From the Journals

Higher preconception blood pressure linked to pregnancy loss



High preconception blood pressure is associated with a greater risk of pregnancy loss, according to analysis of data from a randomized clinical trial of aspirin and pregnancy outcomes.

Researchers in the EAGeR (Effects of Aspirin on Gestational and Reproduction) trial analyzed data from 1,228 women attempting pregnancy with a history of pregnancy loss. After researchers adjusted for treatment assignment, body mass index (BMI), race, marital status, smoking, parity, and time from last pregnancy loss, an increase in all blood pressure measures was associated with a 17% increase in the risk of pregnancy loss (Hypertension. doi: 10.1161/hypertensionaha.117.10705).

A young woman recieving a blood pressure measurement. thodonal/Thinkstock
Each 10–mm Hg increase in mean arterial pressure or in diastolic blood pressure was associated with a 14% greater risk of pregnancy loss.

Women with blood pressure levels higher than the thresholds for stage I and stage II hypertension had a 15% and 18% higher risk of pregnancy loss, respectively, compared with women with normal blood pressure, although the authors noted that group sizes were small.

Overall, one-quarter of the women enrolled in the study met the criteria for hypertension stage I, and 4.3% met the criteria for hypertension stage II.

“Screening and lifestyle interventions targeting maintenance of healthy blood pressure levels among reproductive-aged women may have additional important short-term benefits on reproductive health,” wrote Carrie J. Nobles, MD, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and coauthors.

The authors also saw an impact of early pregnancy blood pressure on pregnancy loss, with an 18% greater risk of loss with each 10–mm Hg increase in mean arterial pressure.

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