Blood pressure patterns in the first half of pregnancy improve early prediction of preeclampsia and gestational hypertension

July 14, 2023
Kaiser Permanente study showed that six blood pressure patterns can better stratify future risk of preeclampsia among ostensibly low- to moderate-risk patients.

Kaiser Permanente researchers discovered that routine blood pressure measurements taken during the initial stages of pregnancy can be categorized into 6 distinct patterns. These patterns accurately classify patients based on their likelihood of experiencing preeclampsia and gestational hypertension in the later stages of pregnancy.

As per the research published in the Journal of the American Heart Association on July 12, it was observed that there are 6 distinct trajectories of blood pressure during the first 20 weeks of pregnancy. These trajectories, along with various clinical, social, and behavioral risk factors, can effectively predict and classify the risk of preeclampsia and gestational hypertension in patients with low to moderate risk. Out of the identified blood pressure trajectories in early pregnancy, three were able to accurately identify 74% of the patients who later developed preeclampsia during their pregnancy. The prediction model demonstrated equal effectiveness across different racial and ethnic groups, including white, Black, Hispanic, and Asian patients involved in the study.

Lead author Erica P. Gunderson, PhD, MPH, who is a senior research scientist at the Kaiser Permanente Division of Research and a professor at the Kaiser Permanente Bernard J. Tyson School of Medicine, stated that the prediction models effectively categorized patients at higher risk of developing preeclampsia and gestational hypertension. This classification was based on the analysis of early blood pressure patterns occurring several months before the onset of these conditions.

The study involved the analysis of routine clinical blood pressure measurements and electronic medical records of nearly 250,000 pregnant patients who were in good health. Previously, another study had identified the 6 distinct blood pressure trajectories. In this new study, data from approximately 75,000 women who were not part of the earlier study were utilized. These women were categorized as low- to moderate-risk according to the current risk criteria set by the U.S. Preventive Services Task Force. It has been historically difficult to assess individual risk of preeclampsia in this particular group of patients.

Kaiser Permanente release on Newswise

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