Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health

TY - CHAP

T1 - Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health

AU - Nzelu, Diane

AU - Ayis, Salma Ahmed Mohamed

AU - Kametas, Nickolas

PY - 2017

Y1 - 2017

N2 - P 33 Does the performance of mean arterial pressure for thescreening of preeclampsia differ between women with chronichypertension and women with a history of gestationalhypertension?Question: Recent studies have demonstrated that different parametersof blood pressure may hold valuable information not only inthe diagnosis of preeclampsia (PE) but also in identifying womenin their first and second trimester at risk of developing PE later inthe pregnancy. One such promising component is mean arterialblood pressure (MAP).This study aims to examine the prediction of MAP for PE, renaldysfunction, liver dysfunction and fetal growth restriction (FGR) intwo groups of high-risk pregnant women: with chronic hypertensionor a history of gestational hypertension.Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 9 (2017) 36–63 51Methods: A retrospective study was conducted on women withchronic hypertension (N = 478) and normotensive women with ahistory of gestational hypertension (N = 511) who booked with theAntenatal Hypertension Clinic, Kings College Hospital, London,between 2009–2016. Blood pressure was measured repeatedly antenatallyusing an automated device validated for use in pregnancyand PE. The updated International Society for the Study ofHypertension in Pregnancy (ISSHP)-2014 definition of PE was used.We constructed probit models to determine the predictive capacityof MAP by comparing the Receiver Operating CharacteristicCurves (ROC) in the two groups. Wald tests of the null hypothesisthat the two ROC curves are equal at different false-positive rateswere performed. Age and medication use were taken into accountin 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 gestationalhypertension, respectively (Figure 1:). The AUC for the predictionof 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 hypertensionand history of gestational hypertension, respectively (Figure 1).There were no differences found between the AUC for the predictionof FGR and liver dysfunction. Estimates were adjusted for age andmedication use, with the latter being strongly associated with hypertensionstatus.Conclusion: The ability of MAP to predict PE and renal dysfunctionis significantly affected by the woman’s hypertensive status, withimproved performance in women with a history of gestationalhypertension.

AB - P 33 Does the performance of mean arterial pressure for thescreening of preeclampsia differ between women with chronichypertension and women with a history of gestationalhypertension?Question: Recent studies have demonstrated that different parametersof blood pressure may hold valuable information not only inthe diagnosis of preeclampsia (PE) but also in identifying womenin their first and second trimester at risk of developing PE later inthe pregnancy. One such promising component is mean arterialblood pressure (MAP).This study aims to examine the prediction of MAP for PE, renaldysfunction, liver dysfunction and fetal growth restriction (FGR) intwo groups of high-risk pregnant women: with chronic hypertensionor a history of gestational hypertension.Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 9 (2017) 36–63 51Methods: A retrospective study was conducted on women withchronic hypertension (N = 478) and normotensive women with ahistory of gestational hypertension (N = 511) who booked with theAntenatal Hypertension Clinic, Kings College Hospital, London,between 2009–2016. Blood pressure was measured repeatedly antenatallyusing an automated device validated for use in pregnancyand PE. The updated International Society for the Study ofHypertension in Pregnancy (ISSHP)-2014 definition of PE was used.We constructed probit models to determine the predictive capacityof MAP by comparing the Receiver Operating CharacteristicCurves (ROC) in the two groups. Wald tests of the null hypothesisthat the two ROC curves are equal at different false-positive rateswere performed. Age and medication use were taken into accountin 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 gestationalhypertension, respectively (Figure 1:). The AUC for the predictionof 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 hypertensionand history of gestational hypertension, respectively (Figure 1).There were no differences found between the AUC for the predictionof FGR and liver dysfunction. Estimates were adjusted for age andmedication use, with the latter being strongly associated with hypertensionstatus.Conclusion: The ability of MAP to predict PE and renal dysfunctionis significantly affected by the woman’s hypertensive status, withimproved performance in women with a history of gestationalhypertension.

M3 - Meeting abstract

VL - 9 (2017)

BT - An International Journal of Women’s Cardiovascular Health

ER -