scholarly journals EP03.07: Early pregnancy biomarkers and prediction of hypertensive disorders of pregnancy

2019 ◽  
Vol 54 (S1) ◽  
pp. 247-247
Author(s):  
M. Al‐Memar ◽  
H. Fourie ◽  
T. Vaulet ◽  
S. Bobdiwala ◽  
S. Saso ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

scholarly journals Maternal Early-Pregnancy Thyroid Function Is Associated With Subsequent Hypertensive Disorders of Pregnancy: The Generation R Study

2014 ◽  
Vol 99 (12) ◽  
pp. E2591-E2598 ◽  
Author(s):  
Marco Medici ◽  
Tim I. M. Korevaar ◽  
Sarah Schalekamp-Timmermans ◽  
Romy Gaillard ◽  
Yolanda B. de Rijke ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Early Pregnancy ◽  
Pregnancy Induced Hypertension ◽  
Hypertensive Disorders Of Pregnancy ◽  
Normal Range ◽  
Free T4 ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
Wide Range ◽  
Induced Hypertension

Context: Hypertensive disorders during pregnancy are associated with a wide range of maternal and fetal complications, and only a few risk factors are known for the development of these disorders during pregnancy. Conflicting and limited data are available on the relationship between thyroid (dys)function and the risk of hypertensive disorders of pregnancy. Objective: The objective of the investigation was to study the associations between early-pregnancy thyroid dysfunction, thyroid function within the normal range, and the risk of hypertensive disorders. Design, Setting, and Participants: In early pregnancy, serum TSH, free T4 (FT4), and thyroperoxidase antibody (TPOAb) levels were determined in 5153 pregnant women. No interventions were done. The associations of thyroid function with the risk of hypertensive disorders were studied. Main Outcome Measures: Mean blood pressures and hypertensive disorders, including pregnancy-induced hypertension (n = 209) and preeclampsia (n = 136), were measured. Results: Hyperthyroid mothers had a higher risk of hypertensive disorders [odds ratio (OR) 3.40 [95% confidence interval (CI) 1.46–7.91], P = .005], which was mainly due to an increased risk of pregnancy-induced hypertension [OR 4.18 (95% CI 1.57–11.1), P = .004]. Hypothyroidism and hypothyroxinemia were not associated with hypertensive disorders. Within the normal range, the high-normal FT4 levels were associated with an increased risk of hypertensive disorders [OR 1.62 (95% CI 1.06–2.47), P = .03], which was mainly due to an increased risk of preeclampsia [OR 2.06 (95% CI 1.04–4.08), P = .04]. The TPOAb status was not associated with hypertensive disorders. Conclusions: We show that biochemical hyperthyroidism and also high-normal FT4 levels during early pregnancy are associated with an increased risk of hypertensive disorders. These data demonstrate that these associations are even seen for a mild variation in thyroid function within the normal range.

scholarly journals Early Pregnancy Serum Metabolite Profiles Associated with Hypertensive Disorders of Pregnancy in African American Women: A Pilot Study

2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Erin P. Ferranti ◽  
Jennifer K. Frediani ◽  
Rebecca Mitchell ◽  
Jolyn Fernandes ◽  
Shuzhao Li ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
Early Pregnancy ◽  
Metabolic Pathways ◽  
Disease Process ◽  
Full Term ◽  
Hypertensive Disorders Of Pregnancy ◽  
American Women ◽  
Hypertensive Disorders ◽  
Increased Risk

