Indian Journal of Public Health Research & Development

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Blood Pressure Pattern in Pregnant Women of Different Body Mass Index in Three Trimesters of Pregnancy


Affiliations
1 Department of Physiology, J.N.Medical College, A.M.U., Aligarh, (U.P), India
2 Department of Obstetrics & Gynaecology, J.N.Medical College, A.M.U., Aligarh, (U.P), India
     

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Study of blood pressure changes during pregnancy is essential for understanding the complications of pregnancy like birth defects, gestational diabetes, preeclampsia, bleeding disorder etc. Determinants of blood pressure (Systolic blood pressure SBP, Diastolic blood pressure DBP) influenced by the prepregnancy body mass index (BMI) and its values gradually changes during all the three trimesters. At present, little is known about the association of BP parameters in different grades of BMI in all the trimesters of pregnancy so our objective of study was to elucidate the aforesaid relationship. We have selected 200 pregnant women from antenatal clinics of obstetrics&gynaecology, J.N. Medical College, A.M.U., Aligarh. Pre-pregnancy Body Mass Index (BMI) was calculated by using Quetlet's Index. On the basis of BMI, all participants were divided into three groups, underweight, normal, overweight. Reading of blood pressure of participating women was taken by using a standard mercury sphygmomanometer in each period of trimesters. Mean values was calculated and compared between different BMI groups in all the trimester of pregnancy. The statistical software SPSS (version 16) was used for data analysis. We have applied unpaired t- test. SBP,DBP of underweight, overweight pregnant women were not significantly decreased from first to second trimester and it were not significantly increased in third from second trimester, while pregnant women of normal weight, there was significantly fall in SBP, DBP in mid pregnancy fall which further increased up to third trimester. This non significant fall in BP parameters in underweight and overweight pregnant women in mid pregnancy was related to the increase in the risk of development of preeclampsia. The cause of preeclampsia may be explained by the mechanism involved in endothelial dysfunction which is to be discussed later on. We found that level of risk for complications of pregnancy is increased with abnormal BP parameters pattern in pregnant women having different BMI thus women of unhealthy weight side should be offered preconception counseling, nutritional consultation, exercise program and careful screening of obstetrics complications during pregnancy.

Keywords

Pregnancy, BP Monitoring, Preeclampsia, BMI
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  • Hytten FE, Leitch I. The physiology of Human Pregnancy.2nd edn. Oxford: Blackwell Scientific Publications, 1971.

  • Weir RJ, Paintin DB, Brown JJ et al. A serial study in pregnancy of the plasma concentrations of renin, corticosteroids,electrolytes and proteins, and of hematocrit and plasma volume. J Obstet Gynaecol Br Commonw 1971; 78:590.

  • MacGillivray I, Rose GA, Rowe B. Blood pressure survey in pregnancy. Clin Sci 1969; 37: 395.

  • Gallery EDM, Hunyor SN, Ross M et al. Predicting the development of pregnancyassociated hypertension. The place of standardised blood pressure measurement. Lancet 1977; 1: 1273.

  • Castro LC, Avina RL. Maternal obesity and pregnancy outcomes. Current Opinion in Obstetrics and Gynecology 2002; 14:601–606.

  • Kaiser PS, Kirby RS. Obesity as a risk factor for cesarean in a low-risk population. Obstetrics and Gynecology 2001; 97:39–43.

  • Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. American Journal of Obstetrics and Gynecology 2000; 183:S1–S22.

  • Hermida RC, Ayala DE, Iglesias M. Predictable blood pressure variability in healthy and complicated pregnancies. Hypertension. 2001; 38: 736–741.

  • Williams D. Pregnancy: a stress test for life. Curr Opin Obstet Gynecol. 2003; 15:465– 471.

  • Wilson BJ, Watson MS, Prescott GJ, Sunderland S, Campbell DM, Hannaford P, Smith WC. Hypertensive diseases of pregnancy and risk of hypertension and stroke in later life: results from cohort study. BMJ. 2003; 326:845– 849.

  • National High Blood Pressure Education Program Working Group report on high blood pressure in pregnancy. Am J Obstet Gynecol 2000; 183: S1-S22.

  • Creasy RK, Resnick R. Maternal fetal medicine, 4th: Philadelphia: W.B. Saunders Co; 1999.

  • WHO. Obesity: preventing and managing the global epidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Geneva: World Health Organization, 2000.

  • WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization, 1995.

  • thefreedictionary.com > trimester.

