Less-Tight Versus Tight Control of Hypertension in Pregnancy

This study was an open, multicenter, international, randomized controlled trial that included women with nonsevere, nonproteinuric preexisting hypertension/gestational hypertension. All women had gestational periods of 14 weeks 0 days to 33 weeks 6 days with preexisting hypertension with a diastolic blood pressure of 90 mm Hg or higher at 20 weeks. Women were randomized 1:1 to less-tight control group (100 mm Hg) or tight control group (85 mm Hg). Primary outcomes focused on pregnancy loss or need for high-level neonatal care more than 48 hours to 28 days after birth. The secondary outcomes focused on “serious” maternal complications up to 6 weeks after birth and was defined as conditions such as stroke, uncontrollable hypertension, or death. Of the women who met the criteria, 497 women were randomly assigned to the less-tight control group, and 490 were assigned to the tight control group. Results for the primary outcome were found to be similar between the 2 groups, with 31.4% for the less-tight control and 30.7% tight control (adjusted odds ratio [aOR], 1.02; 95% confidence interval, 0.77–1.35). Similarities were also found in the secondary outcomes as well with maternal complications at 3.7% and 2.0% (aOR, 1.74; 95% confidence interval, 0.79–3.84). However, results revealed that less-tight control had higher rates of severe maternal hypertension (40.6%) compared with the tight control (27.5%). In addition, there were more patients in the less-tight control group w...
Source: Obstetrical and Gynecological Survey - Category: OBGYN Tags: Obstetrics: Medical Complications of Pregnancy Source Type: research