Pregnancy and Postpartum Trends in Self-Measured Blood Pressure and Derived Indices: The BOSHI Study

Seiya Izumi; Misato Nishimura; Noriyuki Iwama; Hasumi Tomita; Hirotaka Hamada; Taku Obara; Mami Ishikuro; Takahisa Murakami; Michihiro Satoh; Takuo Hirose; Masatoshi Saito; Takayoshi Ohkubo; Shinichi Kuriyama; Nobuo Yaegashi; Kazuhiko Hoshi; Yutaka Imai; Hirohito Metoki; BOSHI Study Group

doi:10.1111/jch.14949

Pregnancy and Postpartum Trends in Self-Measured Blood Pressure and Derived Indices: The BOSHI Study

J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14949. doi: 10.1111/jch.14949.

Authors

Seiya Izumi^{1

2}, Misato Nishimura², Noriyuki Iwama^{1

3}, Hasumi Tomita¹, Hirotaka Hamada¹, Taku Obara^{3

4

5}, Mami Ishikuro^{3

4}, Takahisa Murakami^{2

3}, Michihiro Satoh^{2

3

6}, Takuo Hirose⁷, Masatoshi Saito^{1

8}, Takayoshi Ohkubo^{9

10}, Shinichi Kuriyama^{3

4

11

12}, Nobuo Yaegashi¹², Kazuhiko Hoshi¹³, Yutaka Imai¹⁰, Hirohito Metoki^{2

3

10

12}; BOSHI Study Group

Affiliations

¹ Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
² Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan.
³ Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.
⁴ Division of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
⁵ Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan.
⁶ Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Miyagi, Japan.
⁷ Division of Integrative Renal Replacement Therapy, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Miyagi, Japan.
⁸ Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
⁹ Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
¹⁰ Tohoku Institute for Management of Blood Pressure, Sendai, Miyagi, Japan.
¹¹ International Research Institute of Disaster Science, Tohoku University, Sendai, Miyagi, Japan.
¹² Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
¹³ Suzuki Memorial Hospital, Iwanuma, Miyagi, Japan.

PMID: 39823166
DOI: 10.1111/jch.14949

Abstract

In this study, we aimed to reveal the trends of self-measured blood pressure (SMBP) and SMBP-derived indices during pregnancy and the postpartum period. The Babies and Their Parents Longitudinal Observation in Suzuki Memorial Hospital in the Intrauterine Period (BOSHI) Study is a prospective cohort study in Japan. Participants were instructed to measure SMBP daily during pregnancy and for 1 month after delivery. Among 237 participants with normotensive blood pressure (BP) during pregnancy and the postpartum period who were analyzed using mixed-effects models for repeated measures, the SMBP was measured, on average, 14.3 times from the day before delivery to 28 days postpartum. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) on the day before delivery were 110.6 ± 1.0 and 68.1 ± 0.8 mmHg (estimate ± standard error). Postpartum BP increased from postpartum Days 3-8 in SBP and from Days 3-22 in DBP, compared to that on the day before delivery. The SBP and DBP were 4.9 and 4.7 mmHg higher on postpartum Days 8 and 7 than the day before pregnancy, respectively. During pregnancy, the pulse rate (PR) showed an inverted U-shaped trend and then sharply increased rapidly until the first postpartum day after delivery. The Shock Index showed a similar trend to that of the PR, decreased from labor until postpartum Day 8, and plateaued thereafter. The double product peaked during labor, remained higher than the prelabor levels for approximately 10 days, and then decreased in the postpartum period.

Keywords: blood pressure self‐monitoring; cohort studies; postpartum period; pregnancy; pulse rate.

MeSH terms

Adult
Blood Pressure Determination* / methods
Blood Pressure* / physiology
Female
Heart Rate / physiology
Humans
Japan / epidemiology
Longitudinal Studies
Postpartum Period* / physiology
Pregnancy
Prospective Studies

Abstract

MeSH terms

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