Sutton EF, et al. - Researchers evaluated the maternal and neonatal outcomes in healthy, nulliparous women classified with stage 1 hypertension under the revised American College of Cardiology and American Heart Association Guidelines. They also assessed the impacts of low-dose aspirin on maternal and neonatal outcomes in this population. A cohort of women who are at increased risk for preeclampsia, gestational diabetes mellitus, and preterm birth was identified by the application of the new American College of Cardiology–American Heart Association guidelines in a pregnant population.

Methods

• Experts conducted a secondary analysis of data from a multicenter randomized, double-blind, placebo-controlled trial of low-dose aspirin for prevention of preeclampsia in nulliparous, low-risk women recruited between 13 and 25 weeks of gestation.
• Out of the 3,134 nulliparous women enrolled in the original study, they included 2,947 women with singleton pregnancies and without missing data in this analysis.
• They measured the blood pressure at enrollment between 13 and 25 weeks of gestation, and outcomes were adjudicated from the medical record.

Results

• As per data, they identified 164 participants with lower range stage 1 hypertension (5.6%), systolic blood pressure 130–135 mm Hg, diastolic blood pressure 80–85 mm Hg, or both by the new American College of Cardiology–American Heart Association guidelines.
• Within the placebo group (n=1,482), significantly increased incidence of preeclampsia was seen in women with stage 1 hypertension vs normotensive women, 15.3% (15/98) vs 5.4% (75/1,384) (relative risk 2.66, 95% CI 1.56–4.54, P < .001).
• Furthermore, an increased incidence of gestational diabetes mellitus (6.1% vs 2.5%, P=.03) and more indicated preterm deliveries (4.2% vs 1.1%, P=.01) was seen in women with stage 1 hypertension.
• They noted no differences in rates of preeclampsia (7.6% vs 4.4%, respectively, P=.2), gestational diabetes mellitus, or indicated preterm deliveries while comparing women with stage 1 hypertension and normotensive women receiving low-dose aspirin during pregnancy (n=1,465).
• No significant difference was seen in the rates of placenta abruption, small for gestational age, and spontaneous preterm birth between groups.