Women's views and postpartum follow-up in the CHIPS Trial (Control of Hypertension in Pregnancy Study)

Marianne Vidler, Laura A. Magee, Peter von Dadelszen, Evelyne Rey, Susan Ross, Elizabeth Asztalos, Kellie E. Murphy, Jennifer Menzies, Johanna Sanchez, Joel Singer, Amiram Gafni, Andrée Gruslin, Michael Helewa, Eileen Hutton, Shoo K. Lee, Terry Lee, Alexander Logan, Wessel Ganzevoort, Ross Welch, Jim G. ThorntonJean Marie Moutquin, The CHIPS Study Group, Raquel de Lourdes Martin, Maria Florencia Bassi, Mirta Clara Caruso, Valeria Lagunas, Fernando Vera, Maria Mohedano de Duhalde, Alicia Beatriz Roque, Patricia Roldan, Esteban Marcos Duhalde, Viviana Dip, Jesus Daniel Aguirre, Elba Mirta Alicia Morales, Griselda Itati Abreo, Teresa De Sagastizabal, Carolina Gomez, Nadia Rizzi, Carlos Arias, Ricardo Antonio Bruno, Kassam Mahomed, Alison Drew, Ann Green, Jane Hoare, Bill Hague, Suzette Coat, Caroline Crowther, Peter Muller, Sophie Trenowden, Barry Walters, Claire Parker, Dorothy Graham, Craig Pennell, Eileen Sung, Angela Makris, Gaksoo Lee, Charlene Thornton, Annemarie Hennessy, Louise Farrell, Nelson Sass, Henri Korkes, Dayana Couto Ferreira, Renato Augusto Moreira de Sa, Monique Schmidt Marques Abreu, Rita Guerios Bornia, Nancy Ribeiro da Silva, Fernanda Freitas Oliveira Cardoso, Caio Coelho Marques, Jorge Hornos, Ricardo Leal Davdt, Letícia Germany Paula, Pedro Luis Zanella, Laura A. Magee, Peter von Dadelszen, Gabrielle Inglis, Ruth Dillon, Ashley Docherty, Anna Hutfield, Keith Still, Sayrin Lalji, Tamara Van Tent, Chris Hotz, Tracy Messmer, Joel G. Ray, Howard Berger, Leanne De Souza, Andrea Lausman, Tatiana Freire-Lizama, Kate Besel, Paul Gibson, Greta Ellsworth, Leslie Miller, T. Lee-Ann Hawkins, Michelle Hladunewich, Anna Rogowsky, Dini Hui, Virginia Collins, Isabelle Delisle, Cora Fanning, Nestor Demianczuk, Rshmi Khurana, Winnie Sia, Catherine Marnoch, Carmen Young, Cheryl Lux, Evelyne Rey, Sophie Perreault, Valerie Tremblay, Anne Marie Côte ́, Jean Marie Moutquin, Sophie Desindes, Veronique Dagenais, Andrée Gruslin, Heather Clark, Elaine O’Shea, Ruth Rennicks White, Shital Gandhi, Mary Jean Martin, Cheryl Brush, Gareth Seaward, Jill Newstead-Angel, Judy Brandt, Jocelyne Martel, Kristine Mytopher, Elise Buschau, Erin Keely, Patti Waddell, Svetlana Shachkina, Alan Karovitch, Robert Anderson, Nicole Koenig, Theresa Yong, Marie Vasiliou, Peri Johnson, Beth Allan, Renato Natale, Laura Kennedy, Lucie Opatrny, Lorraine Lavigne, George Carson, Sheila Kelly, Joan Crane, Donna Hutchens, Juan Pedro Kusanovic, Christian Figueroa, Karla Silva Neculman, Juan Andres Ortiz, Paula Vargas, Pedro Ferrand, Jorge Carrillo, Rodrigo Cifuentes Borrero, Dahiana Marcela Gallo, Luisa Fernanda Moreno, Fred Kirss, Kristiina Rull, Anne Kirss, Tamas Major, Andrea Fodor, Tunde Bartha, Mordechai Hallak, Nardin Aslih, Saja Anabousi-Murra, Ester Pri-Or, Linda Harel, Sima Siev, Marwan Hakim, Christina Simona Khoury, Najla Hamati, Mazen El-Zibdeh, Lama Yousef, Ruth Hughes, Di Leishman, Barbra Pullar, Matthew Farrant, Malgorzata Swiatkowska-Freund, Krzysztof Preis, Anette Aleksandra Traczyk-Los, Anna Partyka, Joanna Preis-Orlikowska, Mariusz Lukaszuk, Grzegorz Krasomski, Michael Krekora, Anna Kedzierska-Markowicz, Katarzyna Zych-Krekora, Grzegorz H. Breborowicz, Anna Dera-Szymanowska, Wessel Ganzevoort, Jannet Bakker, Joost Akkermans, Anouk Pels, Eline van den Akker, Sabine Logtenberg, Steven Koenen, Maartje de Reus, David Borman, Martijn A. Oudijk, Annemiek Bolte, Viki Verfaille, Bart Graaf, Martina Porath, Corine Verhoeven, Ben Willem Mol, Maureen T.M. Franssen, Lida Ulkeman, Ineke Hamming, Jose H.M. Keurentjes, Ina van der Wal, S. W.A. Nij Bijvank, A. A. Lutjes, Henricus Visser, Hubertina Catharina Johanna Scheepers, Erik van Beek, Coby van Dam, Kathy van den Berg-Swart, Paula Pernet, Birgit van der Goes, Nico Schuitemaker, Gunilla Kleiverda, Marcel van Alphen, Ageeth Rosman, Ingrid Gaugler-Senden, Marieke Linders, Catherine Nelson-Piercy, Annette Briley, May Ching Soh, Kate Harding, Hayley Tarft, David Churchill, Katherine Cheshire, Julia Icke, Mausumi Ghosh, James Thornton, Yvonne Toomassi, Karen Barker, Joanne Fisher, Nicky Grace, Amanda Green, Joanne Gower, Anna Molnar, Shobhana Parameshwaran, Andrew Simm, George Bugg, Yvette Davis

