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Preconception blood pressure and risk of gestational hypertension and preeclampsia: a large cohort study in China

Hypertension Research volume 43, pages 956–962 (2020)Cite this article

Abstract

Our objective was to examine whether high blood pressure in the preconception period was associated with gestational hypertension and preeclampsia in Chinese women. Data were obtained from the China-US Collaborative Project for Neural Tube Defects Prevention, a large population-based cohort study. We included 45,628 women who were registered before pregnancy in seven counties in South China. Blood pressure was measured during registration by trained health care workers, and other health-related information was recorded prospectively. We used logistic regression to evaluate the associations between preconception blood pressure and the risk of gestational hypertension and preeclampsia, adjusting for potential confounders. The prevalence of hypertension in the preconception study population was 4.57% (2083/45,628). The incidences of gestational hypertension and preeclampsia were 11.95% and 4.08%, respectively, in the hypertension group and 8.60% and 2.28%, respectively, in the nonhypertension group. Compared with the nonhypertension group, the hypertension group showed a significantly increased risk for gestational hypertension [adjusted risk ratio (RR) = 1.40, 95% confidence interval (CI): 1.22–1.60] and preeclampsia [adjusted RR = 1.75, 95% CI: 1.39–2.19]. When participants with normal blood pressure were used as the reference, the adjusted ORs for gestational hypertension were 1.48 (95% CI: 1.37–1.59), 1.70 (95% CI: 1.44–2.01), and 1.29 (95% CI: 1.02–1.64), and for preeclampsia, the adjusted ORs were 1.55 (95% CI: 1.35–1.78), 1.95 (95% CI: 1.46–2.60), and 1.99 (95% CI: 1.39–2.85) for the participants with prehypertension, stage 1 hypertension, and stage 2 hypertension, respectively. Our results support an association between hypertension or higher blood pressure prior to pregnancy and an increased risk of gestational hypertension and preeclampsia.

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Acknowledgements

The authors thank all of the volunteers and staff involved in this research.

Funding

NL was supported by the Beijing Natural Science Foundation (7194285), the National Natural Science Foundation of China (81903327), startup funding from the “Incubation” Program of China and Peking University Health Science Center (No. BMU2017YB003), and the Young Elite Scientist Sponsorship Program by CAST (YESS) (2018QNRC001). The original project was supported by a cooperative agreement between the US Centers for Disease Control and Prevention and Peking University (Grant No. U01 DD000293).

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Authors and Affiliations

  1. Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University Health Science Center, Beijing, China

    Nan Li, Hang An, Zhiwen Li, Rongwei Ye, Le Zhang, Hongtian Li & Jianmeng Liu

  2. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China

    Nan Li, Hang An, Zhiwen Li, Rongwei Ye, Le Zhang, Hongtian Li & Jianmeng Liu

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  1. Nan Li
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Contributions

NL had full access to all of the study’s data and takes complete responsibility for the accuracy of the data analysis. Study concept and design: NL, HA, and RY. Acquisition of data: NL, HA, HL, and JL. Interpretation of data: NL, HA, ZL, LZ, and JL. Drafting of the paper: NL and HA. Critical revision of the paper: NL, HL, RY, ZL, and LZ. Statistical analysis: NL and HA. Funding acquisition: NL, JL, and RY. Administrative and technical support: NL, HA, ZL, and RY. Study supervision: ZL and RY.

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Correspondence to Zhiwen Li or Rongwei Ye.

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Li, N., An, H., Li, Z. et al. Preconception blood pressure and risk of gestational hypertension and preeclampsia: a large cohort study in China. Hypertens Res 43, 956–962 (2020). https://doi.org/10.1038/s41440-020-0438-9

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