Antenatal Blood Pressure Variability and Adverse Pregnancy and Neonatal Outcomes in the United Arab Emirates: The Mutaba’ah Study
1
Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
2
Department of Obstetrics & Gynecology, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
3
Zayed Centre for Health Sciences, UAE University, Al Ain, United Arab Emirates
Popul. Med. 2026;8(Supplement Supplement 1):A2203
ABSTRACT
BACKGROUND:
Blood pressure variability (BPV) is an established marker of cardiovascular risk outside pregnancy, yet its significance during gestation, when maternal hemodynamic and placental perfusion are critical, remains uncertain. We evaluated whether antenatal BPV is associated with adverse pregnancy and neonatal outcomes.
METHODS:
This prospective analysis used data from the population-based Mutaba’ah Study in the United Arab Emirates, including 5597 singleton live-birth pregnancies (2017–2024) with repeated antenatal blood pressure (BP) measurements (≥3 measurements). Visit-to-visit BPV for systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) was assessed using standard deviation (SD), average real variability (ARV), and variability independent of the mean (VIM). Multivariable logistic regression models evaluated associations between BPV and gestational hypertension (GH), preeclampsia (PE), preterm birth, neonatal intensive care unit (NICU) admission, and small-for-gestational-age (SGA) birth, adjusting for maternal age, smoking exposure, education, employment, obesity, parity, and diabetes status.
RESULTS:
Among 5597 singleton pregnancies, greater visit-to-visit BPV across pregnancy was consistently associated with hypertensive disorders of pregnancy. After multivariable adjustment, greater variability in SBP, DBP, and MAP—particularly as measured by SD and VIM—was associated with significantly increased odds of GH (adjusted odds ratios [aORs] up to 1.29) and preeclampsia (aORs up to 1.36). Associations between BPV and neonatal outcomes were modest; 6%–9% significant increases in the odds of preterm birth were observed for DBP and MAP, while no consistent associations were found with NICU admission or SGA birth.
CONCLUSIONS:
Greater visit-to-visit variability in antenatal blood pressure—particularly systolic, diastolic, and mean arterial pressure—was associated with an increased risk of hypertensive disorders of pregnancy. Associations with neonatal outcomes were modest. Overall, blood pressure variability may add value in identifying pregnancies at increased risk of hypertensive disorders, with limited associations with neonatal outcomes.
Blood pressure variability (BPV) is an established marker of cardiovascular risk outside pregnancy, yet its significance during gestation, when maternal hemodynamic and placental perfusion are critical, remains uncertain. We evaluated whether antenatal BPV is associated with adverse pregnancy and neonatal outcomes.
METHODS:
This prospective analysis used data from the population-based Mutaba’ah Study in the United Arab Emirates, including 5597 singleton live-birth pregnancies (2017–2024) with repeated antenatal blood pressure (BP) measurements (≥3 measurements). Visit-to-visit BPV for systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) was assessed using standard deviation (SD), average real variability (ARV), and variability independent of the mean (VIM). Multivariable logistic regression models evaluated associations between BPV and gestational hypertension (GH), preeclampsia (PE), preterm birth, neonatal intensive care unit (NICU) admission, and small-for-gestational-age (SGA) birth, adjusting for maternal age, smoking exposure, education, employment, obesity, parity, and diabetes status.
RESULTS:
Among 5597 singleton pregnancies, greater visit-to-visit BPV across pregnancy was consistently associated with hypertensive disorders of pregnancy. After multivariable adjustment, greater variability in SBP, DBP, and MAP—particularly as measured by SD and VIM—was associated with significantly increased odds of GH (adjusted odds ratios [aORs] up to 1.29) and preeclampsia (aORs up to 1.36). Associations between BPV and neonatal outcomes were modest; 6%–9% significant increases in the odds of preterm birth were observed for DBP and MAP, while no consistent associations were found with NICU admission or SGA birth.
CONCLUSIONS:
Greater visit-to-visit variability in antenatal blood pressure—particularly systolic, diastolic, and mean arterial pressure—was associated with an increased risk of hypertensive disorders of pregnancy. Associations with neonatal outcomes were modest. Overall, blood pressure variability may add value in identifying pregnancies at increased risk of hypertensive disorders, with limited associations with neonatal outcomes.
| eISSN: | 2654-1459 |
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