Metoki Hirohito, Ohkubo Takayoshi, Watanabe Yumiko, Nishimura Misato, Sato Yurie, Kawaguchi Maiko, Hara Azusa, Hirose Takuo, Obara Taku, Asayama Kei, Kikuya Masahiro, Yagihashi Katsuyo, Matsubara Yoichi, Okamura Kunihiro, Mori Shigeru, Suzuki Masakuni, Imai Yutaka
Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences and Medicine, Sendai, Japan.
J Hypertens. 2008 Dec;26(12):2406-13. doi: 10.1097/HJH.0b013e32831364a7.
Blood pressure (BP) increases both in winter and in the last trimester of pregnancy. Some interaction seems to exist between season and gestational age. The present study observed home BP values during pregnancy with adjustment for seasonal variation and gestational age.
We observed 10353 home BP measurements from 101 normal pregnant women attending a maternity hospital in Japan. Home BP values were examined by mixed linear model adjusting for meteorological data and gestational age.
The lowest home BP values were observed in the second trimester [mean (+/-standard deviation) systolic/diastolic BP, 101.8 +/- 7.9/59.8 +/- 5.8 mmHg at gestational week 20]. In the last trimester, home BP values gradually increased and the values after gestational week 26 were significantly higher than those at gestational week 20 (110.1 +/- 9.7/66.8 +/- 7.7 mmHg at gestational week 40). A 10 degrees C increase in daily minimum outdoor temperature was associated with a mean reduction of 2.5/2.5 mmHg (Delta systolic BP/Delta diastolic BP: 95% confidence interval, 2.3/2.4 to 2.6/2.7 mmHg) in home BP with adjustment for gestational age. The largest and smallest estimated home BP changes during pregnancy were 12.8/12.5 and 3.1/3.0 mmHg in pregnant woman who delivered in January and July, respectively.
Interactions among BP, season and gestational age should be considered when evaluating BP in pregnant women. Risks associated with high BP might be underestimated in pregnant woman in summer who will deliver in winter.
血压在冬季和妊娠晚期均会升高。季节与孕周之间似乎存在某种相互作用。本研究观察了孕期家庭血压值，并对季节变化和孕周进行了校正。
我们观察了日本一家妇产医院101名正常孕妇的10353次家庭血压测量值。采用混合线性模型对家庭血压值进行分析，并对气象数据和孕周进行校正。
孕中期家庭血压值最低[平均（±标准差）收缩压/舒张压，孕20周时为101.8±7.9/59.8±5.8 mmHg]。妊娠晚期，家庭血压值逐渐升高，孕26周后的血压值显著高于孕20周时（孕40周时为110.1±9.7/66.8±7.7 mmHg）。每日最低室外温度每升高10℃，校正孕周后家庭血压平均降低2.5/2.5 mmHg（收缩压变化量/舒张压变化量：95%置信区间，2.3/2.4至2.6/2.7 mmHg）。1月和7月分娩的孕妇孕期家庭血压估计最大变化值和最小变化值分别为12.8/12.5 mmHg和3.1/3.0 mmHg。
评估孕妇血压时应考虑血压、季节和孕周之间的相互作用。对于冬季分娩的夏季孕妇，与高血压相关的风险可能被低估。
