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The Control of Hypertension In Pregnancy Study pilot trial

  1. LA Magee*,
  2. P Von Dadelszen,
  3. S Chan,
  4. A Gafni,
  5. A Gruslin,
  6. M Helewa,
  7. S Hewson,
  8. E Kavuma,
  9. SK Lee,
  10. AG Logan,
  11. D McKay,
  12. J-M Moutquin,
  13. A Ohlsson,
  14. E Rey,
  15. S Ross,
  16. J Singer,
  17. AR Willan,
  18. ME Hannah,
  19. CHIPS Pilot Trial Collaborative Group†

Article first published online: 16 MAY 2007

DOI: 10.1111/j.1471-0528.2007.01315.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 114, Issue 6, pages 770–e20, June 2007

Additional Information

How to Cite

Magee, L., Von Dadelszen, P., Chan, S., Gafni, A., Gruslin, A., Helewa, M., Hewson, S., Kavuma, E., Lee, S., Logan, A., McKay, D., Moutquin, J.-M., Ohlsson, A., Rey, E., Ross, S., Singer, J., Willan, A., Hannah, M. and CHIPS Pilot Trial Collaborative Group (2007), The Control of Hypertension In Pregnancy Study pilot trial. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 770–e20. doi: 10.1111/j.1471-0528.2007.01315.x

Author Information

  1. a Department of Medicine and b Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada c Maternal Infant and Reproductive Health Research Unit (MIRU), Centre for Research in Women’s Health, University of Toronto, Toronto, Canada d Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada e Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, Canada f Department of Obstetrics and Gynaecology, University of Manitoba, Winnipeg, Canada g Department of Paediatrics, University of Alberta, Edmonton, Canada h Department of Medicine, University of Toronto, Toronto, Canada i Department of Obstetrics and Gynaecology, University of Sherbrooke, Sherbrooke, Canada j Department of Paediatrics, University of Toronto, Toronto, Canadak Department of Medicine and Obstetrics and Gynaecology, University of Montréal, Montréal, Canadal Department of Obstetrics and Gynaecology, University of Calgary, Calgary, Canadam Department of Health Care and Epidemiology, University of British Columbia, Vancouver, Canadan Department of Public Health Sciences, University of Toronto, Toronto, Canada

  1. †

    See ‡ for the CHIPS Pilot Trial Collaborative Group.

*Dr LA Magee, BC Women’s Hospital and Health Centre, 4500 Oak Street, Room 1U59, Vancouver, British Columbia V6P 1S8, Canada. Email LMagee@cw.bc.ca

Publication History

  1. Issue published online: 16 MAY 2007
  2. Article first published online: 16 MAY 2007
  3. Accepted 8 January 2007.

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Keywords:

  • Antihypertensive therapy;
  • hypertension;
  • maternal outcome;
  • perinatal outcome;
  • pregnancy

Objective  To determine whether ‘less tight’ (versus ‘tight’) control of nonsevere hypertension results in a difference in diastolic blood pressure (dBP) between groups.

Design  Randomised controlled trial (ISRCTN#57277508).

Setting  Seventeen obstetric centres in Canada, Australia, New Zealand, and UK.

Population  Inclusion: pregnant women, dBP 90–109 mmHg, pre-existing/gestational hypertension; live fetus(es); and 20–33+6 weeks. Exclusion: systolic blood pressure ≥ 170 mmHg and proteinuria, contraindication, or major fetal anomaly.

Methods  Randomisation to less tight (target dBP, 100 mmHg) or tight (target dBP, 85 mmHg) blood pressure control.

Main outcome measures  Primary: mean dBP at 28, 32 and 36 weeks. Secondary: clinician compliance and women’s satisfaction. Other: serious perinatal and maternal complications.

Results  A total of 132 women were randomised to less tight (n= 66; seven had no study visit) or tight control (n= 66; one was lost to follow up; seven had no study visit). Mean dBP was significantly lower with tight control: −3.5 mmHg, 95% credible interval (−6.4, −0.6). Clinician compliance was 79% in both groups. Women were satisfied with their care. With less tight (versus tight) control, the rates of other treatments and outcomes were the following: post-randomisation antenatal antihypertensive medication use: 46 (69.7%) versus 58 (89.2%), severe hypertension: 38 (57.6%) versus 26 (40.0%), proteinuria: 16 (24.2%) versus 20 (30.8%), serious maternal complications: 3 (4.6%) versus 2 (3.1%), preterm birth: 24 (36.4%) versus 26 (40.0%), birthweight: 2675 ± 858 versus 2501 ± 855 g, neonatal intensive care unit (NICU) admission: 15 (22.7%) versus 22 (34.4%), and serious perinatal complications: 9 (13.6%) versus 14 (21.5%).

Conclusion  The CHIPS pilot trial confirms the feasibility and importance of a large definitive trial to determine the effects of less tight control on serious perinatal and maternal complications.

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