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O119. Cardiovascular risk management after reproductive and pregnancy related disorders: A Dutch multidisciplinary evidence-based guideline
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 209–258
history of previous PE, by some genetic functional polimorphisms of pathways involved in the pathogenesis of those diseases. Methods: A prospective study was done in a sample of 138 women (35.2 5.48 years old), 90 of those presented PE 2–16 years ago. We evaluated demographic, anthropometric, haemodynamic and biochemical parameters: hsCRP, liver function tests, lipid profile, nitrites, nitrates and myeloperoxidase. Functional polymorphisms of some genes belonging to those pathways were determined by molecular biology techniques (PCR, PCR-RFLP). Statistical analyses were performed by parametric or non-parametric tests when appropriate. Results: Hypertension develops significantly (p < 0.001) in 47,7% of women with history of PE compared with only 10.3% hypertensive women that did not have previous PE. Only some of the genotype carriers of those studied genes present already alterations in those parameters in normotensive women with history of previous PE compared with those without PE. Conclusions: Some potential biomarkers including the genetic ones at different biological levels, of risk for the development of future cardiovascular diseases can be identified in women with previous PE. doi:10.1016/j.preghy.2015.07.067
O118. Subsequent preeclampsia is associated with worse subclinical left ventricular dysfunction York Yann Chow a, Deven Mahadavan b, Gus Dekker c, Noriko Warren b, Melanie Wittwer a, Vikki Clifton d, Margaret Arstall a (a Lyell McEwin Hospital, University of Adelaide, Department of Cardiology, Adelaide, Australia, b Lyell McEwin Hosptial, Department of Cardiology, Adelaide, Australia, c Lyell McEwin Hospital, University of Adelaide, Department of Gynecology and Department of Obstetrics, Adelaide, Australia, d Mater Medial Research Institute, Wollongabba, Australia) Introduction: Preeclampsia is associated with cardiac dysfunction and long-term cardiovascular disease. A novel echocardiography technique measuring cardiac strain using speckle tracking myocardial deformation is closely related to the functional state of the myocardium and is more sensitive in the early detection of subtle left ventricular changes. Objective: Evaluate cardiac structure and function using novel echo assessment in preeclampsia Methods: We evaluated 14 preeclampsia women, 5 of whom had previous preeclampsia, aged 29 5, BMI 37 12 at 36.1 2.2 weeks of gestation within 1 week diagnosis of new onset hypertension (>140/90mmHg) and proteinuria (spot urine protein/creatine ratio >30 mg/mmol). 20 women with uncomplicated pregnancy were matched for age, BMI and gestation. Echocardiography of left ventricular mass index, ejection fraction and global longitudinal strain were assessed. Statistical analysis included Student’s t-test and one-way ANOVA. Results: There was a significantly higher left ventricular mass index in women with preeclampsia (97.52 14.51 g/m2 vs. 82.61 13.21 g/m2) (p = 0.02). Conventional echo assessment of ejection fraction using Simpson biplane was not different between control and preeclampsia. However global longitudinal strain was significantly reduced in preeclampsia group ( 17 2.69 vs. 20.2 1.49) (p = 0.0004). Preeclampsia women with history of preeclampsia was associated with further impairment of global longitudinal strain (one-way ANOVA, p < 0.05). Conclusion: Our data confirm previous studies that preeclampsia is associated with subclinical left ventricular dysfunction measured by speckle tracking. In addition, we have demonstrated that this deterioration is incrementally worse with subsequent preeclampsia
235
events. These preliminary findings will be explored further both in pregnancy and the postpartum period. doi:10.1016/j.preghy.2015.07.068
O119. Cardiovascular risk management after reproductive and pregnancy related disorders: A Dutch multidisciplinary evidence-based guideline Karst Heida a, Michiel Bots b, Miram Cohen c, d e Frederique Van Dunné , Christianne De Groot , Nurah Hammoud a, Annemiek Hoek f, Joop Laven g, Angela Maas h, Jeanine Roeters van Lennep i, Birgitta Velthuis j, Arie Franx a (a University Medical Center Utrecht, Department of Obstetrics, Utrecht, The Netherlands, b University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands, c Camper Practice, Primary Care, Amsterdam, The Netherlands, d Medical Center Haaglanden, Department of Obstetrics, The Hague, The Netherlands, e VU Medical Center Amsterdam, Department of Obstetrics, Amsterdam, The Netherlands, f University Medical Center Groningen, Department of Obstetrics & Gynecology, Groningen, The Netherlands, g Erasmus MC, Department of Obstetrics & Gynecology, Rotterdam, The Netherlands, h Radboud University Medical Center, Department of Cardiology, Nijmegen, The Netherlands, i Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands, j University Medical Center Utrecht, Department of Radiology, Utrecht, The Netherlands) Introduction: In the past decades evidence has accumulated that women with reproductive and pregnancy related disorders are at increased risk of developing cardiovascular disease (CVD) in the future. Up to now there is no standardized follow-up of these women since guidelines on cardiovascular risk management for this group are lacking. However, early identification of high-risk