehypertension is defined as blood pressure of 120-139/80-89 that is associated with increased cardiovascular risks. Our hypothesis is that gestational prehypertension is a pregnancy condition associated with increased risk of pregnancy complications.

      Study Design

      We enrolled 396 pregnant patients who presented for prenatal care to our low risk obstetrics clinic. The inclusion criteria were healthy patients who had blood pressure measurement of 120-139/80-89 in early pregnancy (<15 weeks) and for the control group patients with blood pressure measurement of < 120/80 at similar gestational age. Comparisons between the two groups were performed for demographic characteristics and outcome measures using the chi-square test statistic and two-sample t-tests for categorical and continuous variables, respectively.

      Results

      The study and the control groups consisted of 74 and 322 patients, respectively. The following outcome measures were analyzed, with all resulting in poorer results being associated with the study group compared with control: 12% of the study group vs. 4% of the control group (p=.02) had preeclampsia; 15% of the study group vs. 3% of the control group (p<.0001) were diagnosed with gestational hypertension; 10% of the study group vs. 4% of the control group (p=.05) were admitted to the neonatal intensive care unit; 13% of the study group vs. 7% of the control group (p=.07) had preterm labor; and 41% of the study group vs. 34% of the control group (p=.26) had cesarean section. On admission mean systolic and diastolic blood pressures were significanly different between the groups.

      Conclusion

      “Gestational Pre-hypertension” is suggested as a real condition in pregnancy and as an additional category of hypertensive disorders of pregnancy. When gestational prehypertension is recognized physician attention, patient close monitoring during prenatal care and delivery and early intervention for patients at risk may all promote improved pregnancy outcome. A larger scale study is in progress to evaluate these findings in a larger pregnant population.