title: Association of three different techniques to measure blood pressure in the first trimester with the development of hypertensive disorders of pregnancy.
abstract: OBJECTIVE
  It is not known whether automated devices for measuring blood pressure perform better than conventional sphygmomanometry in predicting preeclampsia. This study compares two different automated devices with conventional sphygmomanometry for their association with development of preeclampsia or gestational hypertension.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  University hospital, Amsterdam, the Netherlands.
  
  
  METHODS
  289 healthy normotensive women of whom 235 were nulliparous and 44 parous with preeclampsia in a previous pregnancy.
  
  
  METHODS
  At 8-11 weeks of pregnancy, blood pressure was measured with two different automated devices (continuous finger arterial pressure waveform registration and ambulatory blood pressure monitoring) and with conventional sphygmomanometry.
  
  
  METHODS
  Preeclampsia and gestational hypertension.
  
  
  RESULTS
  Blood pressure in the first trimester, as measured with all three methods, was significantly higher in women who developed preeclampsia or gestational hypertension. After adjustment for previous preeclampsia, the point estimate of the odds ratios for association with later preeclampsia for both automated devices were comparable and higher than for conventional sphygmomanometry; however, differences were not statistically significant. The odds ratio (95% confidence intervals) for every 1 mmHg pressure increase of mean arterial pressure was 1.08 (1.02-1.15) for sphygmomanometry, 1.17 (1.09-1.27) for finger arterial pressure waveform registration, and 1.17 (1.07-1.27) for ambulatory blood pressure monitoring. Results were comparable if preeclampsia and gestational hypertension were analyzed together.
  
  
  CONCLUSIONS
  Blood pressure in the first trimester was associated with the development of hypertensive disorders of pregnancy. No significant differences were found between measurements by automatic devices compared with conventional sphygmomanometry.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, the Netherlands. mail@kcvollebregt.nl
authors.forename: Karlijn Corien
authors.initials: KC
authors.lastname: Vollebregt
authors.forename: Kees
authors.initials: K
authors.lastname: Boer
authors.forename: Joris A M
authors.initials: JA
authors.lastname: Van Der Post
authors.forename: Hans
authors.initials: H
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001795:Blood Pressure Determination / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis*; D009426:Netherlands; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012372:ROC Curve; D019722:Sphygmomanometers