Measurements of blood pressure, oedema and proteinuria in a pregnant population of New Zealand.
This is the first report of the largest study of blood pressure measurement in pregnancy in a New Zealand population using standardized definitions and methodology. Over 3,800 women who delivered in an 8-month period in the Wellington region were included in the study. Blood pressure measurement and the presence of oedema and proteinuria were recorded from booking until delivery and in the puerperium. Only 2.7% of women were unable to be contacted after delivery for details on outcomes. The results established normal ranges for blood pressure throughout pregnancy. The data show that blood pressure greater than 140/90 until 35 weeks' gestation is outside 2 standard deviations at all gestations and justifies using these measurements as the definition of hypertension in pregnancy. The fall in blood pressure in the 2nd trimester was less than 1 mm Hg per week in both the systolic and diastolic pressures. This fall was smaller than previously recorded in other studies. Gestational hypertension was the commonest blood pressure abnormality occurring in 15.2% of the population. This represented 69% of the pregnant women with a hypertensive disorder. The overall incidence of both gestational hypertension and preeclampsia was 18.5% which is higher than reported in other parts of the world. In this study obesity was significantly associated with hypertensive disorders in pregnancy. An arm circumference of > 33 cm, one of the measurements of obesity, was found in 6.8% of the study population. Even after the effect of arm circumference was taken into account, hypertensive disorders were also more common in Pacific Island women.(ABSTRACT TRUNCATED AT 250 WORDS)
Stone
P
P
Department of Obstetrics and Gynaecology, Wellington School of Medicine, New Zealand.
Cook
D
D
Hutton
J
J
Purdie
G
G
Murray
H
H
Harcourt
L
L
D001794:Blood Pressure; D001795:Blood Pressure Determination; D005260:Female; D006801:Humans; D015994:Incidence; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D011159:Population Surveillance; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis