Does the performance of mean arterial pressure for the screening of preeclampsia differ between women with chronic hypertension and women with a history of gestational hypertension?

Salma Ahmed Mohamed Ayis, Diane Nzelu, Dan Dumitrascu-Biris, Sadia Bhatti, Salma Ahmed Mohamed Ayis, Nikos Kametas

Research output: Chapter in Book/Report/Conference proceedingPoster abstractpeer-review

Abstract

Question Recent studies have demonstrated that different parameters of blood pressure may hold valuable information not only in the diagnosis of preeclampsia (PE) but also in identifying women in their first and second trimester at risk of developing PE later in the pregnancy. One such promising component is mean arterial blood pressure (MAP). This study aims to examine the prediction of MAP for PE, renal dysfunction, liver dysfunction and fetal growth restriction (FGR) in two groups of high-risk pregnant women: with chronic hypertension or a history of gestational hypertension. Methods A retrospective study was conducted on women with chronic hypertension (N = 478) and normotensive women with a history of gestational hypertension (N = 511) who booked with the Antenatal Hypertension Clinic, Kings College Hospital, London, between 2009–2016. Blood pressure was measured repeatedly antenatally using an automated device validated for use in pregnancy and PE. The updated International Society for the Study of Hypertension in Pregnancy (ISSHP)-2014 definition of PE was used. We constructed probit models to determine the predictive capacity of MAP by comparing the Receiver Operating Characteristic Curves (ROC) in the two groups. Wald tests of the null hypothesis that the two ROC curves are equal at different false-positive rates were performed. Age and medication use were taken into account in the comparisons. STATA 14.0 was used for the analysis. Results The area under the curves (AUC) for the prediction of PE (p = <0.001) was 0.65 (95% CI: 0.60–0.70) and 0.75 (95%CI: 0.65–0.85) for women with chronic hypertension and history of gestational hypertension, respectively (Fig. 1). The AUC for the prediction of renal dysfunction (p = 0.079) was 0.66 (95% CI: 0.62–0.71) and 0.79 (95% CI: 0.74–0.85) for women with chronic hypertension and history of gestational hypertension, respectively (Fig. 1). There were no differences found between the AUC for the prediction of FGR and liver dysfunction. Estimates were adjusted for age and medication use, with the latter being strongly associated with hypertension status. Conclusion The ability of MAP to predict PE and renal dysfunction is significantly affected by the woman’s hypertensive status, with improved performance in women with a history of gestational hypertension.
Original languageEnglish
Title of host publication/ Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health
Volume9 (2017)
Publication statusPublished - 2017

Fingerprint

Dive into the research topics of 'Does the performance of mean arterial pressure for the screening of preeclampsia differ between women with chronic hypertension and women with a history of gestational hypertension?'. Together they form a unique fingerprint.

Cite this