Blood pressure is elevated in normotensive pregnant women with intrauterine growth restriction

Objective: To assess the relationship between blood pressure pattern and intrauterine growth restriction in normotensive pregnant women. Study design: Twenty-four-hour ambulatory blood pressure was consecutively performed between 32 and 34 weeks in 139 normotensive, non-proteinuric, primigravidae with intrauterine growth restriction (IUGR) and in 140 primigravidae, matched for age and gestation, who were and remained normotensive throughout pregnancy and whose fetuses had regular fetal growth, who served as controls. Results: Although all measures were within the normotensive range, blood pressure of mothers with IUGR were significantly higher than controls. Twenty-four-hour mean, daytime, and nighttime systolic were 119.9 +/- 11.9, 122.6 +/- 11.7, 114.4 +/- 13.3 mmHg, in women with IUGR and 108.0 +/- 7.4, 109.2 +/- 7.3, 102.1 +/- 8.5 mmHg, in controls. Twenty-four-hour diastolic average, daytime, and nighttime diastolic (mean +/- S.D.) 78.1 +/- 9.3, 69.2 +/- 10.6, 67.2 +/- 9.0 mmHg, in women with IUGR and 64.1 +/- 5.7, 66.0 +/- 5.7, 58.2 +/- 6.3 mmHg, in normal pregnant women. All differences p < 0.0001. Conclusions: Pregnant women with idiopathic IUGR have blood pressure higher than normal. Although within clinic normotensive range, slightly higher levels of blood pressure can alter uterine and placental perfusion and determine fetal growth restriction. (c) 2004 Elsevier Ireland Ltd. All rights reserved.