Associations between blood pressure variability and perinatal outcomes

Objective. This study aimed to investigate the impact of ma­ternal haemodynamics in preeclampsia on nontraumatic peri­natal central nervous system disorders.
Materials and Methods. A case-control study conducted be­tween 2007 and 2014, involving 705 pregnant women, with 339 diagnosed with preeclampsia (baseline group) and 366 without (control group). Gestational age ranged between 28+0 weeks gestation (w.g.) and 41+6 w.g. Maternal haemodynamic chang­es were assessed, focusing on systolic blood pressure variability.
Results. Significant associations were observed between sys­tolic blood pressure fluctuations and perinatal outcomes. In preeclamptic pregnancies, there was a higher prevalence of blood pressure parameter fluctuations, during the pre-deliv­ery period. The presence of at least one systolic blood pressure spike greater than 30 mm Hg was detected in 54.3% of cases in the preeclamptic group compared to 30.0% in the control group. When comparing the presence of 2 or more cases of systolic blood pressure fluctuations ≥ 30 mmHg, significant differences were observed. In preeclamptic women with nontraumatic perinatal brain lesions, 14 cases were recorded (40.0%) 95%CI 23.8-56.2, while in preeclamptic women with­out nontraumatic perinatal brain lesions there were 8 cases (11.4%) 95%CI 4.0-18.8. The differences were confirmed by χ2 11.5, GL 2, p < 0.003.
Conclusions. Fluctuations in blood pressure values during pregnancy, especially in preeclamptic cases, may exacerbate foetal hypoxia and increase the risk of perinatal central ner­vous system damage. The study underscores the importance of monitoring maternal haemodynamics in preeclampsia to mitigate adverse perinatal outcomes.