Prehypertension during pregnancy and risk of small for gestational age: a systematic review and meta-analysis. (17th April 2020)

• Record Type: Journal Article
• Authors: Cao, Chunxia; Cai, Wei; Niu, Xiulong; Fu, Jiaxi; Ni, Jianmei; Lei, Qiong; Niu, Jianmin; Zhou, Xin; Li, Yuming
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 33:Number 8(2020)
• Page Start: 1447
• Page End: 1454
• Publication Date: 2020-04-17
• Subjects: Birth weight -- blood pressure -- pregnancy -- prehypertension -- small for gestational age; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2018.1519015
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective: Emerging evidence shows that high blood pressure (BP) level even below 140/90 mmHg during pregnancy is associated with increased risk for maternal and infant complications. The meta-analysis evaluated the associations between prehypertension (BP 120–139/80–89 mmHg) during pregnancy and the risk of small for gestational age (SGA), as well as the impact of prehypertension on birth weight (BW). Methods: Databases (PubMed, Embase, and Cochrane Library) were searched for cohort studies with data on prehypertension in pregnancy and adverse obstetrical outcomes, including SGA and/or BW. The relative risks (RRs) of SGA and weighted mean differences (WMD) in BW were calculated and reported with 95% confidence intervals (95% CIs). We calculated pooled RRs using fixed- and random-effects models. Results: A total of 143, 835 participants from five cohort studies were included. Prehypertension in pregnancy increased the risk of SGA (RR 1.59, 95%CI 1.44 to 1.76, p < .00001) and lowered BW (WMD −13.71, 95% CI −83.28 to 55.87, p = .70) compared with optimal BP (<120/80 mmHg). In subgroup analyses, for prehypertension in late pregnancy, the risk of SGA was significantly higher than for optimal BP (RR 1.60, 95% CI 1.44 to 1.78). Conclusion: BP within the range of 120–139/80–89 mmHg during pregnancy, as previously defined as prehypertension, particularly in late pregnancy, was associated with a 59% increase in the risk of having an SGA birth.