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Seasonal variation in home blood pressure during pregnancy and frequency of hypertensive disorders of pregnancy: a multicenter prospective study of home blood pressure measurements in pregnant women using information technology

Hypertension Research volume 48, pages 110–120 (2025)Cite this article

Abstract

This multicenter prospective study investigated seasonal variation in home blood pressure (HBP) during pregnancy and its association with the frequency of hypertensive disorders of pregnancy (HDP) and developed trimester-specific upper limits of HBP according to season. Low-risk women with singleton pregnancies were recruited at six university hospitals and three maternity clinics. HBP was measured by a sphygmomanometer twice daily and recorded online using a mobile application. HBP was evaluated according to season (winter, spring, summer, and autumn) and gestational age. Of 705 women recruited, 603 were finally included. Mean diastolic HBP values were lowest in summer and highest in winter throughout pregnancy (mean difference between summer and winter, 3.5–4.6 mmHg). Mean systolic HBP values were also lowest in summer and highest in winter except during the early period of the second trimester (mean difference between summer and the season with the highest value, 2.5–3.4 mmHg). HDP was diagnosed in 32 women (5.3%). The risk of HDP was significantly higher in women who delivered in spring and autumn but not in winter compared with summer. The rounded upper limit of HBP was 120/80 mmHg in the first trimester, 120/75 mmHg in the second trimester, and 125/80 mmHg in the third trimester for summer and 125/85 mmHg, 125/80 mmHg, and 130/85 mmHg, respectively, for other seasons. Systolic and diastolic HBP were lowest in summer throughout pregnancy. Seasonal variation should be considered when interpreting HBP and the risk of HDP during pregnancy.

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Acknowledgements

We gratefully acknowledge the numerous study investigators, fellows, nurses, and research coordinators who participated in the study at the various study sites. The Japan Association of Obstetricians and Gynecologists Telemedicine Proof-of-Concept Home Blood Pressure Research Group is listed in the online appendix. We also thank Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

This work is funded by the Japan Association of Obstetricians and Gynecologists.

Author information

Author notes

  1. A full list of members and their affiliations appears in the Supplementary Information.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Saitama Medical University, Saitama, Japan

    Seung Chik Jwa, Natsuko Takano, Shunsuke Tamaru & Yoshimasa Kamei

  2. Department of Obstetrics and Gynecology, Jichi Medical University, Tochigi, Japan

    Seung Chik Jwa

  3. Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, Saitama, Japan

    Sachi Kijima & Hiroyuki Seki

  4. Aiwa Hospital, Saitama, Japan

    Tadashi Uesato

  5. Department of Regional Pediatrics and Perinatology, Ehime University Graduate School of Medicine, Ehime, Japan

    Keiichi Matsubara

  6. Perinatal Medical Center, Hirosaki University Hospital, Hirosaki, Japan

    Kanji Tanaka

  7. Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan

    Koutarou Doi & Hiroshi Sameshima

  8. Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan

    Takayuki Iriyama

  9. Fukushima Clinic, Fukuoka, Japan

    Kotaro Fukushima

  10. Hirata Clinic, Saitama, Japan

    Yoshiyasu Hirata

  11. Sanno Hospital, Tokyo, Japan

    Tomoyuki Fujii

  12. Ishiwata Obstetrics and Gynecology Hospital, Ibaraki, Japan

    Isamu Ishiwata

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Japan Association of Obstetricians and Gynecologists Telemedicine Proof-of-Concept Home Blood Pressure Research Group

Corresponding author

Correspondence to Seung Chik Jwa.

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Conflict of interest

Some of the sphygmomanometers used in this study were provided by the Japan Association of Obstetricians and Gynecologists at no charge.

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Jwa, S.C., Takano, N., Tamaru, S. et al. Seasonal variation in home blood pressure during pregnancy and frequency of hypertensive disorders of pregnancy: a multicenter prospective study of home blood pressure measurements in pregnant women using information technology. Hypertens Res 48, 110–120 (2025). https://doi.org/10.1038/s41440-024-01952-9

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