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Association of maternal home blood pressure trajectory during pregnancy with infant birth weight: the BOSHI study


This study investigated the association between maternal home blood pressure (HBP) trajectory during pregnancy and infant birth weight. A total of 755 pregnant women were included in this prospective cohort study. A group-based trajectory model identified six trajectory groups for home systolic blood pressure (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). Next, the association of HBP trajectory groups with infant birth weight was evaluated using a general linear model considering potential confounding factors. For home SBP and MAP, the trajectory groups with a low-steep J-curve, moderate J-curve, little high J-curve, and high J-curve were significantly associated with lower infant birth weight than the low-J-curve group. Among the trajectory groups for home DBP, the moderate–steep J-curve, little high J-curve, and high J-curve were significantly associated with lower infant birth weight than the group with low-J-curve. The effect sizes of the trajectory groups varied in infant birth weight from −0.21 standard deviations (SDs) (95% confidence interval (CI): −0.42 to −0.01 SD) to −1.13 SD (95% CI: −1.54 to −0.72 SD). In the analyses of infant birth weight in grams, effect sizes that were significantly associated with infant birth weight varied from −84 g (95% CI: −167 to −1 g) to −567 g (95% CI: −732 to −402 g). Trajectory groups with a moderate–reverse J-curve for home SBP, DBP, and MAP were not significantly associated with infant birth weight. Maternal HBP trajectory during pregnancy was an indicator of infant birth weight. Further studies evaluating the associations between HBP during pregnancy and other perinatal outcomes are needed.

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This study was supported by Grants for Scientific Research (18590587, 18390192, 21390201, 24689061, 25253059, 26860412, 16H05243, 17K15857, 18K15837, and 19H03905) from the Ministry of Education, Culture, Sports, Science, and Technology of Japan; a Grant-in-Aid (19DA1001) for Health Research on Children, Youth and Families, and (H21-Junkankitou [Seishuu]-Ippan-004) from the Ministry of Health, Labor and Welfare, Health and Labor Sciences Research Grants, Japan; Grant (JP19gk0110039) from AMED; and a Grant-in-Aid for Japan Society for the Promotion of Science (JSPS) fellows (19.7152, 20.7198, 20.7477, and 20.54043). There were also Academic Contributions from Pfizer Japan Inc.; Bayer Academic Support; Takeda Research Support; Astellas Research Support; Scholarship donations from Chugai Pharmaceutical Co., Ltd., and Daiichi Sankyo Co., Ltd.

Members of the BOSHI Study Group

Medical members (Obstetrics): Noriyuki Iwama, Hidekazu Nishigori, Kohei Tanaka, Takashi Sugiyama, Junichi Sugawara, Nobuo Yaegashi, Kazuhiko Hoshi, Kunihiko Okamura, Masakuni Suzuki. Medical members (Internal Medicine): Hirohito Metoki, Kei Asayama, Ryusuke Inoue, Masahiro Kikuya, Takayoshi Ohkubo, Shinichi Kuriyama, Yutaka Imai. Coordinating members: Taku Obara, Mami Ishikuro, Rie Tsuchida, Azusa Hara, Takuo Hirose, Takeshi Kobayashi, Kenta Gonokami, Takanao Hashimoto, Yumiko Watanabe, Misato Nishimura, Maiko Kawaguchi, Yurie Sato, Minako Hoshikawa, Ayano Sasaki, Kasumi Sakurai, Michihiro Sato, Konomi Akutsu, Mami Yamamoto, Aya shiraishi, Miki Hosaka. Clinical examination members: Ikuo Tachibana, Maki Omura, Mikiko Ishikawa, Yoshimi Fujii, Hidemi Kobayashi, Kazuyuki Akaishi. Pharmaceutical members: Yuko Kikuchi, Kei Tate, Chieko Koishi, Saori Sugawara. Recruitment members: Katsuyo Yagihashi, Junko Saitou, Hiromi Sasaki, Tomoko Suzuki, Junko Takahashi, Yoko Narita, Satoko Shigihara, Hideko Tada, Yumi Hamada. Outpatient management members: Nozomi Satou. Nami Satou, Setsuko Sai, Nana Atsumi, Naoko Sekine, Yukari Ueno, Yu Itou. Inpatient management members: Yukie Obara, Nami Onodera, Asako Sato, Youko Iwasa, Mamiko Abe, Yukari Kido, Risako Komuro, Yukiko Nakamura, Marie Watanabe, Chikako Matsumoto, Koto Oyama, Aya Takahashi, Michiko Kojima, Miyuki Abe, Mariko Sane, Mana Takahashi, Kana Sugata Miho Igari, Haruhi Sasaki, Mizuki Kobayashi, Aya Kikuchi, Risa Yamamoto, Akiho Goto, Eri Yamauchi, Mika Chiba, Sakiko Ota, Hiromi Ishikawa, Akemi Sasaki, Tomoko Kawamura, Hiroko Hiji, Misaki Kishinami, Yurie Kowata, Eiko Yamauchi, Yasuko Takahashi, Naho Sato.

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Correspondence to Hirohito Metoki.

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TO, YI, TO, and HM concurrently hold the directorship at the Tohoku Institute for Management of Blood Pressure, which is supported by Omron Health care Co. Ltd. HM is also currently involved in collaborative research with Omron Health care in another study. Omron Health care Co. Ltd. was not involved in the study design, paper methodology, writing, or drafting of the paper or its conclusions.

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Iwama, N., Oba, M.S., Satoh, M. et al. Association of maternal home blood pressure trajectory during pregnancy with infant birth weight: the BOSHI study. Hypertens Res 43, 550–559 (2020).

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  • Birth weight
  • Home blood pressure
  • Hypertension
  • Hypertensive disorders of pregnancy
  • Trajectory

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