Key result
Early pulse pressure inter-arm difference is linked to ~4% higher odds of pre-eclampsia.
Why the study?
The association between inter-arm blood pressure differences and within-visit blood pressure variability in early pregnancy with the subsequent development of pre-eclampsia required investigation.
Are inter-arm blood pressure differences and within-visit variability of blood pressure in early pregnancy associated with the development of pre-eclampsia?
Cohort (n=8,117)
Are inter-arm blood pressure differences and within-visit variability of blood pressure in early pregnancy associated with the development of pre-eclampsia?
In early pregnancy, higher diastolic and pulse pressure inter-arm differences are modestly associated with overall and term pre-eclampsia, whereas systolic inter-arm differences and within-visit blood pressure variability show no association.
Answers are grounded in this paper and cite their sources.
Modest association warrants no practice change; hypothesis-generating and leaves open whether pulse pressure IAD aids pre-eclampsia prediction.
To investigate an association of inter-arm blood pressure differences (IAD) and within-visit variability of blood pressure in early pregnancy with pre-eclampsia. 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). 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. 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). Inter-arm blood pressure differences (IAD) and within-visit blood pressure variability in early pregnancy vs. Women not developing pre-eclampsia / lower IAD 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). Pulse pressure inter-arm BP difference in early pregnancy was associated with pre-eclampsia (adjusted OR 1.04; 95% CI 1.01-1.07), whereas systolic IAD and BP variability were not.
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