populations followed by prevention and treatment of CVD risk factors has the potential to reduce CVD incidence. Objective: The Dutch Society of Obstetrics and Gynaecology initiated a multidisciplinary working group (gynecologists, cardiologist, vascular internist, radiologist, general practitioner, epidemiologist and representatives of patient associations) to develop a guideline for cardiovascular risk management after reproductive and pregnancy related disorders. Methods: The guideline was developed using the ‘‘Appraisal of Guidelines for Research and Evaluation’’ instrument. The guideline addresses the cardiovascular risk consequences of gestational hypertension, preeclampsia, preterm delivery, small-for-gestational-age infant, recurrent miscarriage, polycystic ovary syndrome and premature ovarian insufficiency. The best available evidence on these topics was gathered by systematic review and the relation between the reproductive or pregnancy related disorders and CVD risk and risk factors was assessed by meta-analysis. Recommendations for clinical practice were formulated based on the number and quality of the studies and presence or absence of a relative risk >2 of developing CVD events and/or risk factors from the meta-analysis. The Dutch societies of gynaecologists, cardiologists, vascular internists, radiologists, and general practitioners endorsed the guideline to ensure support for implementation in clinical practice. Results: For all reproductive and pregnancy related disorders only a moderate increased relative risk (<2) was found for overall CVD, except for preeclampsia (relative risk 2.15, 95% CI 1.76–2.61). Based on the current available evidence, follow-up is only recommended for women with a history of preeclampsia. A cardiovascular risk profile should be offered at the age of 50 years. Assessment of CVD risk and treatment of cardiovascular risk factors should be
236
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 209–258
performed according to the Dutch guideline for cardiovascular risk management. For all reproductive and pregnancy related disorders optimization of modifiable cardiovascular risk factors is recommended to reduce the risk of future CVD. Conclusion: In this guideline we present the recommendations for cardiovascular risk management after reproductive and pregnancy related disorders. To the best of our knowledge we are the first to make such recommendations in a national guideline. doi:10.1016/j.preghy.2015.07.069
O120. Increased Myeloperoxidase is a cardiovascular risk biomarker in women with previous preeclampsia Andreia Matos a, Alice Rivera b, Alda Pereira da Silva a, Ana Portelinha c, Maria José Areias d, Irene Rebelo e, Manuel Bicho⁄ a, José R. Romero f (a Faculty of Medicine of University of Lisbon and Instituto de Investigação Científica Bento da Rocha Cabral, Genetics Laboratory and Environmental Health Institute, Lisbon, Portugal, b Boston Children’s Hospital and Harvard Medical School, Depts. of Pathology and Laboratory Medicine, Boston, USA , c New University of Lisbon, Chronic Diseases Research Centre (CEDOC), Lisbon, Portugal, d Maria Pia Hospital, Júlio Diniz Maternity, Porto, Portugal, e Faculty of Pharmacy/Institute for Molecular and Cell Biology, University of Porto, Laboratory of Biochemistry, Porto, Portugal, f Brigham and Women’s Hospital and Dept. of Medicine, Harvard Medical School, Div. of Endocrinology, Diabetes and Hypertension, Boston, USA ) Introduction: There is growing evidence showing that women who have had preeclampsia have an increased risk of developing cardiovascular disease (CVD). Various groups have proposed increased levels of the vasoconstrictor, Endothelin-1 (ET-1), in the pathophysiology of preeclampsia via increased angiotensin II and reactive oxygen species (ROS) through mechanisms that remain unresolved. Myeloperoxidase (MPO) is an enzyme that catalyzes ROS formation and is a critical factor of the innate immune responses that may contribute to tissue damage during inflammation. Indeed, increased MPO levels predict the risk of CVD and are proposed as a target for therapeutic intervention. MPO is secreted from azurophilic granules in activated leukocytes and participates in respiratory burst responses. However the relationship between MPO, leukocytes and ET-1 levels in women that had preeclampsia in the past is unclear. Objectives: To evaluate the effect of activation of ex vivo human leukocytes with ET-1 on MPO production and its genotype-phenotype relationship in women that had preeclampsia. Methods: We studied 150 women, aged 35.1 5.5 years [60 (40%)] that had normal blood pressure during pregnancy (NBPP) and compared them to women [90 (60 %)] that had preeclampsia (PE) 2–16 years ago and measured HS-C-reactive protein (CRP) and MPO levels. Results: Our results show dose-dependent increases of MPO from ex vivo human leukocytes treated with either endothelin-1 or angiotensin II via activation of endothelin-1 or angiotensin II receptors, respectively. Consistent with these data, we observed higher circulating MPO levels in PE when compared with NBPP women (n = 55; P < 0.04) that were associated with increased HS-CRP levels in a cohort of our subjects. We then determined the genetic variants of the MPO gene by PCR-RFLP in a larger sample size and observed that PE was associated with increased MPO risk genotype (GG) (n = 71; P < 0.02). Conclusion: Our results suggest that in PE, activated leukocytes and genetic variants of MPO contribute to increased MPO levels.
