Nocturnal blood pressure alterations in patients with preeclampsia – Do they really matter? A systematic review of the literature

Prediction and prevention of preeclampsia in women with preexisting diabetes: the role of home blood pressure, physical activity, and aspirin

Women with type 1 or type 2 (preexisting) diabetes are four times more likely to develop preeclampsia compared with women without diabetes. Preeclampsia affects 9%-20% of pregnant women with type 1 diabetes and 7%-14% of pregnant women with type 2 diabetes. The aim of this narrative review is to investigate the role of blood pressure (BP) monitoring, physical activity, and prophylactic aspirin to reduce the prevalence of preeclampsia and to improve pregnancy outcome in women with preexisting diabetes. Home BP and office BP in early pregnancy are positively associated with development of preeclampsia, and home BP and office BP are comparable for the prediction of preeclampsia in women with preexisting diabetes. However, home BP is lower than office BP, and the difference is greater with increasing office BP. Daily physical activity is recommended during pregnancy, and limiting sedentary behavior may be beneficial to prevent preeclampsia. White coat hypertension in early pregnancy is not a clinically benign condition but is associated with an elevated risk of developing preeclampsia. This renders the current strategy of leaving white coat hypertension untreated debatable. A beneficial preventive effect of initiating low-dose aspirin (150 mg/day) for all in early pregnancy has not been demonstrated in women with preexisting diabetes.

The relationship between circadian blood pressure variability and maternal/perinatal outcomes in women with preeclampsia with severe features

OBJECTIVE

To determine whether circadian blood pressure (BP) variation of women with preeclampsia (PE) with severe features was associated with adverse maternal/perinatal outcomes.

METHODS

173 women with PE with severe features were recruitedand categorized into three groups: dipper, non-dipper and reverse dipper type BP group.. Maternal and perinatal outcomes were compared among groups.

RESULTS

There were significant differences in gestational ages, premature delivery, retinopathy, HELLP syndrome, mean birth weight, rate of low birth weight infants and fetal growth restriction.

CONCLUSION

Aberrant circadian pattern of BP in women with PE with severe features was associated with several adverse maternal/perinatal outcomes.

Current Resources for Evidence-Based Practice, May 2020

An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of a new National Academy of Medicine report on planned place of birth and implications during the SARS-CoV-2 pandemic and commentaries on reviews focused on anorectal sexually transmitted infections and feeding methods following cleft lip repair in infants.