Key result
First-trimester pulse pressure inter-arm difference is linked to ~4% higher pre-eclampsia odds.
Why the study?
The association of inter-arm blood pressure differences and within-visit blood pressure variability in early pregnancy with pre-eclampsia was investigated.
Are inter-arm blood pressure differences and within-visit blood pressure variability in early pregnancy associated with the development of pre-eclampsia?
Cohort (n=8,117)
Are inter-arm blood pressure differences and within-visit blood pressure variability in early pregnancy associated with the development of pre-eclampsia?
Odds Ratio: 1.04 (95% CI 1.01–1.07)
In early pregnancy, higher diastolic and pulse pressure inter-arm differences are modestly associated with subsequent pre-eclampsia, whereas systolic inter-arm differences and within-visit blood pressure variability are not.
Pulse pressure IAD weakly associated with term pre-eclampsia; leaves open its value for early risk stratification pending validation studies.
Objectives To investigate an association of inter-arm blood pressure differences (IAD) and within-visit variability of blood pressure in early pregnancy with pre-eclampsia.Methods Blood pressure information was available on 8117 participants from the prospective PREeclampsia Screening In DEnmark (PRESIDE) study. Three consecutive blood pressure (BP) measurements were taken on both arms simultaneously in participants attending the first-trimester ultrasound. Maternal characteristics, medical history, and pregnancy outcome were collected. Outcomes were pre-eclampsia overall, further stratified into preterm (delivery < 37 weeks of gestation) and term cases (delivery ≥ 37 weeks of gestation).Results Women developing pre-eclampsia had a higher diastolic IAD (2.67 mmHg vs 2.33 mmHg) and pulse pressure IAD (4.67 mmHg vs 4.33 mmHg OR 1.04 (95% CI: 1.01; 1.07)). Pulse pressure IAD was associated with pre-eclampsia (adjusted OR 1.04, 95% CI 1.01, 1.07) and term pre-eclampsia (OR 1.05, 95 % CI 1.02, 1.08), but not with preterm pre-eclampsia (OR 0.99, 95% CI 0.9, 1.06). There were no associations between systolic IAD, within-visit BP variability and pre-eclampsia.Conclusion Diastolic IAD and pulse pressure IAD in early pregnancy were higher in women developing pre-eclampsia. No association was found between systolic IAD or within-visit BP variability and pre-eclampsia.
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Skov et al. (2026) conducted a cohort in Pre-eclampsia (n=8,117). Early pregnancy inter-arm blood pressure differences (IAD) and within-visit blood pressure variability vs. Women not developing pre-eclampsia / lower IAD or BP variability was evaluated on Pre-eclampsia overall (and stratified into preterm <37 weeks and term ≥37 weeks) (OR 1.04, 95% CI 1.01-1.07). First-trimester pulse pressure inter-arm difference was weakly associated with pre-eclampsia (adjusted OR 1.04; 95% CI 1.01-1.07), while systolic IAD and BP variability showed no association.
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