To test the hypothesis that nocturnal hypertension identifies risk for early-onset preeclampsia/eclampsia (PE), we conducted an historical cohort study of consecutive high-risk pregnancies between 1st January 2016 and 31st March 2020. Office blood pressure (BP) measurements and ambulatory blood pressure monitoring (ABPM) were performed. The cohort was divided into patients without PE or with early- or late-onset PE (<34 and ≥34 weeks of gestation, respectively). The relative risks of office and ABPM hypertension for the development of late- or early-onset PE were estimated with multinomial logistic regression using no PE as a reference category. Four hundred and seventy-seven women (mean age 30 ± 7 years, with 23 ± 7 weeks of gestation at the time of the BP measurements) were analyzed; 113 (23.7%) developed PE, 69 (14.5%) developed late-onset PE, 44 (9.2%) developed early-onset PE. Office and ambulatory BP increased between the groups, and women who developed early-onset PE had significantly higher office and ambulatory BP values than those with late-onset PE or without PE. Hypertension prevalence increased across groups, with the highest values in early-onset PE. Nocturnal hypertension was the most prevalent finding and was highly prevalent in women who developed early-onset PE (88.6%); only 1.6% of women without nocturnal hypertension developed early-onset PE. Additionally, nocturnal hypertension was a stronger predictor for early-onset PE than for late-onset PE (adjusted OR, 5.26 95%CI 1.67–16.60) vs. 2.06, 95%CI 1.26–4.55, respectively). In conclusion, nocturnal hypertension was the most frequent BP abnormality and a significant predictor of early-onset PE in high-risk pregnancies.

为了验证夜间高血压确定早发性先兆子痫/子痫 (PE) 风险的假设，我们对 2016 年 1 月 1 日至 2020 年 3 月 31 日期间连续高危妊娠进行了历史队列研究。办公室血压 (BP) 测量和动态进行了血压监测（ABPM）。该队列分为无 PE 或早发性或迟发性 PE 的患者（分别为妊娠<34 周和≥34 周）。办公室和 ABPM 高血压对迟发性或早发性 PE 发展的相对风险使用多项逻辑回归估计，使用无 PE 作为参考类别。分析了 477 名女性（平均年龄 30 ± 7 岁，测量血压时妊娠 23 ± 7 周）；113 (23.7%) 开发了 PE，69 (14. 5%) 发展为迟发性 PE，44 人 (9.2%) 发展为早发性 PE。两组之间的诊室和动态血压均有所增加，而发生早发性肺栓塞的女性的诊室和动态血压值显着高于患有迟发性肺栓塞或未患早发性肺栓塞的女性。高血压患病率在各组中增加，早发性 PE 的值最高。夜间高血压是最普遍的发现，并且在发生早发性 PE 的女性中非常普遍（88.6%）；只有 1.6% 的没有夜间高血压的女性出现早发性 PE。此外，夜间高血压对早发性 PE 的预测作用强于晚发性 PE（调整后的 OR，分别为 5.26 95%CI 1.67–16.60）与 2.06、95%CI 1.26–4.55）。综上所述，