Influence of Gestational Age at Initiation of Antihypertensive Therapy

作者：Anouk Pels, Ben W. Mol, Joel Singer, Terry Lee, Peter von Dadelszen, Wessel Ganzevoort, Elizabeth Asztalos, Laura A. Magee, Amiram Gafni, Andrée Gruslin, Michael Helewa, Eileen K. Hutton, Shoo Lee, Alexander G. Logan, Jennifer Menzies, Jean‐Marie Moutquin, Kellie E. Murphy, Évelyne Rey, Sue Ross, Johanna Sanchez, Jim Thornton, Ross Welch, Trinh Hoac, Joanne Kirton, Katherine Trigiani, Ainy Zahid, Michael B. Bracken, Patricia Crowley, Lelia Duley, Richard A. Ehrenkranz, Kevin E. Thorpe, Sunny Ho‐Wan Chan, Michael Shi, Shelley Yu, Raquel de Lourdes Martin, M. Bassi, Mirta Clara Caruso, Valeria Lagunas, Fernando Vera, Maria Mohedano de Duhalde, Alicia Beatriz Roque, Patricia Roldan, Esteban Marcos Duhalde, Viviana Dip, Jesus Daniel Aguirre, Elba Mirta Morales, Griselda Itati Abreo, Teresa De Sagastizabal, Carolina Cadavid Gómez, Nadia Rizzi, Carlos Arias, R Bruno, Kassam Mahomed, Alison Drew, Ann Green, Jane V. Hoare, Bill Hague, Suzette Coat, Caroline A Crowther, Peter Müller, Sophie Trenowden, Barry N J Walters, Claire Parker, Dorothy Graham, Craig E. Pennell, Eileen Sung, Angela Makris, Gaksoo Lee, Charlene Thornton, Annemarie Hennessy, Louise Farrell, Nelson Sass, Henri Augusto Korkes, Dayana Couto Ferreira, Renato Augusto Moreira de Sá, Monique Schmidt Marques Abreu, Rita Guérios Bornia, Nancy Ribeiro da Silva, Fernanda Cardoso, Caio Coelho Marques, Jorge Hornos, Ricardo Leal Davdt, Letícia Germany Paula, Pedro Luis Zanella, G Inglis, Ruth Dillon, Ashley Docherty, Anna Hutfield, Keith Still, Sayrin Lalji, Tamara Van Tent, Chris Hotz, Tracy Messmer, Joel G. Ray, Howard Berger, Leanne De Souza, Andrea Lausman, Tatiana Freire-Lizama, Kate Besel, Paul Gibson, Greta Ellsworth, Leslie W. Miller, T. Lee‐Ann Hawkins, Michelle Hladunewich, Anna Rogowsky, Dini Hui, Virginia Collins, Isabelle Delisle, Cora A. Fanning, Nestor Demianczuk, Rshmi Khurana, Winnie Sia, Catherine A. Marnoch, Carmen Young, Cheryl Lux, Sophie Perreault, Valerie Tremblay, Sophie Desindes, Anne‐Marie Côté, Véronique Dagenais, Heather Clark, Elaine O’Shea, Ruth Rennicks White, Shital Gandhi, Mary‐Jean Martin, Cheryl Brush, Gareth Seaward, Jill Newstead-Angel, Judy Brandt, Jocelyne Martel, Kristine Mytopher, Elise Buschau, Erin Keely, Patti Waddell, Svetlana Shachkina, Alan Karovitch, Robert J. Anderson, Nicole Koenig, Theresa Yong, Marie Vasiliou, P. L. Johnson, Beth Allan, Renato Natale, Laura C. Kennedy, Lucie Opatrny, L. Lavigne, George Carson, Sheila Kelly, Joan Crane, Donna Hutchens, Juan Pedro Kusanovic, Christian Figueroa, Karla Silva Neculman, Juan A. Ortiz, Paula Vargas, P Ferrand, J. Carrillo, Rodrigo Cifuentes Borrero, Dahiana M. Gallo, Luisa Fernanda Moreno, Fred Kirss, Kristiina Rull, Anne Kirss, Tamás Major, Andrea Fodor, Tünde Bartha, Mordechai Hallak, Nardin Aslih, Saja Anabousi-Murra, Ester Pri-Or, Linda Harel, Sima Siev, Marwan Hakim, Christina Simona Khoury, Najla Hamati, Mazen El-Zibdeh, Lama T. Yousef, Ruth Hughes, Di Leishman, Barbra Pullar, Matthew Farrant, Małgorzata Świątkowska-Freund, Krzysztof Preis, Anette Aleksandra Traczyk-Los, Anna Partyka, Joanna Preis-Orlikowska, Mariusz Łukaszuk, G Krasomski, Michael Krekora, Anna Kędzierska-Markowicz, Katarzyna Zych-Krekora, Grzegorz H. Bręborowicz, Anna Dera-Szymanowska, Jannet JH Bakker, Joost Akkermans, Eline van den Akker, Sabine Logtenberg, Steven V. Koenen, Maartje de Reus, David Borman, Martijn