(587) Placental analyte profiles in nulliparous women with AHA stage 1 hypertension

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: Definitions of chronic hypertension (HTN) differ between Obstetric and non-Obstetric guidelines. The American Heart Association (AHA) classifies a systolic blood pressure (BP) of 130-139 or diastolic BP of 80-89 as stage 1 HTN. It has been well described that stage 1 HTN confers a higher risk of hypertensive disorders of pregnancy (PIH). Further, pregnant women who develop PIH have also been shown to have specific profiles of placental analyte concentration in the first trimester. We aim to establish and compare the first trimester placental analyte profiles among women classified as having chronic HTN by non-Obstetric definitions.

Study Design: This was a secondary analysis of a prospective observational study investigating pregnancy outcomes in nulliparous women with singleton gestations (nuMoM2b). Known structural fetal abnormalities were excluded. Women were stratified based on documented prenatal blood pressures in the first trimester defined as 1) Normotensive ( < 130/ < 80) 2) Stage 1 HTN (130-139/80-89) and 3) Stage 2 HTN (≥140/≥90 or documented history of cHTN). Pair wise analyses were performed comparing mean placental analyte concentrations using Tukey’s multiple comparison test to calculate significant p-values.

Results: There were 2,039 patients who met inclusion criteria with placental analyte data available for analysis. Of these, 1,706 (83.7%), 219 (10.7%), and 114 (5.6%) classified as normotensive, stage 1 HTN, and stage 2 HTN, respectively. When compared to normotensive women, Stage I HTN had lower concentrations of Adam12 (p < .001), free bHCG (p=.034), and PAPP-A (p=.003). There were no differences noted among women with Stage 1 and Stage 2 HTN except for lower levels of sFlt-1 (p=.034, Table 1). Similar findings were noted when the analysis was performed among women who developed PIH (Figure 1).

Conclusion: Placental analyte profiles of nulliparous women with stage 1 hypertension closely resemble those of women with chronic hypertension and those who develop preeclampsia.

Primary & Presenting Author(s)

Ralitza H. Peneva, MD
Medical University of South Carolina
Johns Island, South Carolina, United States

Coauthor(s)

RC
Ryan Cuff, MD
Medical University of South Carolina
Charleston, South Carolina, United States
BH
Barbara Head, MD
MUSC
Charleston, South Carolina, United States
GC
Gene Chang, MD
Division Director
Medical University of South Carolina
Charleston, South Carolina, United States
MF
Matthew M. Finneran, MD
Assistant Professor
Medical University of South Carolina
Charleston, South Carolina, United States