Home Blood Pressure for the Prediction of Preeclampsia in Women With Preexisting Diabetes
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Home Blood Pressure for the Prediction of Preeclampsia in Women With Preexisting Diabetes. / Do, Nicoline Callesen; Vestgaard, Marianne; Asbjornsdottir, Bjorg; Andersen, Lise Lotte Torvin; Jensen, Dorte Moller; Ringholm, Lene; Damm, Peter; Mathiesen, Elisabeth Reinhardt.
I: Journal of Clinical Endocrinology & Metabolism, Bind 107, Nr. 9, 2022, s. E3670-E3678.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Home Blood Pressure for the Prediction of Preeclampsia in Women With Preexisting Diabetes
AU - Do, Nicoline Callesen
AU - Vestgaard, Marianne
AU - Asbjornsdottir, Bjorg
AU - Andersen, Lise Lotte Torvin
AU - Jensen, Dorte Moller
AU - Ringholm, Lene
AU - Damm, Peter
AU - Mathiesen, Elisabeth Reinhardt
PY - 2022
Y1 - 2022
N2 - Context Outside of pregnancy, home blood pressure (BP) has been shown to be superior to office BP for predicting cardiovascular outcomes. Objective This work aimed to evaluate home BP as a predictor of preeclampsia in comparison with office BP in pregnant women with preexisting diabetes. Methods A prospective cohort study was conducted of 404 pregnant women with preexisting diabetes; home BP and office BP were measured in early (9 weeks) and late pregnancy (35 weeks). Discriminative performance of home BP and office BP for prediction of preeclampsia was assessed by area under the receiver operating characteristic curves (AUC). Results In total 12% (n = 49/404) developed preeclampsia. Both home BP and office BP in early pregnancy were positively associated with the development of preeclampsia (adjusted odds ratio (95% CI) per 5 mm Hg, systolic/diastolic): home BP 1.43 (1.21-1.70)/1.74 (1.34-2.25) and office BP 1.22 (1.06-1.40)/1.52 (1.23-1.87). The discriminative performance for prediction of preeclampsia was similar for early-pregnancy home BP and office BP (systolic, AUC 69.3 [61.3-77.2] vs 64.1 [55.5-72.8]; P = .21 and diastolic, AUC 68.6 [60.2-77.0] vs 66.6 [58.2-75.1]; P = .64). Similar results were seen when comparing AUCs in late pregnancy (n = 304). In early and late pregnancy home BP was lower than office BP (early pregnancy P < .0001 and late pregnancy P < .01 for both systolic and diastolic BP), and the difference was greater with increasing office BP. Conclusion In women with preexisting diabetes, home BP and office BP were positively associated with the development of preeclampsia, and for the prediction of preeclampsia home BP and office BP were comparable.
AB - Context Outside of pregnancy, home blood pressure (BP) has been shown to be superior to office BP for predicting cardiovascular outcomes. Objective This work aimed to evaluate home BP as a predictor of preeclampsia in comparison with office BP in pregnant women with preexisting diabetes. Methods A prospective cohort study was conducted of 404 pregnant women with preexisting diabetes; home BP and office BP were measured in early (9 weeks) and late pregnancy (35 weeks). Discriminative performance of home BP and office BP for prediction of preeclampsia was assessed by area under the receiver operating characteristic curves (AUC). Results In total 12% (n = 49/404) developed preeclampsia. Both home BP and office BP in early pregnancy were positively associated with the development of preeclampsia (adjusted odds ratio (95% CI) per 5 mm Hg, systolic/diastolic): home BP 1.43 (1.21-1.70)/1.74 (1.34-2.25) and office BP 1.22 (1.06-1.40)/1.52 (1.23-1.87). The discriminative performance for prediction of preeclampsia was similar for early-pregnancy home BP and office BP (systolic, AUC 69.3 [61.3-77.2] vs 64.1 [55.5-72.8]; P = .21 and diastolic, AUC 68.6 [60.2-77.0] vs 66.6 [58.2-75.1]; P = .64). Similar results were seen when comparing AUCs in late pregnancy (n = 304). In early and late pregnancy home BP was lower than office BP (early pregnancy P < .0001 and late pregnancy P < .01 for both systolic and diastolic BP), and the difference was greater with increasing office BP. Conclusion In women with preexisting diabetes, home BP and office BP were positively associated with the development of preeclampsia, and for the prediction of preeclampsia home BP and office BP were comparable.
KW - pregnancy
KW - diabetes
KW - home blood pressure
KW - office blood pressure
KW - preeclampsia
KW - prediction
KW - MEAN ARTERIAL-PRESSURE
KW - CLINICAL-PRACTICE
KW - AMERICAN-COLLEGE
KW - ORGAN DAMAGE
KW - TASK-FORCE
KW - PREGNANCY
KW - HYPERTENSION
KW - BIOMARKERS
U2 - 10.1210/clinem/dgac392
DO - 10.1210/clinem/dgac392
M3 - Journal article
C2 - 35766641
VL - 107
SP - E3670-E3678
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 9
ER -
ID: 325381449