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Stage 1 hypertension defined by the 2017 ACC/AHA guidelines and neonatal outcomes: Systematic review and

Yue Xiao1, Jieyu Liu2, Haoyue Teng1

  • 1Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China; Department of Epidemiology and Health Statistics, School of Public Health, Medical College of Soochow University, Suzhou, China.

Pregnancy Hypertension
|July 10, 2021
PubMed

Insights

Stage 1 hypertension in pregnancy, defined by 2017 guidelines, significantly increases risks for preterm delivery and low birth weight. Early recognition of this condition is crucial for improving neonatal outcomes.

Area of Science:

  • Cardiology
  • Obstetrics & Gynecology
  • Neonatology

Background:

  • The 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines updated hypertension thresholds for adults.
  • Previous research on applying these lower thresholds to pregnancies and their impact on neonatal outcomes remains inconclusive.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis.
  • To evaluate the association between blood pressure (BP) categories from the 2017 ACC/AHA guidelines and pregnancy outcomes.

Main Methods:

  • Systematic literature search across PubMed, Google Scholar, Embase, and Web of Science.
  • Meta-analysis of 16 eligible studies involving 303,131 pregnancies.
  • Comparison of adverse pregnancy outcomes across normal BP, elevated BP, and stage 1 hypertension groups.

Main Results:

  • Elevated BP showed no significant association with adverse pregnancy outcomes compared to normal BP.
  • Stage 1 hypertension was significantly associated with increased odds of preterm delivery (OR 1.25), small for gestational age (OR 1.16), low birth weight (OR 1.50), and early-term delivery (OR 1.12).

Conclusions:

  • Stage 1 hypertension in pregnancy is a significant risk factor for adverse neonatal outcomes.
  • Recognizing stage 1 hypertension is vital for identifying pregnancies at risk and potentially improving outcomes.
Abstract

Keywords:
2017 ACC/AHA guidelineMeta-analysisNeonatalStage 1 hypertension

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