title: Ethnic differences in blood pressure from early pregnancy to postpartum: a Norwegian cohort study.
abstract: To examine blood pressure (BP) differences and changes between and within ethnic Western European, South Asian, Middle Eastern, East Asian, African, and East European living in Norway, from early pregnancy to postpartum and to explore associations between BP and explanatory variables.
  
  
  
  This was a population-based cohort study of 811 healthy pregnant women, 59% had ethnic minority origin. Participants were from Western Europe, Eastern Europe, South Asia, East Asia, Middle East, and Africa. We performed ANOVA, generalized estimating equations linear regression and multiple linear regression analysis.
  
  
  
  At 15 weeks' gestation, mean SBP were 4.9-7.0 mmHg lower and mean DBP 2.1-3.4 mmHg lower for the non-Europeans compared with Western Europeans. SBP increased in all non-European groups from 15 weeks' gestation to 14 weeks' postpartum (P < 0.01), but not in Europeans. Ethnic differences were further reduced postpartum, with only South Asians having lower mean SBP than Western Europeans (P < 0.01). The ethnic differences persisted after adjusting for age, family history of cardiovascular disease, prepregnancy BMI, and prepregnancy physical activity. Age, prepregnancy BMI, prepregnancy physical activity, postpartum weight retention, and breastfeeding were independently associated with postpartum BP (P < 0.05).
  
  
  
  Pregnancy may have a more adverse effect on BP trajectories from early pregnancy to postpartum among non-European women compared with Western Europeans, despite their more favorable BP in early pregnancy.
authors.affiliation: aDepartment of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital bFaculty of Medicine, University of Oslo, Institute of Health and Society cSection for Obstetrics, Women and Children's Division, Oslo University Hospital Rikshospitalet dNorwegian National Advisory Unit on Women's Health, Oslo University Hospital eInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo fDepartment of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Christin W
authors.initials: CW
authors.lastname: Waage
authors.forename: Ibrahimu
authors.initials: I
authors.lastname: Mdala
authors.forename: Anne Karen
authors.initials: AK
authors.lastname: Jenum
authors.forename: Trond M
authors.initials: TM
authors.lastname: Michelsen
authors.forename: Kåre I
authors.initials: KI
authors.lastname: Birkeland
authors.forename: Line
authors.initials: L
authors.lastname: Sletner
mesh_terms: D000349:Africa / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D001942:Breast Feeding; D015331:Cohort Studies; D005060:Europe / Q000208:ethnology; D005061:Europe, Eastern / Q000208:ethnology; D015444:Exercise; D005260:Female; D006801:Humans; D008423:Maternal Age; D009664:Norway; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology*; D011262:Pregnancy Trimester, Second / Q000502:physiology*