title: Relationship between body mass index and mean arterial pressure in normotensive and chronic hypertensive pregnant women: a prospective, longitudinal study.
abstract: BACKGROUND
  Being overweight is associated with both higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) during pregnancy and increased risk of gestational hypertensive disorders. The objective of this study was to determine and quantify the effect of body mass index (BMI) on mean arterial pressure (MAP) at several time points throughout pregnancy in normotensive (NT) and chronic hypertensive pregnant (HT) women.
  
  
  METHODS
  A prospective longitudinal study was carried out in 461 singleton pregnancies (429 low-risk and 32 with chronic arterial hypertension), with measurements taken at the 1(st), 2(nd), and 3(rd) trimesters and at delivery. Linear mixed-effects regression models were used to evaluate the time-progression of BMI, SBP, DBP and MAP during pregnancy (NT vs. HT). The longitudinal effect of BMI on MAP, adjusted for the hypertensive status, was investigated by the same methodology.
  
  
  RESULTS
  BMI consistently increased with time in both NT and HT women. In contrast, MAP decreased during the first half of pregnancy, after which it increased until the moment of delivery in both groups. A 5-unit increase in BMI was predicted to produce an increase of approximately 1 mmHg in population MAP values. This effect is independent from the time period and from hypertensive status.
  
  
  CONCLUSIONS
  In both NT and HT pregnant women, MAP is strongly (and significantly) influenced by increases in BMI.
authors.affiliation: Department of Women and Reproductive Medicine, Hospital Centre of Porto EPE, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. luis.guedes.martins@gmail.com.|Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. luis.guedes.martins@gmail.com.
authors.forename: Luís
authors.initials: L
authors.lastname: Guedes-Martins
authors.affiliation: Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313, Porto, Portugal. marianaslcc@hotmail.com.
authors.forename: Mariana
authors.initials: M
authors.lastname: Carvalho
authors.affiliation: Department of Mathematics, Faculty of Sciences, University of Porto, 4169-007, Porto, Portugal. catarinajoaosilva16@gmail.com.
authors.forename: Catarina
authors.initials: C
authors.lastname: Silva
authors.affiliation: Department of Women and Reproductive Medicine, Hospital Centre of Porto EPE, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. anacpcunha@gmail.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Cunha
authors.affiliation: Department of Women and Reproductive Medicine, Hospital Centre of Porto EPE, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. saraivajp@hotmail.com.|Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. saraivajp@hotmail.com.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Saraiva
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. filipe.macedo@hsjoao.min-saude.pt.
authors.forename: Filipe
authors.initials: F
authors.lastname: Macedo
authors.affiliation: Department of Women and Reproductive Medicine, Hospital Centre of Porto EPE, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. almeidah@med.up.pt.|Department of Experimental Biology, Faculty of Medicine, University of Porto, 4200-319, Porto, Portugal. almeidah@med.up.pt.|Obstetrics-Gynaecology, CUF-Hospital Porto, 4100 180, Porto, Portugal. almeidah@med.up.pt.
authors.forename: Henrique
authors.initials: H
authors.lastname: Almeida
authors.affiliation: Department of Mathematics, Faculty of Sciences, University of Porto, 4169-007, Porto, Portugal. argaio@fc.up.pt.|CMUP-Centre of Mathematics, University of Porto, 4169-007, Porto, Portugal. argaio@fc.up.pt.
authors.forename: A Rita
authors.initials: AR
authors.lastname: Gaio
mesh_terms: D000293:Adolescent; D000328:Adult; D062186:Arterial Pressure / Q000502:physiology*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology*; D008137:Longitudinal Studies; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D011247:Pregnancy; D011264:Pregnancy Trimesters / Q000502:physiology; D011446:Prospective Studies; D012307:Risk Factors; D044465:White People; D055815:Young Adult