Center for Perinatal Medicine, Tohoku University Hospital, Sendai, Miyagi, Japan.
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.
Hypertens Res. 2020 Jun;43(6):550-559. doi: 10.1038/s41440-020-0416-2. Epub 2020 Mar 10.
This study investigated the association between maternal home blood pressure (HBP) trajectory during pregnancy and infant birth weight. A total of 755 pregnant women were included in this prospective cohort study. A group-based trajectory model identified six trajectory groups for home systolic blood pressure (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). Next, the association of HBP trajectory groups with infant birth weight was evaluated using a general linear model considering potential confounding factors. For home SBP and MAP, the trajectory groups with a low-steep J-curve, moderate J-curve, little high J-curve, and high J-curve were significantly associated with lower infant birth weight than the low-J-curve group. Among the trajectory groups for home DBP, the moderate-steep J-curve, little high J-curve, and high J-curve were significantly associated with lower infant birth weight than the group with low-J-curve. The effect sizes of the trajectory groups varied in infant birth weight from -0.21 standard deviations (SDs) (95% confidence interval (CI): -0.42 to -0.01 SD) to -1.13 SD (95% CI: -1.54 to -0.72 SD). In the analyses of infant birth weight in grams, effect sizes that were significantly associated with infant birth weight varied from -84 g (95% CI: -167 to -1 g) to -567 g (95% CI: -732 to -402 g). Trajectory groups with a moderate-reverse J-curve for home SBP, DBP, and MAP were not significantly associated with infant birth weight. Maternal HBP trajectory during pregnancy was an indicator of infant birth weight. Further studies evaluating the associations between HBP during pregnancy and other perinatal outcomes are needed.
本研究旨在探讨孕妇孕期家庭血压(HBP)轨迹与婴儿出生体重之间的关系。这项前瞻性队列研究共纳入了 755 名孕妇。采用基于群组的轨迹模型确定了家庭收缩压(SBP)、舒张压(DBP)和平均动脉压(MAP)的 6 个轨迹群组。接下来,考虑到潜在的混杂因素,使用一般线性模型评估 HBP 轨迹组与婴儿出生体重的关联。对于家庭 SBP 和 MAP,低-陡峭 J 型曲线、中-陡峭 J 型曲线、小高 J 型曲线和高 J 型曲线的轨迹组与低 J 型曲线组相比,婴儿出生体重明显较低。对于家庭 DBP 的轨迹组,中-陡峭 J 型曲线、小高 J 型曲线和高 J 型曲线与低 J 型曲线组相比,婴儿出生体重明显较低。轨迹组在婴儿出生体重上的效应大小从-0.21 个标准差(95%置信区间(CI):-0.42 至-0.01 SD)到-1.13 SD(95% CI:-1.54 至-0.72 SD)不等。在婴儿出生体重以克为单位的分析中,与婴儿出生体重显著相关的效应大小从-84 克(95% CI:-167 至-1 克)到-567 克(95% CI:-732 至-402 克)不等。家庭 SBP、DBP 和 MAP 呈中-反向 J 型曲线的轨迹组与婴儿出生体重无显著关联。孕妇孕期 HBP 轨迹是婴儿出生体重的一个指标。需要进一步研究评估孕期 HBP 与其他围产期结局之间的关系。