Blood Pressure Changes During Healthy & Hypertensive Pregnancy: A Systematic Review and Meta-Analysis

Author(s): MaIzab Alli

Preventing Gestational Hypertension: Deviant Haemodynamic Adjustments Affect Blood Pressure Our goal was to understand the timing and extent of blood pressure changes during singleton (normal) and hypertensive (hypertensive) pregnancies. We searched for relevant studies in PubMed (NCBI).We searched until November 2019.We included studies reporting original blood pressure during pregnancy combined with a non- pregnant reference measurement. We excluded studies in which women had a preexisting cardiovascular or metabolic disease or were taking antihypertensive medications. We pooled mean differences between pregnant women and non- pregnant women, and calculated absolute blood pressure values for pre-defined gestational intervals in normal and hypertensive pregnancy using a random-effect model.Meta-regression analysis to evaluate group differences in adjustments Blood pressure decreased in the first trimester of normal pregnancy, reaching its maximum reduction of −4 mmHg in the 2nd trimester (95% CI − 6–1 mmHg). Blood pressure decreased in both systoles and diastols (95% CI – 5–3 mmHg). Afterward, blood pressure increased towards pre-pregnancy values. All absolute blood pressure values throughout normal pregnancy were < 130/80 mmHg. Hypertensive pregnancies decreased only diastols at the beginning of pregnancy. Clinically moderate but significant mid pregnancy blood pressure decreases during normal pregnancy reinforce the current liberal cut-off limit of gestational hypertension Lack of a mid-pregnancy systolic drop may reflect increased vascular resistance in premenopausal women at risk for hypertensive pregnancy complication.