Inter-arm blood pressure differences and blood pressure variability in early pregnancy: limited associations with...

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.