Time-Qualified Reference Values for Ambulatory Blood Pressure Monitoring in Pregnancy
Population
235 women with uncomplicated pregnancies
Design
Cohort
Follow-up
From first obstetric visit until delivery
Authors
Discussion
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Member takes
Implication
May challenge current diagnostic thresholds in pregnancy; leaves open whether time-qualified ambulatory references improve outcomes before clinical adoption.
Key Points
- To establish time-qualified reference values for blood pressure in pregnant women, aiming to improve the diagnosis of gestational hypertension and preeclampsia.
- Analyzed 1408 blood pressure series monitored ambulatory over 48 hours for 235 women with uncomplicated pregnancies.
- Data synchronized with each woman's rest-activity cycle to reduce variability in measurements.
- Computed 90% circadian tolerance intervals for blood pressure across trimesters using bootstrap techniques.
- Upper limits of blood pressure tolerance significantly below current diagnostic thresholds.
- Time-qualified tolerance limits provide high sensitivity and specificity for early identification of gestational hypertension and preeclampsia.
Structured PICO
P
Population
235 women with uncomplicated pregnancies
I
Intervention
Ambulatory blood pressure monitoring for 48 consecutive hours every 4 weeks from the first obstetric visit until delivery
O
Outcome
Time-specified reference standards (90% circadian tolerance intervals) for blood pressure as a function of gestational agesurrogate
Time-qualified reference limits for ambulatory blood pressure in pregnancy are markedly lower than current diagnostic thresholds, potentially improving early identification of gestational hypertension.
Cite This Study
Hermida et al. (2001) studied this question.