Hypertensive disorders of pregnancy (HDP) are the most common cardiometabolic complications of pregnancy, affecting nearly 10% of US pregnancies and contributing substantially to maternal and infant morbidity and mortality. In the US, women of African American race are at increased risk for HDP. Early biomarkers that reliably identify women at risk for HDP remain elusive, yet are essential for the early identification and targeting of interventions to improve maternal and infant outcomes. We employed high-resolution metabolomics (HRM) to identify metabolites and metabolic pathways that were altered in early (8-14 weeks) gestation serum samples of pregnant African American women who developed HDP after 20 weeks’ gestation (n=20)—either preeclampsia (PE; n=11) or gestational hypertension (gHTN; n=9)—compared to those who delivered full term without complications (n=80). We found four metabolic pathways that were significantly (p<0.05) altered in women who developed PE and five pathways that were significantly (p<0.05) altered in women who developed gHTN compared to women who delivered full term without complications. We also found that four specific metabolites (p<0.05) were distinctly upregulated (retinoate, kynurenine) or downregulated (SN-glycero-3-phosphocholine, 2′4′-dihydroxyacetophenone) in women who developed PE compared to gHTN. These findings support that there are systemic metabolic disruptions that are detectable in early pregnancy (8-14 weeks of gestation) among pregnant African American women who develop PE and gHTN. Furthermore, the early pregnancy metabolic disruptions associated with PE and gHTN are distinct, implying they are unique entities rather than conditions along a spectrum of the same disease process despite the common clinical feature of high blood pressure.

790: The early pregnancy bioinflammatory milieu and hypertensive disorders of pregnancy

2016 ◽  
Vol 214 (1) ◽  
pp. S413
Author(s):  
Niraj Chavan ◽  
Kristin Ashford ◽  
Amanda Wiggins ◽  
Andrea McCubbin ◽  
Janine Barnett ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Early Pregnancy Blood Pressure Patterns Identify Risk of Hypertensive Disorders of Pregnancy Among Racial and Ethnic Groups.

Hypertension ◽  
2021 ◽  
Author(s):  
Erica P. Gunderson ◽  
Mara Greenberg ◽  
Mai N. Nguyen-Huynh ◽  
Cassidy Tierney ◽  
James M. Roberts ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Early Pregnancy ◽  
Latent Class ◽  
Gestational Hypertension ◽  
Individual Risk ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Race Ethnicity ◽  
Trajectory Group ◽  
Blood Pressure Patterns

Background: Hypertensive disorders of pregnancy are a leading cause of severe maternal morbidity and mortality and 4-fold higher perinatal mortality in Black women. Early pregnancy blood pressure patterns may differentiate risk of hypertensive disorders of pregnancy. Methods: This study identified distinct blood pressure trajectories from 0 to 20 weeks’ gestation to evaluate subsequent pregnancy-related hypertension in a retrospective cohort of 174 925 women with no prior hypertension or history of preeclampsia, prenatal care entry ≤14 weeks, and a stillborn or live singleton birth delivered at Kaiser Permanente Northern California hospitals in 2009 to 2019. We used electronic health records to obtain clinical outcomes, covariables, and longitudinal outpatient blood pressure measurements ≤20 weeks’ gestation (mean 4.1 measurements). Latent class trajectory modeling identified 6 blood pressure groups: ultra-low-declining(referent), low-declining, moderate-fast-decline, low-increasing, moderate-stable, and elevated-stable. Multivariable logistic regression evaluated trajectory group-associations with odds of preeclampsia and gestational hypertension and effect modification by race-ethnicity and prepregnancy body size. Results: Compared with ultra-low-declining, adjusted odds ratios (95% CIs) for low-increasing, moderate-stable, and elevated-stable groups were 3.25 (2.7–3.9), 5.3 (4.5–6.3), and 9.2 (7.7–11.1) for preeclampsia, and 6.4 (4.9–8.3), 13.6 (10.5–17.7), and 30.2 (23.2–39.4) for gestational hypertension. Race/ethnicity, and prepregnancy obesity modified the trajectory-group associations with preeclampsia (interaction P <0.01), with highest risks for Black, then Hispanic and Asian women for all blood pressure trajectories, and with increasing obesity class. Conclusions: Early pregnancy blood pressure patterns revealed racial and ethnic differences in associations with preeclampsia risk within equivalent levels and patterns. These blood pressure patterns may improve individual risk stratification permitting targeted surveillance and early mitigation strategies.

50. Cardiovascular health in early pregnancy and hypertensive disorders of pregnancy

2018 ◽  
Vol 13 ◽  
pp. S62-S63
Author(s):  
Laura Benschop ◽  
Sarah Schalekamp-Timmermans ◽  
Stieneke Schelling ◽  
Vincent Jaddoe ◽  
Jeanine Roeters van Lennep ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Cardiovascular Health ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders
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