Evidence map›Paper›PMID 34963295›Full record

ArticleHypertension (Dallas, Tex. : 1979)2022

Early Pregnancy Blood Pressure Patterns Identify Risk of Hypertensive Disorders of Pregnancy Among Racial and Ethnic Groups.

Erica P Gunderson, Mara Greenberg, Mai N Nguyen-Huynh, Cassidy Tierney, James M Roberts, Alan S Go, Wei Tao, Stacey E Alexeeff

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hypertension (Dallas, Tex. : 1979), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07606027 (Postpartum Remote Monitoring and Integration of Mobile Health With Engagement From Community Health Workers for Regulating Elevated Blood Pressure), which is not on this map. Cited by 30 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 2 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07606027 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Postpartum Remote Monitoring and Integration of Mobile Health With Engagement From Community Health Workers for Regulating Elevated Blood Pressure

TypeinterventionalSponsorUniversity of NebraskaRan2026 to 2031Enrolled404ConditionsHypertensive Disorders of Pregnancy (HDP), Hypertension, Pregnancy Induced, Severe Maternal Morbidity, Postpartum HypertensionArmsCollaborative care, Standard of Care (SOC)
3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.

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  7. Comment on "Morning blood pressure and adverse pregnancy outcomes in high-risk pregnancies".Hypertension research : official journal of the Japanese Society of Hypertension · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Erica P GundersonDivision of Research, Kaiser Permanente Northern California, Oakland, CA (E.P.G., M.N.N.-H., A.S.G., W.T., S.E.A.).ORCID 0000-0002-2039-1964
Mara GreenbergDepartment of Obstetrics and Gynecology, Kaiser Permanente, Oakland Medical Center, CA (M.G., C.T.).
Mai N Nguyen-HuynhDivision of Research, Kaiser Permanente Northern California, Oakland, CA (E.P.G., M.N.N.-H., A.S.G., W.T., S.E.A.).ORCID 0000-0002-8228-0282
Cassidy TierneyDepartment of Obstetrics and Gynecology, Kaiser Permanente, Oakland Medical Center, CA (M.G., C.T.).
James M RobertsMagee-Womens Research Institute, Department of Obstetrics, Gynecology and Reproductive Sciences, Epidemiology and Clinical and Translational Research, University of Pittsburgh, PA (J.M.R.).ORCID 0000-0002-2671-3207
Alan S GoDivision of Research, Kaiser Permanente Northern California, Oakland, CA (E.P.G., M.N.N.-H., A.S.G., W.T., S.E.A.).ORCID 0000-0001-9109-0811
Wei TaoDivision of Research, Kaiser Permanente Northern California, Oakland, CA (E.P.G., M.N.N.-H., A.S.G., W.T., S.E.A.).
Stacey E AlexeeffDivision of Research, Kaiser Permanente Northern California, Oakland, CA (E.P.G., M.N.N.-H., A.S.G., W.T., S.E.A.).ORCID 0000-0001-8988-6976
Kaiser Permanente · USKaiser Permanente Oakland Medical Center · USMagee-Womens Research Institute · US

Funding

Prenatal Blood Pressure Patterns to Predict Pregnancy-Related Hypertension and Later Life Cardiovascular RiskR01HL145808 · NHLBI · KAISER FOUNDATION RESEARCH INSTITUTE · PI GUNDERSON, ERICA PAULINE · 2019 to 2022
$3.3M
NHLBI NIH HHS R01 HL145808
6 · The paper itself

Abstract

backgroundHypertensive disorders of pregnancy are a leading cause of severe maternal morbidity and mortality and confer 4-fold higher perinatal mortality in Black women. Early pregnancy blood pressure patterns may differentiate risk of hypertensive disorders of pregnancy.

methodsThis study identified distinct blood pressure trajectories from 0 to 20 weeks' gestation to evaluate subsequent pregnancy-related hypertension in a retrospective cohort of 174 925 women with no prior hypertension or history of preeclampsia, prenatal care entry ≤14 weeks, and a stillborn or live singleton birth delivered at Kaiser Permanente Northern California hospitals in 2009 to 2019. We used electronic health records to obtain clinical outcomes, covariables, and longitudinal outpatient blood pressure measurements ≤20 weeks' gestation (mean 4.1 measurements). Latent class trajectory modeling identified 6 blood pressure groups: ultra-low-declining(referent), low-declining, moderate-fast-decline, low-increasing, moderate-stable, and elevated-stable. Multivariable logistic regression evaluated trajectory group-associations with the odds of preeclampsia/eclampsia and gestational hypertension' and effect modification by race-ethnicity and prepregnancy body size.

resultsCompared with ultra-low-declining, adjusted odds ratios (95% confidence intervals [CIs]) for low-increasing, moderate-stable, and elevated-stable groups were 3.25 (2.7-3.9), 5.3 (4.5-6.3), and 9.2 (7.7-11.1) for preeclampsia/eclampsia' and 6.4 (4.9-8.3), 13.6 (10.5-17.7), and 30.2 (23.2-39.4) for gestational hypertension. Race/ethnicity, and prepregnancy obesity modified the trajectory-group associations with preeclampsia/eclampsia (interaction

conclusionsEarly pregnancy blood pressure patterns revealed racial and ethnic differences in associations with preeclampsia/eclampsia risk within equivalent levels and patterns. These blood pressure patterns may improve individual risk stratification permitting targeted surveillance and early mitigation strategies.

Indexed as

AdolescentAdultBlood PressureEthnicityFemaleHumansHypertension, Pregnancy-InducedObesityPregnancyRetrospective StudiesRisk FactorsYoung Adultblood pressurebody sizeepidemiologyobesitypreeclampsiapregnancyprenatal carerisk factors

Identifiers

PMID34963295
PMCPMC9004135
OpenAlexW4200138939

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.