title: Transient gestational hypertension: Not always a benign event.
abstract: OBJECTIVE
  Pregnancy outcome in women with transient gestational hypertension (TGH);defined as de novo blood pressure elevation after 20weeks gestation that normalizes by subsequent evaluation in a Day Assessment Unit.
  
  
  METHODS
  Retrospective cohort analysis of hypertensive pregnancies between 2003 and 2008.
  
  
  METHODS
  Final hypertensive delivery diagnosis and composites of adverse maternal and fetal outcome.
  
  
  RESULTS
  Overall 1417 women were referred; 890 met criteria; 41% (65% of study population) had TGH. Twenty percent with TGH developed gestational hypertension and 19% preeclampsia. Women with TGH who developed preeclampsia had similar composite adverse maternal outcomes to other preeclamptic women (51% vs. 63%; p=0.24) but fewer adverse fetal outcomes (50% vs. 71%; p<0.01) due to less prematurity (30% vs. 45%; p=0.02) and small for gestational age babies (33% vs. 51%; p=0.02). Within the TGH population;developing gestational hypertension or preeclampsia was associated with referral at gestation <33weeks (RRR 2.8; p<0.01);initial average systolic blood pressure 130-139mmHg (RRR 2.1; p<0.01) and initial average diastolic blood pressure 80-89mmHg (RRR 3.2; p<0.01).
  
  
  CONCLUSIONS
  TGH after 20weeks is common in pregnancy. Although initial assessment implies low risk;the risk of progression to gestational hypertension or preeclampsia is substantial and warrants appropriate clinical surveillance.
authors.affiliation: Departments of Medicine and Obstetrics and Gynaecology, University of Calgary, Alberta, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Lee-Ann Hawkins
authors.affiliation: Department of Women's Health, St. George Hospital, University of New South Wales, Kogarah, NSW, Australia; Departments of Renal Medicine and Medicine, St. George Hospital, University of New South Wales, Kogarah, NSW, Australia. Electronic address: mbrown@unsw.edu.au.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Brown
authors.affiliation: Department of Women's Health, St. George Hospital, University of New South Wales, Kogarah, NSW, Australia; Departments of Renal Medicine and Medicine, St. George Hospital, University of New South Wales, Kogarah, NSW, Australia.
authors.forename: George J
authors.initials: GJ
authors.lastname: Mangos
authors.affiliation: Department of Women's Health, St. George Hospital, University of New South Wales, Kogarah, NSW, Australia.
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Davis
keywords: Gestational hypertension; Preeclampsia; Pregnancy; Transient gestational hypertension