• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Is there an Association Between ‘White Coat’ Hypertension and Adverse Perinatal Outcomes?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • White coat hypertension (WCH)
    • Hypertensive disorder with elevated office BP (≥140/90 mm Hg) but a normal blood pressure measured at home or work (<135/85 mm Hg)
    • Approximately 25% of nonpregnant individuals may have WCH
    • Prevalence in pregnant population ranges from 4% to 30%
  • Johnson et al. (Hypertension, 2020) investigated whether white-coat hypertension (WCH) has an adverse effect on maternal, fetal, and neonatal outcomes

METHODS:

  • Systematic review and meta-analysis
  • Data sources 
    • Medline | EMBASE | Clinicaltrials.gov | Cochrane Library
  • Study inclusion criteria
    • Pregnant women diagnosed with apparent office hypertension throughout pregnancy who underwent 24-hour ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) | Maternal and fetal outcomes available
  • Groups
    • WCH
    • Normotensive controls
    • Chronic hypertension
    • Hypertensive disorder of pregnancy
  • Primary outcomes
    • Preeclampsia
    • Gestational age at delivery
    • Preterm birth (<37 weeks)
    • FGR or SGA

RESULTS:

  • Total of 12 studies met criteria
  • Women with WCH  had a significantly increased risk of
    • Preeclampsia: Pooled risk ratio (RR) 2.36 (95% CI, 1.16–4.78; P=0.017)
      • Subgroup analysis: Effect stronger when diagnosis at <20 weeks (RR 5.43)
    • SGA: RR 2.47 (95% CI, 1.21 to 5.05; P=0.013)
    • Preterm birth: RR 2.86 (95% CI, 1.44 to 5.68; P=0.002)
  • Compared to women with gestational hypertension, women with WCH had significantly lower risks for
    • Preeclampsia: RR 0.43 (95% CI, 0.23 to 0.78; P=0.005)
    • SGA: RR 0.46 (95% CI, 0.26 to 0.82; P=0.008)
    • Preterm birth: RR 0.47 (95% CI, 0.31 to 0.71; P<0.001)
  • Women with WCH delivered later compared with women with chronic hypertension
    • Mean difference: 1.06 weeks (95% CI, 0.44 to 1.67 weeks; P<0.001)

CONCLUSION:

  • Women with WCH during pregnancy had worse perinatal and maternal outcomes compared to normotensive patients
  • WCH was associated with better outcomes vs gestational or chronic hypertension
  • The authors conclude that

Women with WCH have HBPM or ABPM and should continue to be followed up because of their increased risk of developing preeclampsia, SGA neonate, and preterm birth

Learn More – Primary Sources:

Maternal and Perinatal Outcomes of White Coat Hypertension During Pregnancy
A systematic Review and Meta-Analysis

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Reducing White-Coat Hypertension
Is White Coat Hypertension Associated with Increased Cardiovascular Risk?
Does Hypertension in Pregnancy Predict Hypertension Later in Life?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site