A. Oudijk, A. Bolte, Viki Verfaille, Bart Graaf, Martina Porath, Corine Verhoeven, Maureen Franssen, Lida Ulkeman, Ineke Hamming, Jose H.M. Keurentjes, Ina van der Wal, S.W.A. Nij Bijvank, A.A. Lutjes, Henricus Visser, Hubertina Catharina Johanna Scheepers, Erik van Beek, C. van Dam, Kathy van den Berg-Swart, Paula Pernet, Birgit van der Goes, Nico Schuitemaker, Gunilla Kleiverda, Marcel van Alphen, Ageeth N. Rosman, Ingrid P.M. Gaugler-Senden, Marieke Linders, Catherine Nelson‐Piercy, Annette Briley, May Ching Soh, Kate Harding, Hayley Tarft, David Churchill, Katherine Cheshire, Julia Icke, Mausumi Ghosh, Jim Thornton, Yvonne Toomassi, Karen Barker, Joanne Fisher, Nicky Grace, Amanda Green, Joanne Gower, Anna Molnar, Shobhana Parameshwaran, Andrew Simm, George Bugg, Yvette Davis, Ruta Desphande, Y. Gunn, Mohammed R Houda, Nia Jones, Jason Waugh, Carly Allan, Gareth Waring, Steve Walkinshaw, Angela Pascall, Mark Clement-Jones, Michelle Dower, Gillian Houghton, H. Longworth, Tej Purewal, Derek Tuffnell, Diane Farrar, Jennifer Syson, Gillian Butterfield, Vicky Jones, Rebecca J Palethorpe, Tracey Germaine, Marwan Habiba, Debbie Lee, Olufemi Eniola, L.D. Blake, Jane C. Khan, H. M. Cameron, Kim Hinshaw, Amanda Bargh, Eileen Walton, Olanrewaju Sorinola, Anna Guy, Zoë D'souza, Rhiannon Gabriel, Jo Williams, Heidi Hollands, Olujimi Jibodu, Sara Collier, Pauline Tottie, C B Oxby, James H. Dwyer, F Majoko, Helen Goldring, Sharon Jones, Janet Cresswell, Louise Underwood, Mary Kelly-Baxter, Rebecca Robinson, Dilly Anumba, Anne Chamberlain, Clare Pye, Clare Tower, Sue Woods, L. A. Horrocks, Fiona Prichard, Lynsey Moorhead, Sarah Lee, Louise Stephens, Cara Taylor, Suzanne M. Thomas, Melissa Whitworth, Jenny Myers, Ellen Knox, Katie Freitas, Mark D. Kilby, A M Cotterill, Khalil Abdo, Katrina Rigby, Julie Butler, Fiona Crosfill, Sean Hughes, Sanjeev Prashar, Fatimah Soydemir, Janet R. Ashworth, Lorraine Mycock, Jill Smith, Amaju Ikomi, Kerry Goodsell, Jean Byrne, Maxwell Masuku, Alice Pilcher, Meena Khandelwal, Gunda Simpkins, Michelle Iavicoli, Yon Sook Kim, Richard L. Fischer, Robin Perry, Eugene Chang, Tamara D. Saunders, Betty W. Oswald, Kristin D. Zaks, Sarosh Rana, Dawn McCullough, Anna K. Sfakianaki, Cheryl Danton, Erin Kustan, Luisa Coraluzzi, Helen How, Christina Waldon, Jeffrey Livingston, Sherry Avery Jackson, Lisa Greene, Dinesh Shah, Jorge E. Tolosa, Mónica Rincón, Leonardo Pereira, Amy E. Lawrence, Janice E. Snyder, David M. Armstrong, Teresa Blue, Austin G. Hester, Kathryn Salisbury · 发表于：Hypertension · 年份：2018 · DOI：10.1161/hypertensionaha.117.10689 · 被引用次数：29 · 研究领域：Pregnancy and preeclampsia studies、Birth, Development, and Health、Assisted Reproductive Technology and Twin Pregnancy

For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation. Gestational age was considered categorically (quartiles) and continuously (linear or quadratic form), and the optimal functional form selected to provide the best fit to the data based on the Akaike information criterion. Randomization before (but not after) 24 weeks to less-tight (versus tight) control was associated with fewer babies with birth weight <10th centile ( P interaction =0.005), but more preterm birth ( P interaction =0.043), and no effect on perinatal death or high-level neonatal care >48 hours ( P interaction =0.354). For the mother, less-tight (versus tight) control was associated with more severe hypertension at all gestational ages but particularly so be...