Change in pulse pressure during the preclinical phase of preeclampsia.

OBJECTIVE

To measure and compare pulse pressure in early pregnancy between parturients who subsequently did or did not develop preeclampsia.

STUDY

DESIGN

Retrospective chart review of 44 parturients with preeclampsia and 187 controls without. The groups were compared for blood pressure indices before 15 weeks' gestation and other maternal variables.

RESULTS

The preeclampsia group had a higher proportion of African Americans (23% vs. 9.6%, p = 0.005) and higher body mass index (26.2 +/- 7.1 SD vs. 24.0 +/- 4.9 kg/m2, p = 0.03). Before 15 weeks' gestation, women who later developed preeclampsia had higher systolic (114.3 +/- 11.6 vs. 107 +/- 12 mm Hg, p = 0.001), mean arterial (83.7 +/- 8.8 vs. 79.6 +/- 7.6 mm Hg, p = 0.002) and pulse (45.8 +/- 7.7 vs. 42.4 +/- 8.3 mm Hg, p = 0.001) pressure. On multivariable logistic regression analysis, only African American race (OR 3.1; 95% CI 1.13, 8.40; p = 0.028), and pulse pressure (OR 1.05; 95% CI 1.01, 1.1; p = 0.014) were independently associated with the development of preeclampsia.

CONCLUSION

Primiparous women who later develop preeclampsia have an elevation in pulse, systolic and mean arterial pressure before 15 weeks.