The preventive effects of different interventions on gestational hypertension: incidence and network meta-analysis.
Yu Wu, Kangle Guo, Yongxiu Yang et al.
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In 30 seconds
This network meta-analysis of randomized controlled trials assessed interventions to prevent gestational hypertension in pregnant women. It included 50 trials involving 57,836 women and compared 12 interventions. Versus placebo, aspirin, calcium, and aspirin plus calcium were associated with lower odds of gestational hypertension; the largest reported reduction was with combined aspirin and calcium (OR = 0.12, 95% CI [0.03, 0.47]). Exercise and combined supplementation also outperformed usual care. Ranking analysis gave aspirin plus calcium the highest probability of being the most effective intervention.
Key findings
- Compared with placebo, aspirin was associated with lower odds of gestational hypertension (OR = 0.68, 95% CI [0.48, 0.95]).
- Compared with placebo, calcium was associated with lower odds of gestational hypertension (OR = 0.55, 95% CI [0.38, 0.80]).
- Aspirin plus calcium was associated with lower odds than placebo (OR = 0.12, 95% CI [0.03, 0.47]) and usual care (OR = 0.12, 95% CI [0.03, 0.42]).
- Exercise, including yoga and walking, was superior to usual care for prevention of gestational hypertension (OR = 0.39, 95% CI [0.19, 0.82]).
Why it matters
Gestational hypertension is the outcome targeted by these prevention trials, and the analysis suggests that several interventions may reduce its occurrence. The findings help compare options across a broad evidence base, while the network estimates and rankings should be interpreted cautiously because the authors note limited trial availability and potential heterogeneity.
What to keep in mind
The authors cite a limited number of available trials and potential heterogeneity, and call for further large-scale, high-quality randomized controlled trials.