White coat hypertension in pregnant women: comparative assesment of risk factors, target organ damage and gestational outcomes

Objective: to conduct a comparative assessment of risk factors, target organ damage, and gestation outcomes in pregnant women with AH and normal blood pressure (BP). Material and methods. The prospective cohort study included 88 pregnant women divided into two groups: group 1 (main group) (44 women with white coat hypertension) and group 2 (comparison group) (44 women with normal blood pressure). Clinical factors, 24-h BP monitoring parameters, the state of target organs (heart, kidneys, and blood vessels), and pregnancy course and outcomes were recorded. Results. Women with white coat hypertension compared with normotensive pregnant women had a higher prevalence of abdominal obesity (90.9% vs 47.7%; p<0.001) and history of preeclampsia (11.4% vs 0%; p=0.021), higher night-time systolic (SBP) and diastolic BP, daytime diastolic BP (p<0.001), night-time diastolic BP (p=0.006), daytime heart rate (HR) (p=0.006), left ventricular posterior wall thickness (p<0.001), interventricular septal thickness (p<0.001), relative wall thickness (p=0.003), left ventricular myocardial mass (p<0.001), left ventricular end-diastolic volume (p=0.020), intima-media thickness on the right (p=0.022) and left (p=0.006), right cardio-ankle vascular index (p=0.043), urine albumin/creatinine ratio (p<0.001). The course of pregnancy in women with white coat hypertension was more often complicated by gestational diabetes mellitus (79.5% vs 25%; p<0.001) and late preeclampsia (11.4% vs 0%; p=0.021). Conclusion. Pregnancy in women with white coat hypertension is characterized by an increased risk of developing structural and functional changes in target organs and a high frequency of complications compared to pregnant women with normal BP.