{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:24:46Z","timestamp":1783099486930,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T00:00:00Z","timestamp":1701820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_12011\/4"],"award-info":[{"award-number":["MC_UU_12011\/4"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR203319"],"award-info":[{"award-number":["NIHR203319"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["SI\u20100515\u201010042"],"award-info":[{"award-number":["SI\u20100515\u201010042"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["SP\/F\/21\/150013"],"award-info":[{"award-number":["SP\/F\/21\/150013"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RG\/15\/17\/3174"],"award-info":[{"award-number":["RG\/15\/17\/3174"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the association with adverse pregnancy outcomes of: (1) American College of Cardiology\/American Heart Association blood pressure (BP) thresholds, and (2) visit\u2010to\u2010visit BP variability (BPV), adjusted for BP level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>An observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Analysis of data from the population\u2010based UK Southampton Women's Survey (SWS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population or sample<\/jats:title><jats:p>3003 SWS participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Generalised estimating equations were used to estimate crude and adjusted relative risks (RRs) of adverse pregnancy outcomes by BP thresholds, and by BPV (as standard deviation [SD], average real variability [ARV] and variability independent of the mean [VIM]). Likelihood ratios (LRs) were calculated to evaluate diagnostic test properties, for BP at or above a threshold, compared with those below.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Gestational hypertension, severe hypertension, pre\u2010eclampsia, preterm birth (PTB), small\u2010for\u2010gestational\u2010age (SGA) infants, neonatal intensive care unit (NICU) admission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A median of 11 BP measurements were included per participant. For BP at \u226520\u2009weeks\u2019 gestation, higher BP was associated with more adverse pregnancy outcomes; however, only BP &lt;140\/90\u2009mmHg was a good rule\u2010out test (negative LR &lt;0.20) for pre\u2010eclampsia and BP \u2265140\/90\u2009mmHg a good rule\u2010in test (positive LR &gt;8.00) for the condition. BP \u2265160\/110\u2009mmHg could rule\u2010in PTB, SGA infants and NICU admission (positive LR &gt;5.0). Higher BPV (by SD, ARV, or VIM) was associated with gestational hypertension, severe hypertension, pre\u2010eclampsia, PTB, SGA and NICU admission (adjusted RRs 1.05\u20131.39).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While our findings do not support lowering the BP threshold for pregnancy hypertension, they suggest BPV could be useful to identify elevated risk of adverse outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17724","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T09:29:10Z","timestamp":1701854950000},"page":"1006-1016","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Blood pressure measurement and adverse pregnancy outcomes: A cohort study testing blood pressure variability and alternatives to 140\/90\u2009mmHg"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6127-8282","authenticated-orcid":false,"given":"Milly G.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7704-1677","authenticated-orcid":false,"given":"Jeffrey N.","family":"Bone","sequence":"additional","affiliation":[{"name":"British Columbia Children's Hospital Research Institute University of British Columbia  Vancouver British Columbia Canada"},{"name":"Department of Obstetrics and Gynaecology University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura J.","family":"Slade","sequence":"additional","affiliation":[{"name":"Robinson Research Institute The University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Obstetrics and Gynaecology Women's and Children's Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiten D.","family":"Mistry","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Singer","sequence":"additional","affiliation":[{"name":"School of Population and Public Health University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah R.","family":"Crozier","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Centre University of Southampton  Southampton UK"},{"name":"NIHR Applied Research Collaboration Wessex, Southampton Science Park  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith M.","family":"Godfrey","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Centre University of Southampton  Southampton UK"},{"name":"NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janis","family":"Baird","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Centre University of Southampton  Southampton UK"},{"name":"NIHR Applied Research Collaboration Wessex, Southampton Science Park  Southampton UK"},{"name":"NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust  Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4136-3070","authenticated-orcid":false,"given":"Peter","family":"von Dadelszen","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"Laura A.","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health, Faculty of Medicine, School of Life Course and Population Sciences King's College London  London 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