Association of Antepartum Blood Pressure and Angiogenic Profile in Women With Chronic Hypertension [3OP]

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This pilot study explored the association between antenatal blood pressure (BP) and angiogenic biomarkers (sFlt and PlGF) at delivery among women with chronic hypertension (cHTN).


Blood samples were collected within 96 hours of delivery. Mean outpatient BP was stratified as controlled (cBP<140/90) or uncontrolled (uBP≥140/90). Angiogenic factors were measured on an automated platform. Descriptive statistics were assessed with Wilcoxon Rank Sum or chi-square tests, as appropriate. Logistic regression was employed to assess for adverse pregnancy outcomes.


Of the 78 women enrolled, 58 (74.3%) were African American and 22 (28.2%) had uBP. There was no difference between cBP and uBP in age, race, ethnicity, BMI, smoking/substance abuse, parity, or previous preeclampsia (preE) diagnosis. A higher proportion cBP patients did not use a HTN agent (46.4% vs 13.6%, P=.01), although aspirin usage did not differ. Women with uBP had higher levels of sFlt1 and sFlt1/PlGF (sFlt: 4218.5 vs 3056.0 pg/mL, P=.046; sFlt/PlGF: 62.5 vs. 25.0, P=.04). A greater proportion of uBP vs. cBP patients had superimposed (SI) preE with severe features (preE-SF) (54.6% vs. 25.0%; P=.01), preterm delivery (40.9% vs. 10.7%; P=.002), and more admissions to rule out preE (77.3% vs. 30.4%; P=.0002). In the multivariable model, women with uBP had greater odds of preterm delivery (OR: 6.78; P=.01), SI preE (OR: 3.20; P=.03) and SI preE-SF (OR: 3.27; P=.04).


Antepartum control of BP is associated with a favorable angiogenic profile at delivery and improved outcomes among women with cHTN. Larger studies are needed to confirm these findings.

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