{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T17:58:43Z","timestamp":1778954323667,"version":"3.51.4"},"reference-count":47,"publisher":"Georg Thieme Verlag KG","issue":"15","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:p>\n            Objective\u2003The American College of Obstetrics threshold for hypertension (\u2265140\/90\u2009mm Hg) differs from those of the American College of Cardiology (ACC) and the American Heart Association (AHA). It is unknown if ACC\/AHA hypertension levels are associated with adverse pregnancy outcomes (APOs) after 20 weeks gestation. The purpose of this study is to analyze APOs in women with blood pressure (BP) in the elevated or stage 1 range after 20 weeks gestation.<\/jats:p><jats:p>\n            Study Design\u2003This was a secondary analysis of the nuMoM2b prospective cohort study of 10,038 nulliparous, singleton pregnancies between 2010 and 2014. BP was measured at three visits during the pregnancy using a standard protocol. Women without medical comorbidities, with normal BP by ACC\/AHA guidelines (systolic BP [SBP]\u2009&lt;\u2009120 and diastolic BP [DBP]\u2009&lt;\u200980\u2009mm Hg) up to 22 weeks, were included. Exposure was BP between 22 and 29 weeks gestation: normal (SBP\u2009&lt;\u2009120 and DBP\u2009&lt;\u200980\u2009mm Hg), elevated (SBP: 120\u2013129 and DBP\u2009&lt;\u200980\u2009mm Hg), and stage 1 (SBP: 130\u2013139 or DBP: 80\u201389\u2009mm Hg). The primary outcome was hypertensive disorder of pregnancy (HDP) at delivery. Secondary outcomes included fetal growth restriction (FGR), placental abruption, preterm delivery, and cesarean delivery. Multivariable-adjusted odds ratio (aORs) and 95% confidence intervals (CIs) were estimated using logistic regression models.<\/jats:p><jats:p>\n            Results\u2003Of 4,460 patients that met inclusion criteria, 3,832 (85.9%) had BP in the normal range, 408 (9.1%) in elevated, and 220 (4.9%) in stage 1 range between 22 and 29 weeks. The likelihood of HDP was significantly higher in women with elevated BP (aOR: 1.71, 95%CI: 1.18,2.48), and stage 1 BP (aOR: 2.79, 95%CI: 1.84,4.23) compared to normal BP (p\u2009&lt;\u20090.001). Stage 1 BP had twice odds of FGR (aOR: 2.33, 95%CI: 1.22,4.47) and elevated BP had three times odds of placental abruption (aOR: 3.03; 95%CI: 1.24,7.39).<\/jats:p><jats:p>\n            Conclusion\u2003Elevated or stage 1 BP &gt;20 weeks of pregnancy are associated with HDP, FGR, and placental abruption.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2298-5347","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T22:34:27Z","timestamp":1712183667000},"page":"2135-2143","source":"Crossref","is-referenced-by-count":6,"title":["Pregnancy Outcomes in Women Who Developed Elevated Blood Pressure and Stage I Hypertension after 20 Weeks, Gestation"],"prefix":"10.1055","volume":"41","author":[{"given":"Helen","family":"Woolcock","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New 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Medical Center, Los Angeles, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliza","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Neurology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0405-069X","authenticated-orcid":false,"given":"Whitney A.","family":"Booker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,4,23]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1097\/AOG.0000000000003020","article-title":"ACOG Practice Bulletin No. 203: Chronic Hypertension in Pregnancy","volume":"133","author":"American 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and race","volume":"33","author":"C Gyamfi-Bannerman","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1097\/AOG.0000000000002441","article-title":"Racial disparities in adverse pregnancy outcomes and psychosocial stress","volume":"131","author":"W A Grobman","year":"2018","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1080\/14767058.2017.1374363","article-title":"Prehypertension in early versus late pregnancy","volume":"32","author":"J Y Rosner","year":"2019","journal-title":"J Matern Fetal Neonatal Med"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"606.e1","DOI":"10.1016\/j.ajog.2019.12.272","article-title":"Challenging the definition of hypertension in pregnancy: a retrospective cohort study","volume":"222","author":"M Reddy","year":"2020","journal-title":"Am J Obstet 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Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy","volume":"122","year":"2013","journal-title":"Obstet Gynecol"},{"issue":"02","key":"ref44","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1161\/HYP.0000000000000208","article-title":"Hypertension in pregnancy: diagnosis, blood pressure goals, and pharmacotherapy: a scientific statement from the American Heart Association","volume":"79","author":"V D Garovic","year":"2022","journal-title":"Hypertension"},{"issue":"19","key":"ref45","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1056\/NEJMoa2201295","article-title":"Treatment for mild chronic hypertension during pregnancy","volume":"386","author":"A T Tita","year":"2022","journal-title":"N Engl J Med"},{"issue":"02","key":"ref46","doi-asserted-by":"crossref","first-page":"B24","DOI":"10.1016\/j.ajog.2022.04.011","article-title":"Society for Maternal-Fetal Medicine Statement: antihypertensive therapy for mild chronic hypertension in pregnancy\u2014the chronic hypertension and pregnancy trial","volume":"227","author":"Society for Maternal-Fetal Medicine; Publications Committee. 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