Thus MPO measures may serve to improve CVD risk stratification among women that had PE. doi:10.1016/j.preghy.2015.07.070
O121. Maternal metabolic outcomes in women with a history of hypertensive pregnancy disorders Laura Benschop a, Jeanine E. Roeters-van Lennep b, Sarah Schalekamp-Timmermans a, Vincent W.V. Jaddoe c, Nienke E. Bergen a, Eric A.P. Steegers a (a Erasmus MC, Department of Obstetrics & Gynecology, Rotterdam, The Netherlands, b Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands, c Erasmus MC, Dept. Epideimology & Dept. Pediatrics, Rotterdam, The Netherlands) Introduction: Women with preeclampsia or pregnancy induced hypertension (PIH) show metabolic aberrations during pregnancy similar to the metabolic syndrome. These women also are at increased risk of cardiovascular disease later in life. Objective: To assess whether women with preeclampsia or PIH have more unfavorable metabolic outcomes six years after pregnancy compared to normotensive women. Methods: This study was embedded in the Generation R study, a population-based prospective cohort study. Information on pregnancy and metabolic outcomes six years after pregnancy was available in 4933 women. We measured total body and abdominal fat distribution, weight and plasma lipid concentrations (total cholesterol, LDL-c, HDL-c, triglycerides, Apolipoprotein-B (Apo-B), lipoprotein (a) (lp-a)). Results: Compared with normotensive women, women with PIH had higher Apo-B (0.05g/l; 95%CI 0.02, 0.08), LDL-c (0.13 mmol/l; 95%CI 0.04, 0.22), triglyceride (0.11 mmol/l; 95%CI 0.01, 0.21) and total cholesterol concentrations (0.15 mmol/l; 95%CI 0.02, 0.29) and lower HDL-c concentrations ( 0.06 mmol/l; 95%CI 0.11, 0.01). No differences were observed in lipid concentrations between normotensive and preeclamptic women. Women with PIH or preeclampsia both had higher body fat percentages (0.03%; 95%CI 0.02, 0.04 and 0.02%; 0.00, 0.04), higher BMI (3.6 kg/m2; 95%CI 2.9, 4.2 and 2.4 kg/m2; 1.4, 3.4, respectively) and increased risk of clustering of metabolic risk factors (OR 2.2; 95%CI 1.4, 3.3 and OR 2.3; 95%CI 1.3, 4.3, respectively) compared with normotensive women. These associations attenuated after adjustment for maternal weight gain after pregnancy. Early pregnancy weight seems to be a predictor for these unfavorable outcomes (figure). Conclusion: Hypertensive pregnancy disorders, especially PIH, were associated with adverse metabolic outcomes and an increased risk of clustering of metabolic risk factors six years after pregnancy compared to normotensive women. We therefore advise to perform regular metabolic check-up on these women after delivery.
