Ambulatory Blood Pressure Monitoring in Pregnancy; Does It Influence Our Practice?

Maternal hypertensive disorder is a well-known medical problem during pregnancy and is associated with morbidity and mortality. Out-of-office blood pressure (BP) measurement has been widely used but the importance of detecting white coat hypertension (WCH) is still a topic for debate. The aim of this study was to determine the prevalence of WCH in high-risk pregnant women. We included 56 pregnant women with in-office higher-than-normal BP without previous history of HTN to assess their BP using 24-hour ambulatory blood pressure monitoring (ABPM). The mean age of the participants was 31.61 ± 5.42 years (n = 56) and the majority in the second or third trimesters. Hypertension was detected in 55.4% using 24-hour ABPM. Twenty-five patients (44.6%) had WCH, 60% of whom were in the third trimester. There was a significant difference in the incidence of WCH between women younger than 30 and older individuals (P = 0.041). The mean age was 33.13 ± 5.16 years in patients with true HTN and 29.72 ± 5.22 years in WCH patients (P = 0.018). The prevalence of WCH in pregnancy is noteworthy. Regarding its favorable outcome, this might be a heads-up to avoid unnecessary medication during pregnancy and be concise about defining HTN in this population.