In a nutshell
This study examined the risks associated with tight control compared to less tight control of hypertension during pregnancy. The authors concluded that the risks of pregnancy loss, intensive care of newborns, and other maternity complication were not affected by the level of controlled hypertension.
Some background
About 10% of women who are pregnant have hypertension. This can be brought on by the pregnancy or may be a pre-existing condition. Types of hypertension brought on by the pregnancy are gestational hypertension or preeclampsia. These conditions can increase the risk of complications for both the mother and the fetus. It is thought that tight control of hypertension during pregnancy may benefit the mother, but could contribute to poor fetal development. It is not clear if less tight controls would be more or less beneficial for both the mother and the fetus.
Methods & findings
987 women who were pregnant and had pre-existing or gestational hypertension were included in this study. Women were randomly assigned to adhere to either tight control or less tight control of their condition. Tight control was a target diastolic blood pressure (DBP- pressure when the heart is between beats) of 85 mm Hg. Less tight control was a target DBP of 100 mm Hg.
The average gestational age at delivery and rate of cesarean deliveries was similar in both groups. The number of serious complications, pregnancy losses, and infants requiring intensive care was also similar between groups.
The rate of severe hypertension was 40.6% in the less-tight control group compared to just 27.5% in the tight control group. Average DBP was 4.6 mm Hg higher in the less-tight control group.
The bottom line
The authors concluded that the risks of pregnancy loss, intensive care of newborns, and other maternity complication were not affected by the level of controlled hypertension.
The fine print
Only women with pre-existing or gestational hypertension were included in this study. Women with eclampsia or preeclampsia were not assessed.
What’s next?
Consult with your physician for advice on controlling hypertension during pregnancy.
Published By :
The New England Journal of Medicine
Date :
Jan 29, 2015
