Blood Pressure Changes in Adolescents with Preeclampsia: A Multicentre, Case-Control Study in Latin American Hospitals

Objective To determine the minimum blood pressure increases that would confirm or exclude, with the greatest predictive values, hypertensive disorders of pregnancy (HDP) in pregnant adolescents after 24 weeks gestation. Methods We conducted a case-control study of pregnant women aged ≤19 years with and without HDP. Using systolic and diastolic blood pressure increases, a predictive analysis was performed, and the area under the curve was calculated. Results The cases and controls had systolic blood pressure increases of 45.3 ± 17.5 mm Hg and 6.4 ± 7.9 mm Hg, respectively (P = 0.001) and diastolic blood pressure increases of 30.8 ± 11.7 mm Hg and 3.5 ± 5.7 mm Hg, respectively (P = 0.001). Systolic and diastolic increases of ≥20 mm Hg showed the greatest sensitivity and specificity. A combined analysis showed that an increase of ≥20 mm Hg had a greater positive likelihood ratio of 35.4 (95% CI 22.4–55.9) and negative likelihood ratio of 0.10 (95% CI 0.07–0.13), with an area under the curve of 0.98 (95% CI 0.96–0.99). Conclusions Systolic and diastolic blood pressure increases of ≥20 mm Hg must be considered in the diagnostic criteria for preeclampsia and gestational hypertension among pregnant adolescents past 24 weeks gestation.