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Parameterization of the mid-trimester drop in blood pressure trajectory during pregnancy and its utility for predicting preeclampsia.

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Mi, Baibing, Wen, Xiaozhong, Li, Shanshan, Liu, Danmeng, Lei, Fangliang, Liu, Xin, Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464, Li, Xuelan, Shittu, Abdal Aziz T, Dang, Shaonong and Yan, Hong (2020) 'Parameterization of the mid-trimester drop in blood pressure trajectory during pregnancy and its utility for predicting preeclampsia.'. Journal of Hypertension, Vol 38, Issue 7, pp. 1355-1366.

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Abstract

OBJECTIVES
The purpose of this study was to parameterize mid-trimester drop in blood pressure (BP) trajectory during pregnancy and to evaluate its utility for predicting preeclampsia.
METHODS
To develop parametric models for BP trajectory during pregnancy, we used data from 7923 Chinese pregnant women with 24 810 routine antenatal care visits. Then, we evaluated the utility of BP trajectory parameters for predicting clinician-diagnosed preeclampsia in a separate sample of 3524 pregnant women from a randomized controlled trial of prenatal vitamin supplementation conducted in the same area. We focused on parameters related to the mid-trimester BP drop, including the gestational age and BP value at the nadir (lowest point), change in BP, velocity, and area under curve during two periods (from 12 weeks of gestation to the nadir and from the nadir to 33 weeks of gestation).
RESULTS
All participants in our analysis had a mid-pregnancy drop in their SBP, DBP, and mean arterial pressure (MAP) trajectories. There were high correlations (|r| > 0.90) among trajectory parameters of the same BP measure. The final prediction model included selective parameters of SBP, DBP, and MAP trajectories, prepregnancy BMI and gestational age at the first antenatal care visit. The area under the receiver-operating curve for predicting preeclampsia was 0.886 (95% confidence interval 0.846--0.926) in the training dataset and 0.802 (0.708--0.895) in the validation dataset.
CONCLUSION
Our novel BP trajectory parameters are informative and can predict preeclampsia at a clinically acceptable level.

Item Type: Article
Subjects: WG Cardiovascular System > WG 100 General works
WQ Obstetrics > Pregnancy Complications > WQ 215 Toxemias
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1097/HJH.0000000000002395
Depositing User: Julie Franco
Date Deposited: 07 Apr 2020 15:05
Last Modified: 22 Jul 2020 12:03
URI: https://archive.lstmed.ac.uk/id/eprint/14138

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