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Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: an updated metaregression analysis.

von Dadelszen, P; Magee, LA (2002) Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: an updated metaregression analysis. Journal of Obstetrics and Gynaecology Canada, 24 (12). pp. 941-945. ISSN 1701-2163 https://doi.org/10.1016/S1701-2163(16)30592-8
SGUL Authors: von Dadelszen, Peter

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Abstract

OBJECTIVE: To update our previous analysis of randomized controlled trials in pregnancy hypertension, which discerned that greater treatment-induced decreases in maternal mean arterial pressure (MAP) appear to adversely affect fetal growth. METHODS: We conducted an English-language computer search of MEDLINE, Hypertension in Pregnancy, the relevant Cochrane reviews, and the bibliographies of retrieved papers, review articles, and standard obstetric and toxicology texts. Metaregression analysis was used to compare the change in MAP from enrollment to delivery with birth weight. RESULTS: Seven new trials with 335 women were added to the 27 trials with 2305 women previously reported. No new trials reported on the frequency of small for gestational age infants. Treatment-induced mean difference in MAP was associated with lower mean birth weight (slope: -17.55 [SD 6.67], r2 = 0.19, Spearman's non-parametric p = 0.031, Pearson's parametric p = 0.013). Therefore, over the range of reported mean differences in MAP, a 10 mm Hg fall in MAP was associated with a 176 g decrease in birth weight, and 19% of the birth weight difference between trials could be explained by differential blood pressure control. CONCLUSION: These results strengthen the association between blood pressure control and restricted fetal growth, and reinforce the need for new data to elucidate optimal antihypertensive use for mild to moderate pregnancy hypertension.

Item Type: Article
Additional Information: © 2002 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved. Made available with permission from the publisher. Contact publisher for any further re-use.
Keywords: Birth Weight, Blood Pressure, Female, Fetal Growth Retardation, Humans, Hypertension, Infant, Newborn, Infant, Small for Gestational Age, MEDLINE, Pregnancy, Pregnancy Complications, Cardiovascular, Randomized Controlled Trials as Topic, Regression Analysis, Humans, Fetal Growth Retardation, Pregnancy Complications, Cardiovascular, Hypertension, Birth Weight, Regression Analysis, Pregnancy, Blood Pressure, MEDLINE, Infant, Newborn, Infant, Small for Gestational Age, Female, Randomized Controlled Trials as Topic, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Journal of Obstetrics and Gynaecology Canada
ISSN: 1701-2163
Language: eng
Dates:
DateEvent
1 December 2002Published
Publisher License: Publisher's own licence
PubMed ID: 12464992
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/107541
Publisher's version: https://doi.org/10.1016/S1701-2163(16)30592-8

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