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
Hypertensive disorder of pregnancy
Gestational age at delivery
Preterm birth (<37 weeks)
FGR or SGA
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)
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
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