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Objective To compare women's views about blood pressure (BP) control in CHIPS (Control of Hypertension In Pregnancy Study) (NCT01192412). Design Quantitative and qualitative analysis of questionnaire responses. Setting International randomised trial (94 sites, 15 countries). Population/sample 911 (92.9%) women randomised to ‘tight’ (target diastolic blood pressure, 85 mmHg) or ‘less tight’ (target diastolic blood pressure, 100 mmHg) who completed questionnaires. Methods A questionnaire was administered at ∼6–12 weeks postpartum regarding post-discharge morbidity and views about trial participation. Questionnaires were administered by the site co-ordinator, and contact was made by phone, home or clinic visit; rarely, data was collected from medical records. Quantitative analyses were Chi-square or Fisher's exact test for categorical variables, mixed effects multinomial logistic regression to adjust for confounders, and p < 0.001 for statistical significance. NVivo software was used for thematic analysis of women's views. Main outcome measures Satisfaction, measured as willingness to have the same treatment in another pregnancy or recommend that treatment to a friend. Results Among the 533 women in ‘tight’ (N = 265) vs. ‘less tight’ (N = 268) control who provided comments for qualitative analysis, women in ‘tight’ (vs. ‘less tight’) control made fewer positive comments about the amount of medication taken (5 vs. 28 women, respectively) and intensity of BP monitoring (7 vs. 17, respectively). However, this did not translate into less willingness to either have the same treatment in another pregnancy (434, 95.8% vs. 423, 92.4%, respectively; p = 0.14) or recommend that treatment to a friend (435, 96.0% and 428, 93.4%, respectively; p = 0.17). Importantly, although satisfaction remained high among women with an adverse outcome, those in ‘tight’ control who suffered an adverse outcome (vs. those who did not) were not consistently less satisfied, whereas this was not the case among women in ‘less tight’ control among whom satisfaction was consistently lower for the CHIPS primary outcome (p < 0.001), severe hypertension (p ≤ 0.01), and pre-eclampsia (p < 0.001). Conclusions Women in ‘tight’ (vs. ‘less tight’) control were equally satisfied with their care, and more so in the face of adverse perinatal or maternal outcomes.

Original languageEnglish
Pages (from-to)105-113
Number of pages9
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume206
DOIs
Publication statusPublished - Nov 2016
Externally publishedYes

Keywords

  • Blood pressure control
  • Hypertension
  • Postpartum
  • Pregnancy
  • Satisfaction

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