Association of three different techniques to measure blood pressure in the first trimester with the development of hypertensive disorders of pregnancy


  • All authors fulfilled all conditions required for authorship and approved the submissions. The authors have stated explicitly that there are no conflicts of interest in connection with this article.


Karlijn C Vollebregt, Department of Obstetrics & Gynecology, Academic Medical Center, P.O. Box 226600, 1100 DD Amsterdam, the Netherlands. E-mail:



It is not known whether automated devices for measuring blood pressure perform better than conventional sphygmomanometry in predicting preeclampsia. This study compares two different automated devices with conventional sphygmomanometry for their association with development of preeclampsia or gestational hypertension.


Prospective observational cohort study.


University hospital, Amsterdam, the Netherlands.


289 healthy normotensive women of whom 235 were nulliparous and 44 parous with preeclampsia in a previous pregnancy.


At 8–11 weeks of pregnancy, blood pressure was measured with two different automated devices (continuous finger arterial pressure waveform registration and ambulatory blood pressure monitoring) and with conventional sphygmomanometry.

Main outcome measures

Preeclampsia and gestational hypertension.


Blood pressure in the first trimester, as measured with all three methods, was significantly higher in women who developed preeclampsia or gestational hypertension. After adjustment for previous preeclampsia, the point estimate of the odds ratios for association with later preeclampsia for both automated devices were comparable and higher than for conventional sphygmomanometry; however, differences were not statistically significant. The odds ratio (95% confidence intervals) for every 1 mmHg pressure increase of mean arterial pressure was 1.08 (1.02–1.15) for sphygmomanometry, 1.17 (1.09–1.27) for finger arterial pressure waveform registration, and 1.17 (1.07–1.27) for ambulatory blood pressure monitoring. Results were comparable if preeclampsia and gestational hypertension were analyzed together.


Blood pressure in the first trimester was associated with the development of hypertensive disorders of pregnancy. No significant differences were found between measurements by automatic devices compared with conventional sphygmomanometry.