Obstetrics & Gynecology · 2 h ago
White-Coat Hypertension in Early Pregnancy Linked to Hypertensive Disorders
A retrospective cohort study of 320 pregnant women assessed before 20 weeks compared three blood pressure phenotyping strategies. White-coat hypertension was associated with higher odds of hypertensive disorders of pregnancy across all strategies, while fetal-outcome associations were not detected.
- White-coat hypertension was associated with higher maternal hypertensive-disorder odds.
- Associations were similar across three classification strategies.
- About 12% of untreated women were reclassified between two models.
- Few fetal events limited assessment of fetal outcomes.
Researchers conducted a retrospective cohort study of 320 pregnant women evaluated before 20 weeks at a specialized hypertension-pregnancy clinic. They classified blood pressure phenotypes using three strategies, ranging from home monitoring alone to full ambulatory monitoring. Women taking antihypertensive medication before 20 weeks were classified as having sustained hypertension. Analyses adjusted for maternal age, body mass index, parity, previous hypertensive disorders and aspirin use.
White-coat hypertension was associated with higher odds of hypertensive disorders of pregnancy across the three models (adjusted odds ratios, 2.08–2.23; 95% CI, 1.01–4.93). Agreement between models was high in the full cohort (κ=0.878–0.943), but lower among 194 untreated women (κ=0.729–0.881); 24 untreated women (12.4%) were reclassified between the simplest and most comprehensive models. No association with adverse fetal outcomes was detected, but events were few.
The findings suggest that the association with maternal hypertensive disorders was not dependent on the classification strategy used. The authors describe home blood pressure monitoring as a reasonable first-line phenotyping tool, while noting that strategy choice may reclassify about one in eight untreated women. The retrospective, specialist-clinic cohort and limited fetal events constrain interpretation; the results do not establish that one strategy improves outcomes.
In practice
In pregnant patients evaluated before 20 weeks, this retrospective specialist-clinic cohort found white-coat hypertension associated with higher odds of hypertensive disorders of pregnancy across three phenotyping strategies. The authors consider home monitoring a reasonable first-line tool, but this study does not show that a particular monitoring approach improves maternal or fetal outcomes. Among untreated women, about 12% were classified differently between the simplest and most comprehensive models. The limited fetal events and selected cohort constrain applicability.
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Clinical Kidney Journal: White-Coat Hypertension in Early Pregnancy and Risk of Hypertensive Disorders: Consistency Across Blood Pressure Phenotyping Strategies ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.