doi:10.1016/j.preghy.2015.07.071
O122. The role of framing in modifying behavior to reduce cardiovascular risk after preeclampsia, a vignette study Anouk Bokslag a, Wietske Hermes b, Christianne De Groot a, Pim Teunissen c (a VU Medical Center Amsterdam, Department of Obstetrics & Gynecology, Amsterdam, The Netherlands, b Medical Center Haaglanden, Department of Obstetrics & Gynecology, The Hague, The Netherlands, c VU Medical Center Amsterdam, 1st Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands)
history of previous PE, by some genetic functional polimorphisms of pathways involved in the pathogenesis of those diseases. Methods: A prospective study was done in a sample of 138 women (35.2 5.48 years old), 90 of those presented PE 2–16 years ago. We evaluated demographic, anthropometric, haemodynamic and biochemical parameters: hsCRP, liver function tests, lipid profile, nitrites, nitrates and myeloperoxidase. Functional polymorphisms of some genes belonging to those pathways were determined by molecular biology techniques (PCR, PCR-RFLP). Statistical analyses were performed by parametric or non-parametric tests when appropriate. Results: Hypertension develops significantly (p < 0.001) in 47,7% of women with history of PE compared with only 10.3% hypertensive women that did not have previous PE. Only some of the genotype carriers of those studied genes present already alterations in those parameters in normotensive women with history of previous PE compared with those without PE. Conclusions: Some potential biomarkers including the genetic ones at different biological levels, of risk for the development of future cardiovascular diseases can be identified in women with previous PE. doi:10.1016/j.preghy.2015.07.067
O118. Subsequent preeclampsia is associated with worse subclinical left ventricular dysfunction York Yann Chow a, Deven Mahadavan b, Gus Dekker c, Noriko Warren b, Melanie Wittwer a, Vikki Clifton d, Margaret Arstall a (a Lyell McEwin Hospital, University of Adelaide, Department of Cardiology, Adelaide, Australia, b Lyell McEwin Hosptial, Department of Cardiology, Adelaide, Australia, c Lyell McEwin Hospital, University of Adelaide, Department of Gynecology and Department of Obstetrics, Adelaide, Australia, d Mater Medial Research Institute, Wollongabba, Australia) Introduction: Preeclampsia is associated with cardiac dysfunction and long-term cardiovascular disease. A novel echocardiography technique measuring cardiac strain using speckle tracking myocardial deformation is closely related to the functional state of the myocardium and is more sensitive in the early detection of subtle left ventricular changes. Objective: Evaluate cardiac structure and function using novel echo assessment in preeclampsia Methods: We evaluated 14 preeclampsia women, 5 of whom had previous preeclampsia, aged 29 5, BMI 37 12 at 36.1 2.2 weeks of gestation within 1 week diagnosis of new onset hypertension (>140/90mmHg) and proteinuria (spot urine protein/creatine ratio >30 mg/mmol). 20 women with uncomplicated pregnancy were matched for age, BMI and gestation. Echocardiography of left ventricular mass index, ejection fraction and global longitudinal strain were assessed. Statistical analysis included Student’s t-test and one-way ANOVA. Results: There was a significantly higher left ventricular mass index in women with preeclampsia (97.52 14.51 g/m2 vs. 82.61 13.21 g/m2) (p = 0.02). Conventional echo assessment of ejection fraction using Simpson biplane was not different between control and preeclampsia. However global longitudinal strain was significantly reduced in preeclampsia group ( 17 2.69 vs. 20.2 1.49) (p = 0.0004). Preeclampsia women with history of preeclampsia was associated with further impairment of global longitudinal strain (one-way ANOVA, p < 0.05). Conclusion: Our data confirm previous studies that preeclampsia is associated with subclinical left ventricular dysfunction measured by speckle tracking. In addition, we have demonstrated that this deterioration is incrementally worse with subsequent preeclampsia
235
events. These preliminary findings will be explored further both in pregnancy and the postpartum period. doi:10.1016/j.preghy.2015.07.068
O119. Cardiovascular risk management after reproductive and pregnancy related disorders: A Dutch multidisciplinary evidence-based guideline Karst Heida a, Michiel Bots b, Miram Cohen c, d e Frederique Van Dunné , Christianne De Groot , Nurah Hammoud a, Annemiek Hoek f, Joop Laven g, Angela Maas h, Jeanine Roeters van Lennep i, Birgitta Velthuis j, Arie Franx a (a University Medical Center Utrecht, Department of Obstetrics, Utrecht, The Netherlands, b University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands, c Camper Practice, Primary Care, Amsterdam, The Netherlands, d Medical Center Haaglanden, Department of Obstetrics, The Hague, The Netherlands, e VU Medical Center Amsterdam, Department of Obstetrics, Amsterdam, The Netherlands, f University Medical Center Groningen, Department of Obstetrics & Gynecology, Groningen, The Netherlands, g Erasmus MC, Department of Obstetrics & Gynecology, Rotterdam, The Netherlands, h Radboud University Medical Center, Department of Cardiology, Nijmegen, The Netherlands, i Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands, j University Medical Center Utrecht, Department of Radiology, Utrecht, The Netherlands) Introduction: In the past decades evidence has accumulated that women with reproductive and pregnancy related disorders are at increased risk of developing cardiovascular disease (CVD) in the future. Up to now there is no standardized follow-up of these women