Management of non-severe pregnancy hypertension – A summary of the CHIPS Trial (Control of Hypertension in Pregnancy Study) research publications

Publication date: October 2019Source: Pregnancy Hypertension, Volume 18Author(s): Laura A. Magee, Evelyne Rey, Elizabeth Asztalos, Eileen Hutton, Joel Singer, Michael Helewa, Terry Lee, Alexander G. Logan, Wessel Ganzevoort, Ross Welch, Jim G. Thornton, Peter von DadelszenAbstractThe international CHIPS Trial (Control of Hypertension In Pregnancy Study) enrolled 987 women with chronic (75%) or gestational (25%) hypertension. Pre-eclampsia developed in 48%; women remained on their allocated BP control and delivered an average of two weeks later. ‘Less tight’ control (target diastolic BP 100 mmHg) achieved BP that was 6/5mmHg higher (p < 0.001) than ‘tight’ control (target diastolic 85 mmHg, BP achieved 133/85 mmHg). ‘Less tight’ (vs. ‘tight’) control resulted in similar adverse perinatal outcomes (31.5% vs. 30.7%; p = 0.84) that balanced birthweight < 10th percentile (16.1% vs. 19.8%; p = 0.14) against preterm birth (35.6% vs. 31.5%; p = 0.18). 12-month follow-up revealed no compelling evidence for developmental programming of child growth. However, ‘less tight’ (vs. ‘tight’) control resulted in more severe maternal hypertension (40.6% vs. 27.5%; p < 0.001), and more women with platelets < 100 × 109/L (4.3% vs. 1.6%; p = 0.02) or symptomatic elevated liver enzymes (4.3% vs. 1.8%; p = 0.03), with no difference in serious maternal complications (3.7% vs. 2.0%; p = 0.17). Labetalol was the ...
Source: Pregnancy Hypertension: An International Journal of Womens Cardiovascular Health - Category: OBGYN Source Type: research