What question did this study set out to answer?

To examine the link between intensive diastolic blood pressure lowering and adverse neonatal outcomes in patients with hypertensive disorders of pregnancy.

June 3, 2026

Association of Intensive Diastolic Blood Pressure Lowering With Adverse Neonatal Outcome in Patients With Hypertensive Disorders of Pregnancy

Puntos clave

To examine the link between intensive diastolic blood pressure lowering and adverse neonatal outcomes in patients with hypertensive disorders of pregnancy.
Included 725 patients with hypertensive disorders of pregnancy admitted from January 2010 to December 2024.
Categorized patients by diastolic blood pressure levels: <70mmHg, 70-79mmHg, 80-89mmHg, >90mmHg.
Used multivariate logistic regression to calculate odds ratios and confidence intervals for adverse neonatal outcomes.
Adverse outcomes in groups were 26.83% (<70mmHg), 23.81% (70-79mmHg), 31.62% (80-89mmHg), and 28.26% (>90mmHg).
Patients with DBP 80-89mmHg had a 72% higher risk (OR: 1.76, 95% CI: 1.04-2.98) of adverse outcomes.
Patients with DBP >90mmHg had a 94% higher risk (OR: 2.01, 95% CI: 1.13-3.55) of adverse outcomes.

Resumen

Objective: We sought to examine the association of intensive diastolic blood pressure (DBP) lowering with adverse neonatal outcome in patients with hypertensive disorders of pregnancy (HDP). Design and method: The current study included 725 patients with HDP who were admitted in First Medical Center and Sixth Medical Center of Chinese PLA General Hospital between January 2010 to December 2024, and free of preeclampsia or eclampsia. Study patients were categorized into 4 groups according to their DBP level: DBP less than 70mmHg, DBP 70 to 79mmHg, DBP 80 to 89mmHg, and DBP greater than 90mmHg. Adverse neonatal outcome included: neonatal intensive care unit admission, small for gestational age, fetal distress, and neonatal asphyxia (Apgar score less than 8). We used multivariate Logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of adverse neonatal outcome among four DBP groups. Restricted cubic spline was used to examine the association of DBP as a continuous variable with the risk of adverse neonatal outcome. Results: Of 725 patients included in the current study, the mean age was 33.02±4.28 years, 653 were gestational hypertension and 72 were chronic hypertension. The percentages of adverse neonatal outcome among DBP less than 70mmHg, DBP 70 to 79mmHg, DBP 80 to 89mmHg, and DBP greater than 90mmHg groups were 11/41 (26.83%), 30/126 (23.81%), 86/272 (31.62%), 78/276 (28.26%), respectively. After adjusting for age, gestational age, multiparous women, chronic hypertension, systolic blood pressure, heart rate, hemoglobin, white blood cells, fasting blood glucose, estimated glomerular filtration rate, alanine aminotransferase, total cholesterol, and triglycerides, patients with DBP less than 70mmHg showed no significant higher risk compared with those with DBP 70 to 79mmHg (OR: 0.91, 95% CI: 0.38-2.17), but patients with DBP 80 to 89mmHg and DBP greater than 90mmHg had 72% (OR: 1.76, 95% CI: 1.04-2.98) and 94% (OR: 2,01, 95% CI: 1.13-3.55) higher risk of adverse neonatal outcome, respectively. Conclusions: In conclusion, DBP less than 80mmHg was associated with lower risk of adverse neonatal outcome in patients with HDP. Intensive management on DBP may improve the neonatal outcome in patients with HDP.

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