BP Variability Linked to Adverse Perinatal Outcomes

TOPLINE: 

Visit-to-visit blood pressure (BP) variability was associated with adverse perinatal outcomes, including foetal growth restriction (FGR) and preterm birth (PTB) in high-risk pregnancies.

METHODOLOGY:

• The study retrospectively analysed data from 996 pregnant women (mean age, 33.8 ± 5.4 years) with hypertension or its risk factors between 2017 and 2021.
• It included women with at least two antenatal BP measurements using validated digital BP monitors.
• BP variability was calculated using visit-to-visit mean difference and SD, and its relationship with perinatal outcomes was assessed through logistic regression.
• The link between visit-to-visit BP variability and adverse perinatal outcomes, including FGR and PTB, was assessed, and the impact of different antihypertensive medications on BP variability was examined.

TAKEAWAY:

• FGR occurred in 13% of pregnancies, PTB in 23%, and PTB before 34 weeks in 8%.
• Increased visit-to-visit BP variability was linked to elevated risks for FGR (adjusted odds ratio [OR], 1.16; P = .02) and PTB (adjusted OR, 1.16; P = .004).
• Nifedipine was associated with greater BP variability than labetalol (adjusted difference, 1.93 mm Hg; P = .04).
• Women on multiple antihypertensives had an increased risk for FGR (OR, 7.08; P = .002) and PTB (OR, 50.37; P

IN PRACTICE:

“Variation in BP variability between women taking different antihypertensives may reflect efficacy, duration, or factors influencing antihypertensive choice. Findings from this study do not yet support the clinical utility of BP variability over absolute BP values in obstetric decision-making,” the authors wrote.

SOURCE:

The study was led by Laura Ormesher, The University of Manchester, Manchester, United Kingdom. It was published online on February 13, 2025, in Pregnancy Hypertension.

LIMITATIONS:

Limitations included the absence of preeclampsia and gestational diabetes diagnoses, variability in visit schedules, and reliance on BP measurements solely from specialist clinics using validated devices, which may have limited the comprehensiveness of BP data.

DISCLOSURES:

The study was funded by the Biomedical Research Centre, Manchester NHS Foundation Trust, University of Manchester; Tommy’s charity, Maternal & Fetal Health Research Centre; and Professor Myers’ Clinician Scientist Award. The authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.