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

Objective: to carry out a comparative assessment of risk factors, target organ damage, and gestational outcomes in pregnant women with HTN and normal blood pressure (BP). Materials and Methods. The prospective cohort study included 88 pregnant women distributed among two groups: Group 1 (main group) included 44 women with white coat HTN), while Group 2 (comparison group) comprised 44 women with normal BP). We performed an assessment of clinical factors, 24-hour BP monitoring parameters, damage to target organs (heart, kidneys, and blood vessels), and pregnancy course and outcomes. Results. Women with white coat HTN vs. normotensive pregnant females 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 systolic (SBP) and diastolic BP (DBP) during daytime (p<0.001) and at night (p=0.006); higher daytime heart rate (p=0.006); thicker left ventricular posterior wall (p<0.001) and interventricular septum (p<0.001); greater relative wall thickness of the left ventricle (LV) (p=0.003); higher LV myocardial mass (p<0.001) and LV end-diastolic volume (p=0.020); thicker intima-media of blood vessels on the right (p=0.022) and left (p=0.006); and higher value of the right cardio-ankle vascular index (p=0.043) and urine albumin/creatinine ratio (p<0.001). The course of pregnancy in women with white coat HTN was more often aggravated by gestational diabetes mellitus (79.5% vs. 25%; p<0.001) and late-onset preeclampsia (11.4% vs. 0%; p=0.021). Conclusion. Pregnancy in women with white coat HTN is characterized by an increased risk of developing structural and functional changes in target organs and a high frequency of complications vs. normotensive pregnant women.