title: Ambulatory BP monitoring and clinic BP in predicting small-for-gestational-age infants during pregnancy.
abstract: The significance of ambulatory blood pressure (ABP) monitoring during pregnancy has not been established. We performed a prospective study to elucidate whether ABP measures are associated with small-for-gestational-age birth weight (SGA). We studied 146 pregnant women who were seen for maternal medical checkups or suspected hypertension. ABP monitoring was performed for further assessment of hypertension. The outcome measure was SGA. The subjects were classified by their medical history and ABP as having preeclampsia or gestational hypertension (n=68 cases), chronic hypertension (n=48) or white-coat hypertension (n=30). There were 50 (34.2%) cases of SGA by the fetal growth reference standard. In multivariable logistic regression analyses adjusting for age, body mass index, the presence of prior pregnancy, current smoking habit and the use of antihypertensive medications, 24-h SBP (per 10 mm Hg (odds ratio (OR): 1.74; 95% confidence interval (CI): 1.28-2.38; P<0.001)) was more closely associated with SGA than clinic BP (OR: 1.40; 95% CI: 0.92-2.13; P=0.11). The results were essentially the same if 24-h BP was replaced by awake or sleep SBP. Ambulatory diastolic BP showed the same tendency. However, abnormal circadian rhythm was not associated with the outcome. In conclusion, ambulatory BP monitoring measures performed during pregnancy were more closely associated with SGA than clinic BP.
authors: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: K
authors: K
authors: Eguchi
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: T
authors: T
authors: Ohmaru
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: A
authors: http://orcid.org/0000-0002-8861-1572
authors: A
authors: Ohkuchi
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: C
authors: C
authors: Hirashima
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: K
authors: K
authors: Takahashi
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: H
authors: H
authors: Suzuki
authors: Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: K
authors: http://orcid.org/0000-0002-8251-4480
authors: K
authors: Kario
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: S
authors: S
authors: Matsubara
authors: Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Tochigi, Japan.
authors: Mitsuaki
authors: M
authors: Suzuki
mesh_terms: D000328:Adult; D001724:Birth Weight; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis*; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D059466:White Coat Hypertension / Q000175:diagnosis*