  • Duvekot JJ, Cheriex EC, Pieters FA, Menheere PP, Peeters LH. Early pregnancy changes in hemodynamics and volume homeostasis are consecutive adjustments triggered by a primary fall in systemic vascular tone. Am J Obstet Gynecol. 1993; 169:1382–1392.

  • Savvidou MD, Hingorani AD, Tsikas D, Frolich JC, Vallance P, Nicolaides KH. Endothelial dysfunction and raised plasma concentrations of asymmetric dimethylarginine in pregnant women who subsequently develop preeclampsia. Lancet. 2003; 361:1511–1517.

  • Hermida RC, Ayala DE, Iglesias M. Predictable blood pressure variability in healthy and complicated pregnancies. Hypertension. 2001; 38: 736–741.

  • Garcia RG, Celedon J, Sierra-Laguado J, Alarcon MA, Luengas C, Silva F, renas-Mantilla M, Lopez- Jaramillo P. Raised C-reactive protein and impaired flow-mediated vasodilation precede the development of preeclampsia. Am J Hypertens. 2007; 20:98–103.

  • Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998 Nov; 179(5):1359-75.

  • Roberts et al., (1989) J.M. Roberts, R.N. Taylor and T.J. Musci et al., Preeclampsia: an endothelial cell disorder, Am. J. Obstet. Gynecol. 161 (1989), pp. 1200–1204.

  • Roberts and Redman, (1993) J.M. Roberts and C.W.G. Redman, Pre-eclampsia: more than pregnancy-induced-hypertension, Lancet 341 (1993), pp. 1447–1451.

  • Dekker and Sukcharoen, (2004) G.A. Dekker and N. Sukcharoen, Etiology of preeclampsia: an update, J. Med. Assoc. Thai. 87 (Suppl. 3) (2004), pp. S96–S103.

  • Redman and Sargent, (2005) C.W. Redman and I.L. Sargent, Latest advances in understanding preeclampsia, Science 308 (2005), pp. 1592–1594.

  • Sibai et al., (2005) B. Sibai, G.A. Dekker and M. Kupfermink, Pre-eclampsia, Lancet 365 (2005), pp. 789–799.


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  • Blood Pressure Pattern in Pregnant Women of Different Body Mass Index in Three Trimesters of Pregnancy

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Authors

Gul Ar Navi Khan
Department of Physiology, J.N.Medical College, A.M.U., Aligarh, (U.P), India
Nazia Ishrat
Department of Obstetrics & Gynaecology, J.N.Medical College, A.M.U., Aligarh, (U.P), India
Noor Afshan Sabzposh
Department of Obstetrics & Gynaecology, J.N.Medical College, A.M.U., Aligarh, (U.P), India

Abstract


Study of blood pressure changes during pregnancy is essential for understanding the complications of pregnancy like birth defects, gestational diabetes, preeclampsia, bleeding disorder etc. Determinants of blood pressure (Systolic blood pressure SBP, Diastolic blood pressure DBP) influenced by the prepregnancy body mass index (BMI) and its values gradually changes during all the three trimesters. At present, little is known about the association of BP parameters in different grades of BMI in all the trimesters of pregnancy so our objective of study was to elucidate the aforesaid relationship. We have selected 200 pregnant women from antenatal clinics of obstetrics&gynaecology, J.N. Medical College, A.M.U., Aligarh. Pre-pregnancy Body Mass Index (BMI) was calculated by using Quetlet's Index. On the basis of BMI, all participants were divided into three groups, underweight, normal, overweight. Reading of blood pressure of participating women was taken by using a standard mercury sphygmomanometer in each period of trimesters. Mean values was calculated and compared between different BMI groups in all the trimester of pregnancy. The statistical software SPSS (version 16) was used for data analysis. We have applied unpaired t- test. SBP,DBP of underweight, overweight pregnant women were not significantly decreased from first to second trimester and it were not significantly increased in third from second trimester, while pregnant women of normal weight, there was significantly fall in SBP, DBP in mid pregnancy fall which further increased up to third trimester. This non significant fall in BP parameters in underweight and overweight pregnant women in mid pregnancy was related to the increase in the risk of development of preeclampsia. The cause of preeclampsia may be explained by the mechanism involved in endothelial dysfunction which is to be discussed later on. We found that level of risk for complications of pregnancy is increased with abnormal BP parameters pattern in pregnant women having different BMI thus women of unhealthy weight side should be offered preconception counseling, nutritional consultation, exercise program and careful screening of obstetrics complications during pregnancy.

Keywords


Pregnancy, BP Monitoring, Preeclampsia, BMI

References