Details

Autor(en) / Beteiligte

• Singer, Joel
• Logan, Alexander
• Menzies, Jennifer
• Murphy, Kellie
• Ross, Sue
• Welch, Ross
• Hoac, Trinh
• Zahid, Ainy
• Bracken, Michael B
• Duley, Lelia
• Chan, Sunny
• Shi, Michael
• de Lourdes Martin, Raquel
• Lagunas, Valeria
• Vera, Fernando
• Roque, Alicia Beatriz
• Bruno, Ricardo Antonio
• Mahomed, Kassam
• Coat, Suzette
• Walters, Barry
• Parker, Claire
• Thornton, Charlene
• Moreira de Sa, Renato Augusto
• Abreu, Monique Schmidt Marques
• Bornia, Rita Guerios
• Lalji, Sayrin
• Hotz, Chris
• Freire-Lizama, Tatiana
• Hladunewich, Michelle
• Collins, Virginia
• Delisle, Isabelle
• Khurana, Rshmi
• Perreault, Sophie
• Clark, Heather
• O’Shea, Elaine
• White, Ruth Rennicks
• Newstead-Angel, Jill
• Brandt, Judy
• Martel, Jocelyne
• Keely, Erin
• Vasiliou, Marie
• Hutchens, Donna
• Gallo, Dahiana Marcela
• Harel, Linda
• Siev, Sima
• Hamati, Najla
• Leishman, Di
• Pullar, Barbra
• Farrant, Matthew
• Swiatkowska-Freund, Malgorzata
• Partyka, Anna
• Preis-Orlikowska, Joanna
• Krekora, Michael
• Breborowicz, Grzegorz H
• Logtenberg, Sabine
• Koenen, Steven
• de Reus, Maartje
• Verfaille, Viki
• Verhoeven, Corine
• Franssen, Maureen T.M
• Keurentjes, Jose H.M
• van der Wal, Ina
• van Alphen, Marcel
• Gaugler-Senden, Ingrid
• Linders, Marieke
• Nelson-Piercy, Catherine
• Tarft, Hayley
• Churchill, David
• Toomassi, Yvonne
• Barker, Karen
• Parameshwaran, Shobhana
• Jones, Nia
• Waugh, Jason
• Waring, Gareth
• Walkinshaw, Steve A
• Pascall, Angela
• Purewal, Tej
• Butterfield, Gillian
• Habiba, Marwan
• Lee, Debbie
• Cameron, Helen M
• Hinshaw, Kim
• Bargh, Amanda
• Guy, Anna
• Tottie, Pauline
• Oxby, Claire
• Cresswell, Janet
• Pye, Clare
• Lee, Sarah
• Myers, Jenny
• Abdo, Khalil
• Rigby, Katrina
• Hughes, Sean
• Prashar, Sanjeev
• Smith, Jill
• Perry, Robin
• Chang, Eugene Y
• Sfakianaki, Anna
• Armstrong, D Michael
• Blue, Teresa

Titel

Influence of Gestational Age at Initiation of Antihypertensive Therapy: Secondary Analysis of CHIPS Trial Data (Control of Hypertension in Pregnancy Study)

Ist Teil von

• Hypertension (Dallas, Tex. 1979), 2018-06, Vol.71 (6), p.1170-1177

Ort / Verlag

United States: American Heart Association, Inc

Erscheinungsjahr

2018

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• 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 (Pinteraction=0.005), but more preterm birth (Pinteraction=0.043), and no effect on perinatal death or high-level neonatal care >48 hours (Pinteraction=0.354). For the mother, less-tight (versus tight) control was associated with more severe hypertension at all gestational ages but particularly so before 28 weeks (Pinteraction=0.076). In women with nonsevere, chronic, or gestational hypertension, there seems to be no gestational age at which less-tight (versus tight) control is the preferred management strategy to optimize maternal or perinatal outcomes. CLINICAL TRIAL REGISTRATION—URLhttps://www.isrctn.com. Unique identifierISRCTN71416914.Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDerivs License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made.