Kaminker Jennifer D, MacMaster Alexandra, Pudwell Jessica, King Kira, Smith Graeme N
School of Medicine, Queen's University, Kingston, Ontario, Canada (Kaminker, MacMaster and Smith).
Department of Obstetrics & Gynaecology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada (Pudwell, King and Smith).
AJOG Glob Rep. 2025 May 30;5(3):100519. doi: 10.1016/j.xagr.2025.100519. eCollection 2025 Aug.
Pregnancy induces a state of cardiovascular stress and can lead to long-lasting effects irrespective of complications in pregnancy. However, the magnitude of these effects needs to be clarified. This study seeks to determine the prevalence of newly diagnosed essential hypertension within one year postpartum among the obstetric population who experienced uncomplicated pregnancies.
A comprehensive search of the databases MEDLINE, Cochrane Central Register of Controlled Clinical Trials, EMBASE, Web of Science, and CINAHL was conducted for studies published up to March 2023.
Studies that assessed healthy individuals between 12 weeks and one year postpartum with newly diagnosed essential hypertension (≥140/90) and without pregnancy complications were included. Case studies, systematic reviews, and meta-analyses were excluded, along with studies involving pregnant patients who were either less than three months or more than one year postpartum, those with pre-existing hypertension or pregnancy complications, or those with pre-existing medical conditions.
Meta-analyses using random-effects models calculated pooled prevalence estimates and examined mean arterial pressure, systolic blood pressure, and diastolic blood pressure. Subgroup analyses considered the timing of blood pressure assessment, geographical location, and the presence of interventions.
In eight studies with 3070 participants, the prevalence of newly diagnosed hypertension was 2.96% (95% confidence interval [CI], 1.15%-7.43%; I², 80%). No significant differences were observed in the subgroup analyses. Across 30 studies with 1782 individuals, the average systolic blood pressure was 109.88 mmHg (95% CI, 108-111.75; I², 92.2%), and diastolic blood pressure was 70.99 mmHg (95% CI, 68.84-73.14; I², 95.7%). In 12 studies with 339 individuals, the average mean arterial pressure was 82.01 mmHg (95% CI, 79.84-84.19; I², 93.6%).
These findings suggest that nearly 3 in 100 healthy individuals with uncomplicated pregnancies are diagnosed with de novo essential hypertension within one year postpartum. This underscores the need to extend cardiovascular screening to all postpartum individuals for one year, regardless of medical or pregnancy history.
妊娠会引发心血管应激状态，且无论妊娠有无并发症，都可能产生长期影响。然而，这些影响的程度尚需明确。本研究旨在确定妊娠结局正常的产科人群产后一年内新诊断原发性高血压的患病率。
全面检索MEDLINE、Cochrane临床对照试验中心注册库、EMBASE、科学引文索引和护理学与健康领域数据库，纳入截至2023年3月发表的研究。
纳入评估产后12周内至产后一年的健康个体，这些个体新诊断为原发性高血压（收缩压≥140mmHg和舒张压≥90mmHg）且无妊娠并发症。排除病例研究、系统评价和荟萃分析，以及涉及产后不足三个月或超过一年的孕妇、有既往高血压或妊娠并发症的孕妇或有既往病史的孕妇的研究。
采用随机效应模型进行荟萃分析，计算合并患病率估计值，并检查平均动脉压、收缩压和舒张压。亚组分析考虑血压评估时间、地理位置和干预措施的存在情况。
在8项涉及3070名参与者的研究中，新诊断高血压的患病率为2.96%（95%置信区间[CI]，1.15%-7.43%；I²，80%）。亚组分析未观察到显著差异。在30项涉及1782名个体的研究中，平均收缩压为109.88mmHg（95%CI，108-111.75；I²，92.2%），舒张压为70.99mmHg（95%CI，68.84-73.14；I²，95.7%）。在12项涉及339名个体的研究中，平均动脉压为82.01mmHg（95%CI，79.84-84.19；I²，93.6%）。
这些发现表明，每100名妊娠结局正常的健康个体中，近3人在产后一年内被诊断为新发原发性高血压。这凸显了有必要对所有产后个体进行为期一年的心血管筛查，无论其病史或妊娠史如何。
