Maternal clinic and home blood pressure measurements during pregnancy and infant birth weight: the BOSHI study.
This prospective cohort study compared measurements of maternal home blood pressure (HBP) with clinic blood pressure (CBP) before 20 weeks' gestation to determine associations with the risk of delivering a lower birth weight infant. A total of 605 Japanese women were included. Exposures were initial CBP, made between 10 weeks 0 days and 19 weeks 0 days, and HBP for comparison made within 1 week of CBP. Outcome was infant's birth weight, categorized and ranked as follows: ⩾3500 g, 3000-3499 g, 2500-2999 g and <2500 g. The proportional odds model with possible confounding factors was applied to compare the associations between CBP and HBP on infant birth weight. When both CBP and HBP were included simultaneously, the adjusted odds ratios (ORs) per 1 standard deviation (1s.d.) increase in clinic and home diastolic BP (DBP) were 1.06 (95% confidence interval (CI): 0.87-1.30) and 1.28 (95% CI: 1.04-1.58), respectively. The adjusted ORs per 1s.d. increase in clinic and home mean arterial pressure (MAP) were 1.02 (95% CI: 0.83-1.24) and 1.29 (95% CI: 1.04-1.59), respectively. Systolic BP measurement was not associated with infant birth weight. In conclusion, high maternal home DBP and MAP before 20 weeks' gestation was associated with a higher risk of lower infant birth weight than clinic DBP and MAP. Therefore, in addition to CBP, it may be worth having pregnant women measure HBP to determine the risk of lower infant birth weight.
Tohoku University Graduate School of Medicine, Sendai, Japan.|Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan.
Noriyuki
N
Iwama
Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan.|Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Hirohito
H
Metoki
Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
Takayoshi
T
Ohkubo
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Mami
M
Ishikuro
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Taku
T
Obara
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Masahiro
M
Kikuya
Suzuki Memorial Hospital, Iwanuma, Japan.
Katsuyo
K
Yagihashi
Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan.
Hidekazu
H
Nishigori
Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan.
Takashi
T
Sugiyama
Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan.|Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Junichi
J
Sugawara
Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan.
Nobuo
N
Yaegashi
Suzuki Memorial Hospital, Iwanuma, Japan.
Kazuhiko
K
Hoshi
Suzuki Memorial Hospital, Iwanuma, Japan.
Masakuni
M
Suzuki
Division of Molecular Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Shinichi
S
Kuriyama
Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan.
Yutaka
Y
Imai
D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult