title: Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort.
abstract: BACKGROUND
  The maternal cardiovascular system undergoes progressive adaptations throughout pregnancy, causing blood pressure fluctuations. However, no consensus has been established on its normal variation in uncomplicated pregnancies.
  
  
  OBJECTIVE
  To describe the variation in systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels during pregnancy according to early pregnancy body mass index (BMI).
  
  
  METHODS
  SBP and DBP were measured during the first, second and third trimesters and at 30-45 days postpartum in a prospective cohort of 189 women aged 20-40 years. BMI (kg/m2) was measured up to the 13th gestational week and classified as normal-weight (<25.0) or excessive weight (≥ 25.0). Longitudinal linear mixed-effects models were used for statistical analysis.
  
  
  RESULTS
  A decrease in SBP and DBP was observed from the first to the second trimester (βSBP=-0.394; 95%CI: -0.600- -0.188 and βDBP=-0.617; 95%CI: -0.780- -0.454), as was an increase in SBP and DBP up to 30-45 postpartum days (βSBP=0.010; 95%CI: 0.006-0.014 and βDBP=0.015; 95%CI: 0.012-0.018). Women with excessive weight at early pregnancy showed higher mean SBP in all gestational trimesters, and higher mean DBP in the first and third trimesters. Excessive early pregnancy BMI was positively associated with prospective changes in SBP (βSBP=7.055; 95%CI: 4.499-9.610) and in DBP (βDBP=3.201; 95%CI: 1.136-5.266).
  
  
  CONCLUSIONS
  SBP and DBP decreased from the first to the second trimester and then increased up to the postpartum period. Women with excessive early pregnancy BMI had higher SBP and DBP than their normal-weight counterparts throughout pregnancy, but not in the postpartum period.
authors.affiliation: Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Rebelo
authors.affiliation: Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Dayana Rodrigues
authors.initials: DR
authors.lastname: Farias
authors.affiliation: Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Roberta Hack
authors.initials: RH
authors.lastname: Mendes
authors.affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Michael Maia
authors.initials: MM
authors.lastname: Schlüssel
authors.affiliation: Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Kac
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D001938:Brazil; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D059012:Lost to Follow-Up; D009765:Obesity / Q000503:physiopathology; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000502:physiology*; D011446:Prospective Studies; D013599:Systole / Q000502:physiology; D055815:Young Adult