since guidelines on cardiovascular risk management for this group are lacking. However, early identification of high-risk populations followed by prevention and treatment of CVD risk factors has the potential to reduce CVD incidence. Objective: The Dutch Society of Obstetrics and Gynaecology initiated a multidisciplinary working group (gynecologists, cardiologist, vascular internist, radiologist, general practitioner, epidemiologist and representatives of patient associations) to develop a guideline for cardiovascular risk management after reproductive and pregnancy related disorders. Methods: The guideline was developed using the ‘‘Appraisal of Guidelines for Research and Evaluation’’ instrument. The guideline addresses the cardiovascular risk consequences of gestational hypertension, preeclampsia, preterm delivery, small-for-gestational-age infant, recurrent miscarriage, polycystic ovary syndrome and premature ovarian insufficiency. The best available evidence on these topics was gathered by systematic review and the relation between the reproductive or pregnancy related disorders and CVD risk and risk factors was assessed by meta-analysis. Recommendations for clinical practice were formulated based on the number and quality of the studies and presence or absence of a relative risk >2 of developing CVD events and/or risk factors from the meta-analysis. The Dutch societies of gynaecologists, cardiologists, vascular internists, radiologists, and general practitioners endorsed the guideline to ensure support for implementation in clinical practice. Results: For all reproductive and pregnancy related disorders only a moderate increased relative risk (<2) was found for overall CVD, except for preeclampsia (relative risk 2.15, 95% CI 1.76–2.61). Based on the current available evidence, follow-up is only recommended for women with a history of preeclampsia. A cardiovascular risk profile should be offered at the age of 50 years. Assessment of CVD risk and treatment of cardiovascular risk factors should be
236
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 209–258
performed according to the Dutch guideline for cardiovascular risk management. For all reproductive and pregnancy related disorders optimization of modifiable cardiovascular risk factors is recommended to reduce the risk of future CVD. Conclusion: In this guideline we present the recommendations for cardiovascular risk management after reproductive and pregnancy related disorders. To the best of our knowledge we are the first to make such recommendations in a national guideline. doi:10.1016/j.preghy.2015.07.069
O120. Increased Myeloperoxidase is a cardiovascular risk biomarker in women with previous preeclampsia Andreia Matos a, Alice Rivera b, Alda Pereira da Silva a, Ana Portelinha c, Maria José Areias d, Irene Rebelo e, Manuel Bicho⁄ a, José R. Romero f (a Faculty of Medicine of University of Lisbon and Instituto de Investigação Científica Bento da Rocha Cabral, Genetics Laboratory and Environmental Health Institute, Lisbon, Portugal, b Boston Children’s Hospital and Harvard Medical School, Depts. of Pathology and Laboratory Medicine, Boston, USA , c New University of Lisbon, Chronic Diseases Research Centre (CEDOC), Lisbon, Portugal, d Maria Pia Hospital, Júlio Diniz Maternity, Porto, Portugal, e Faculty of Pharmacy/Institute for Molecular and Cell Biology, University of Porto, Laboratory of Biochemistry, Porto, Portugal, f Brigham and Women’s Hospital and Dept. of Medicine, Harvard Medical School, Div. of Endocrinology, Diabetes and Hypertension, Boston, USA ) Introduction: There is growing evidence showing that women who have had preeclampsia have an increased risk of developing cardiovascular disease (CVD). Various groups have proposed increased levels of the vasoconstrictor, Endothelin-1 (ET-1), in the pathophysiology of preeclampsia via increased angiotensin II and reactive oxygen species (ROS) through mechanisms that remain unresolved. Myeloperoxidase (MPO) is an enzyme that catalyzes ROS formation and is a critical factor of the innate immune responses that may contribute to tissue damage during inflammation. Indeed, increased MPO levels predict the risk of CVD and are proposed as a target for therapeutic intervention. MPO is secreted from azurophilic granules in activated leukocytes and participates in respiratory burst responses. However the relationship between MPO, leukocytes and ET-1 levels in women that had preeclampsia in the past is unclear. Objectives: To evaluate the effect of activation of ex vivo human leukocytes with ET-1 on MPO production and its genotype-phenotype relationship in women that had preeclampsia. Methods: We studied 150 women, aged 35.1 5.5 years [60 (40%)] that had normal blood pressure during pregnancy (NBPP) and compared them to women [90 (60 %)] that had preeclampsia (PE) 2–16 years ago and measured HS-C-reactive protein (CRP) and MPO levels. Results: Our results show dose-dependent increases of MPO from ex vivo human leukocytes treated with either endothelin-1 or angiotensin II via activation of endothelin-1 or angiotensin II receptors, respectively. Consistent with these data, we observed higher circulating MPO levels in PE when compared with NBPP women (n = 55; P < 0.04) that were associated with increased HS-CRP levels in a cohort of our subjects. We then determined the genetic variants of the MPO gene by PCR-RFLP in a larger sample size and observed that PE was associated with increased MPO risk genotype (GG) (n = 71; P < 0.02). Conclusion: Our results suggest that in PE, activated leukocytes and genetic variants of MPO contribute to increased MPO levels.
