The clinical significance of predictions based on screening second trimester mean arterial pressure: adverse maternal [corrected] and infant outcomes.
The design of a trial of primary prevention of hypertension in pregnancy rests on both the ability to identify women who are at risk and the definition of a clinically important outcome. The risk of developing antepartum hypertension can now be assessed nonivasively by the midpoint of pregnancy. However, maternal hypertension is not always associated with a clinically important adverse outcome for either mother or infant. The purpose of this study was to prospectively assess whether increasing risk of antepartum hypertension is associated with increasing rates of clinically important maternal and/or infant morbidity. We assembled a prospective cohort of 720 women with singleton pregnancies. The proportion of pregnancies complicated by both antepartum hypertension and maternal and/or infant morbidity increased significantly between low, moderate, and high risk groups (0.2, 6 and 58.8%, respectively, p less than 0.0001). We conclude that a trial of primary prevention of hypertension in pregnancy should include a measure of significant morbidity in mother and infant.
Ales
K L
KL
Department of Medicine, New York Hospital-Cornell University Medical Center, New York 10021.
Norton
M E
ME
Druzin
M L
ML
D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D011322:Primary Prevention; D011446:Prospective Studies; D012306:Risk