What does an elevated mean arterial pressure in second half of pregnancy predict —Gestational hypertension or preeclampsia?

• Published in: American journal of obstetrics and gynecology Vol. 169; no. 3; pp. 509 - 514
• Main Authors: Conde-Agudelo, Agustín, Belizán, José M., Lede, Roberto, Bergel, Eduardo F.
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.09.1993
• Subjects: Blood Pressure; Cohort Studies; Female; Follow-Up Studies; gestational hypertension; Humans; Hypertension - diagnosis; Hypertension - physiopathology; Mean arterial pressure; Pre-Eclampsia - diagnosis; Pre-Eclampsia - physiopathology; prediction; Predictive Value of Tests; preeclampsia; Pregnancy; Pregnancy Complications, Cardiovascular - diagnosis; Pregnancy Complications, Cardiovascular - physiopathology; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prospective Studies; gestational hypertension; prediction; preeclampsia; Mean arterial pressure
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/0002-9378(93)90609-M

OBJECTIVE: The purpose of this study was to determine the predictive value of elevated mean arterial pressure in the second half of pregnancy for both preeclampsia and gestational hypertension. STUDY DESIGN: This was a cohort of 588 nulliparous pregnant women studied prospectively from the twentieth week until delivery. Mean arterial pressure was obtained by means of a random-zero sphygmomanometer at 20, 26, and 31 weeks of gestation. The best cutoff point for the determination of predictive values was established by a receiver-operator characteristic curve. RESULTS: Patterns of mean arterial pressure throughout pregnancy were different between preeclamptic and gestational hypertensive women. Receiver-operator characteristic curves for mean arterial pressure showed better predictive capacity for gestational hypertension than for preeclampsia. Sensitivity of mean arterial pressure to predict preeclampsia ranged between 39% and 48%, whereas for prediction of gestational hypertension it varied from 72% to 92%. Specificities for both groups were moderate (60% to 86%). Positive predictive values were low for all groups (5% to 33%). CONCLUSION: Elevated mean arterial pressure in the second half of pregnancy is a good predictor of gestational hypertension but is a poor predictor of preeclampsia.