Thus MPO measures may serve to improve CVD risk stratification among women that had PE. doi:10.1016/j.preghy.2015.07.070
O121. Maternal metabolic outcomes in women with a history of hypertensive pregnancy disorders Laura Benschop a, Jeanine E. Roeters-van Lennep b, Sarah Schalekamp-Timmermans a, Vincent W.V. Jaddoe c, Nienke E. Bergen a, Eric A.P. Steegers a (a Erasmus MC, Department of Obstetrics & Gynecology, Rotterdam, The Netherlands, b Erasmus MC, Department of Internal Medicine, Rotterdam, The Netherlands, c Erasmus MC, Dept. Epideimology & Dept. Pediatrics, Rotterdam, The Netherlands) Introduction: Women with preeclampsia or pregnancy induced hypertension (PIH) show metabolic aberrations during pregnancy similar to the metabolic syndrome. These women also are at increased risk of cardiovascular disease later in life. Objective: To assess whether women with preeclampsia or PIH have more unfavorable metabolic outcomes six years after pregnancy compared to normotensive women. Methods: This study was embedded in the Generation R study, a population-based prospective cohort study. Information on pregnancy and metabolic outcomes six years after pregnancy was available in 4933 women. We measured total body and abdominal fat distribution, weight and plasma lipid concentrations (total cholesterol, LDL-c, HDL-c, triglycerides, Apolipoprotein-B (Apo-B), lipoprotein (a) (lp-a)). Results: Compared with normotensive women, women with PIH had higher Apo-B (0.05g/l; 95%CI 0.02, 0.08), LDL-c (0.13 mmol/l; 95%CI 0.04, 0.22), triglyceride (0.11 mmol/l; 95%CI 0.01, 0.21) and total cholesterol concentrations (0.15 mmol/l; 95%CI 0.02, 0.29) and lower HDL-c concentrations ( 0.06 mmol/l; 95%CI 0.11, 0.01). No differences were observed in lipid concentrations between normotensive and preeclamptic women. Women with PIH or preeclampsia both had higher body fat percentages (0.03%; 95%CI 0.02, 0.04 and 0.02%; 0.00, 0.04), higher BMI (3.6 kg/m2; 95%CI 2.9, 4.2 and 2.4 kg/m2; 1.4, 3.4, respectively) and increased risk of clustering of metabolic risk factors (OR 2.2; 95%CI 1.4, 3.3 and OR 2.3; 95%CI 1.3, 4.3, respectively) compared with normotensive women. These associations attenuated after adjustment for maternal weight gain after pregnancy. Early pregnancy weight seems to be a predictor for these unfavorable outcomes (figure). Conclusion: Hypertensive pregnancy disorders, especially PIH, were associated with adverse metabolic outcomes and an increased risk of clustering of metabolic risk factors six years after pregnancy compared to normotensive women. We therefore advise to perform regular metabolic check-up on these women after delivery.
doi:10.1016/j.preghy.2015.07.071
O122. The role of framing in modifying behavior to reduce cardiovascular risk after preeclampsia, a vignette study Anouk Bokslag a, Wietske Hermes b, Christianne De Groot a, Pim Teunissen c (a VU Medical Center Amsterdam, Department of Obstetrics & Gynecology, Amsterdam, The Netherlands, b Medical Center Haaglanden, Department of Obstetrics & Gynecology, The Hague, The Netherlands, c VU Medical Center Amsterdam, 1st Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands)