‘Stage 1 hypertension’: RR 3.0 (95% PI, 1.1 to 8.5)
‘Stage 2 hypertension’: RR 7.9 (95% PI, 1.8 to 35.1)
There was between-study variability, and this was related to the magnitude of association
Stronger relationships seen among
Larger studies at low-risk of bias
Unselected populations with multiple routine BP measurements
None of the following were determined to be useful in ruling out development of preeclampsia (all had negative likelihood ratios [LRs] >0.2)
Systolic BP <120 mmHg
The only good rule-in test for development of preeclampsia was BP ≥140/90mmHg (+LR 5.95)
Findings were similar for other primary outcomes
While having elevated and stage 1 BP was associated with a higher risk for preeclampsia and other adverse outcomes, these lower thresholds may not be clinically useful
The authors state
This systematic review of publications examining the relationship between 2017 ACC/AHA BP criteria and pregnancy outcomes has found no evidence that lowering the diagnostic threshold for chronic hypertension in pregnancy to below 140/90mmHg would assist clinicians in identifying women more likely to develop preeclampsia or other adverse pregnancy outcomes
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