{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:35:43Z","timestamp":1768455343272,"version":"3.49.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72274133"],"award-info":[{"award-number":["72274133"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82321001"],"award-info":[{"award-number":["82321001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82071674"],"award-info":[{"award-number":["82071674"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021171","name":"Guangdong Basic and Applied Basic Research Foundation","doi-asserted-by":"publisher","award":["2025A1515011861"],"award-info":[{"award-number":["2025A1515011861"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Tianjin Key Medical Discipline (Specialty) Construction Project","award":["TJYXZDXK-069C"],"award-info":[{"award-number":["TJYXZDXK-069C"]}]},{"DOI":"10.13039\/501100019065","name":"Tianjin Science and technology planning project","doi-asserted-by":"crossref","award":["21ZXJBSY00120"],"award-info":[{"award-number":["21ZXJBSY00120"]}],"id":[{"id":"10.13039\/501100019065","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>To examine how mid-trimester systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, considered both independently and jointly, are associated with individual and co-occurring adverse pregnancy outcomes (APOs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We analyzed two cohorts from northern and southern China, consisting of 78,891 singleton pregnancies. Mid-trimester (20\u201328 weeks\u2019 gestation) SBP and DBP were evaluated as qualitative classifications (isolated systolic, isolated diastolic, and systolic\u2013diastolic hypertension) and quantitative measurements (levels of SBP\/DBP and pulse pressure). Using two-dimensional SBP\u2013DBP heat maps, we assessed their associations with major APOs (gestational diabetes mellitus [GDM], preterm birth, small for gestational age [SGA], postpartum hemorrhage [PPH], placental abruption [PA], and severe preeclampsia) by latent class analysis (LCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>LCA identified four latent APO classes: (1) preterm placental dysfunction, with 100% preterm birth, 26.6% SGA, 21.4% GDM and 13.2% severe preeclampsia, associated with concurrent SBP\u2013DBP association (SBP+\/DBP+); (2) term placental dysfunction, with 44.0% PPH, 34.0% PA, 25.2% severe preeclampsia and no preterm birth, associated with DBP elevation (DBP+); (3) term GDM, with 100% probability for GDM, no preterm birth and minimal other APOs, associated with SBP elevation (SBP+) and wider pulse pressure; (4) term SGA, with 100% SGA, 16.2% GDM and no preterm birth, associated with a divergent changes in SBP and DBP (SBP\u2212\/DBP+) and narrower pulse pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Mid-trimester SBP and DBP interact in distinct patterns to influence co-occurring APO risks. This study demonstrates the independent and joint influence of BP components on risk, emphasizing the role of BP stratification in guiding pregnancy management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaf160","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T11:53:09Z","timestamp":1755690789000},"page":"152-160","source":"Crossref","is-referenced-by-count":0,"title":["Joint Contribution of Mid-Trimester Systolic and Diastolic Blood Pressure to Co-occurring Adverse Pregnancy Outcomes: A Cohort Study"],"prefix":"10.1093","volume":"39","author":[{"given":"Yiwen","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huaxi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Tianjin Hospital , Tianjin ,","place":["China"]},{"name":"Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingbo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruimin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongli","family":"Duan","sequence":"additional","affiliation":[{"name":"Medical Genetic Center, Guangdong Women and Children Hospital , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuanyi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lushu","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xueli","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Occupational Health and Environmental Health, School of Public Health, Tianjin Medical University , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0209-3138","authenticated-orcid":false,"given":"Qing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijuan","family":"Lv","sequence":"additional","affiliation":[{"name":"Medical Genetic Center, Guangdong Women and Children Hospital , Guangzhou ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cha","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-7103","authenticated-orcid":false,"given":"Xin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Medical University General Hospital , Tianjin ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"key":"2026011413233193000_CIT0001","first-page":"e13","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/Apha\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"71","author":"Whelton","year":"2018","journal-title":"Hypertension"},{"key":"2026011413233193000_CIT0002","doi-asserted-by":"crossref","first-page":"e024202","DOI":"10.1161\/JAHA.121.024202","article-title":"Prevalence, Predictors, progression, and prognosis of hypertension subtypes in the Framingham Heart Study","volume":"11","author":"Bourdillon","year":"2022","journal-title":"J Am Heart Assoc"},{"key":"2026011413233193000_CIT0003","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1001\/archinte.1993.00410050036006","article-title":"Blood pressure, systolic and diastolic, and cardiovascular risks. 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