{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T19:07:22Z","timestamp":1788030442570,"version":"build-2784847793"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"S 01","funder":[{"name":"Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine"},{"name":"Eunice Kennedy Shriver National Institute of Child Health & Human Development Building Interdisciplinary Research in Women's Health (BIRCWH) Award","award":["K12-HD085845"],"award-info":[{"award-number":["K12-HD085845"]}]},{"name":"Johns Hopkins University School of Medicine Robert E. Meyerhoff Professorship Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>\n            Objective\u2003The aim of the study is to compare maternal and neonatal outcomes among patients who are normotensive, hypertensive by Stage I American College of Cardiology-American Heart Association (ACC-AHA) criteria, and hypertensive by American College of Obstetricians and Gynecologists (ACOG) criteria.<\/jats:p><jats:p>\n            Study Design\u2003Secondary analysis of a prospective first trimester cohort study between 2007 and 2010 at three institutions in Baltimore, MD, was conducted. Blood pressure at 11 to 14 weeks' gestation was classified as (1) normotensive (systolic blood pressure [SBP] &lt;130\u2009mm Hg and diastolic blood pressure [DBP] &lt;80\u2009mm Hg); (2) hypertensive by Stage I ACC-AHA criteria (SBP 130\u2013139\u2009mm Hg or DBP 80\u201389\u2009mm Hg); or (3) hypertensive by ACOG criteria (SBP \u2265140\u2009mm Hg or DBP \u226590\u2009mm Hg). Primary outcomes included preeclampsia, small for gestational age (SGA) neonate, and preterm birth.<\/jats:p><jats:p>\n            Results\u2003Among 3,422 women enrolled, 2,976 with delivery data from singleton pregnancies of nonanomalous fetuses were included. In total, 20.2% met hypertension criteria (Stage I ACC-AHA n\u2009=\u2009254, 8.5%; ACOG n\u2009=\u2009347, 11.7%). The Stage I ACC-AHA group's risk for developing preeclampsia was threefold higher than the normotensive group (adjusted relative risk [aRR] 3.70, 95% confidence interval [CI] 2.40\u20135.70). The Stage I ACC-AHA group had lower preeclampsia risk than the ACOG group but the difference was not significant (aRR 0.87, 95% CI 0.55\u20131.37). The Stage I ACC-AHA group was more likely than the normotensive group to deliver preterm (aRR 1.44, 95% CI 1.02\u20132.01) and deliver an SGA neonate (aRR 1.51, 95% CI 1.07\u20132.12). The Stage I ACC-AHA group was less likely to deliver preterm compared with the ACOG group (aRR 0.65, 95% CI 0.45\u20130.93), but differences in SGA were not significant (aRR 1.31, 95% CI 0.84\u20132.03).<\/jats:p><jats:p>\n            Conclusion\u2003Pregnant patients with Stage I ACC-AHA hypertension in the first trimester had higher rates of preeclampsia, preterm birth, and SGA neonates compared with normotensive women. Adverse maternal and neonatal outcomes were numerically lower in the Stage I ACC-AHA group compared with the ACOG group, but these comparisons only reached statistical significance for preterm birth. Optimal pregnancy management for first trimester Stage I ACC-AHA hypertension requires active study.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0040-1709465","type":"journal-article","created":{"date-parts":[[2020,5,23]],"date-time":"2020-05-23T22:31:01Z","timestamp":1590273061000},"page":"e249-e255","source":"Crossref","is-referenced-by-count":32,"special_numbering":"S","title":["ACC-AHA Diagnostic Criteria for Hypertension in Pregnancy Identifies Patients at Intermediate Risk of Adverse Outcomes"],"prefix":"10.1055","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-0205","authenticated-orcid":false,"given":"Kristin C.","family":"Darwin","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0321-6280","authenticated-orcid":false,"given":"Jerome J.","family":"Federspiel","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany L.","family":"Schuh","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet A.","family":"Baschat","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2370-3716","authenticated-orcid":false,"given":"Arthur J.","family":"Vaught","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,5,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1016\/S0140-6736(12)61766-8","article-title":"A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"S S 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01","published-online":{"date-parts":[[2021,8,27]]},"published-print":{"date-parts":[[2021,8]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0040-1709465","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,23]]}}}