2018 Volume 6 Issue 2 Pages 38
Objective: Chronic hypertension is associated with an increased risk of preeclampsia and fetal growth restriction (FGR). Although recent guidelines recommend a systolic blood pressure (sBP) between 110 and 140 mmHg, the influence and goal of sBP control during early pregnancy have not been elucidated. This pilot study aimed to clarify the effects of tight hypertension control before 20 weeks’ gestation on pregnancy outcomes.
Methods: This retrospective study analyzed 37 cases of singleton pregnancies managed at our institution between January 2007 and June 2018, which were diagnosed with chronic hypertension either before pregnancy or within 14 weeks’ gestation. Patients were subdivided according to sBP between 16–20 weeks’ gestation: Group 1, sBP<130 mmHg; Group 2, 130≤sBP<140 mmHg; and Group 3, sBP≥140 mmHg. Between-group differences were assessed for the risk of preterm birth, FGR, and superimposed preeclampsia.
Results: Overall, 21 cases (60%) received antihypertensive medication before 20 weeks’ gestation. On comparing Group 1 (n=16) with Group 2 (n=10) and Group 3 (n=11), a significantly longer gestational duration (38.6±2.3, 34.8±4.6, and 30.9±3.8, respectively) and higher Z score (0.19±0.94, −0.97±1.1, and −2.0±1.4, respectively) were observed in Group 1. Moreover, the incidence of superimposed preeclampsia was significantly higher in Group 2 (60%) and Group 3 (72%), compared with Group 1 (31%).
Conclusion: Introducing tight sBP control before 16 weeks’ gestation was associated with good pregnancy outcomes in patients with chronic hypertension.