[106-POS]

Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 5 (2015) 53–156

[105-POS] Clinical evaluation of placental growth factor (PlGF) for the management of suspected placental pathology in high-risk pregnancies Emma Shawkat a, Edward Johnstone a, Daniella Nice b, Andrew Sayce b, Katharine Hayden b, Jenny Myers a (a The University of Manchester, Manchester, United Kingdom, b Central Manchester NHS Trust, Manchester, United Kingdom) Introduction: Recent data suggest placental growth factor (PlGF) has clinical utility for the management of suspected pre-eclampsia (PE) and/or fetal growth restriction (FGR). Objective: To evaluate the added value of PlGF as a diagnostic test for placental dysfunction in a high-risk cohort. Methods: High-risk women <35 weeks gestation (n = 39; suspected FGR = 13, superimposed PE = 21, both = 4) had a PlGF measured using Alere Triage. The test was revealed and surveillance adjusted. Delivery decisions were made using standard clinical protocols and were not based on PlGF measurements. Test results were classified as normal (>100 pg/ml), low (12–100 pg/ml) or very low (<12 pg/ml). Results: The median test to delivery interval was shorter with a low/very low vs normal PlGF; 11.5 vs 24 days (p = 0.02). Using the test nearest delivery, 11/39 had a very low PLGF; 10/11 delivered preterm (<37 weeks) median birthweight centile 0.8 (IQR: 0.2–15.6). Women with a very low PlGF were offered inpatient surveillance, the decision to admit was changed by the PlGF result in 4/11 women. One woman with worsening hypertension and a PlGF <12 pg/ ml on two occasions (33–35 weeks) declined admission; delivery was not indicated using routine clinical assessments until 37 weeks. In another, PlGF was <12 pg/ml on three occasions (23–29 weeks) and despite developing preeclampsia, delivery was delayed until 29 weeks following 46 days inpatient surveillance. A normal PlGF measurement was obtained in 19 women (superimposed PE = 0, FGR = 4, preterm delivery = 4). Surveillance was reduced and/or preterm delivery avoided in 11/19. There was one fetal death in utero in a FGR pregnancy with reassuring ultrasound assessments; the PlGF was >100 pg/ml measured 21 days prior to delivery. Conclusions: In this small high-risk group, PlGF was useful in distinguishing superimposed pre-eclampsia from deterioration in chronic maternal disease (without features of placental dysfunction) but less discriminative for FGR in the absence of maternal disease. Disclosures: E. Shawkat: None. E. Johnstone: None. D. Nice: None. A. Sayce: None. K. Hayden: None. J. Myers: None. doi:10.1016/j.preghy.2014.10.111

[106-POS] Blood pressure one month after delivery will predict subsequent hypertension five years after delivery

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Asako Mito a, Naoko Arata a, Dongmei Qiu b, Naoko Sakamoto c, Yukihiro Ohya d, Atsuko Murashima a, Atsuhiro Ichihara e, Michihiro Kitagawa a (a Center for Maternal-Fetal-Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan, b Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan, c Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan, d Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan, e Department of Medicine II, Institute of Endocrinology and Hypertension, Tokyo Women’s Medical University, Tokyo, Japan) Objectives: Hypertensive disease in pregnancy (HDP) was revealed as a risk of subsequent hypertension five years after index delivery in our previous study. However the association between the postnatal blood pressure (BP) and subsequent hypertension is unclear. We investigate the association between the BP one month after index delivery and the risk of subsequent hypertension. Methods: The study subjects were recruited from‘‘Seiiku cohort study’’at the National Center for Child Health and Development in Tokyo from 2003 to 2005. After that period, women suffering from HDP at high risk of suffering cardiovascular diseases were given follow-up examinations and are included in this study. They were invited to undergo a physical examination five years after delivery and 753 women completed the analysis. The influence of postpartum BP on subsequent hypertension was assessed by a multiple logistic regression analysis. The odds ratio for subsequent hypertension was adjusted by age, BMI, familial history of hypertension, kidney disease and salt intake. [Criteria] HDP was defined as sBP P140 mmHg or dBP P90 mmHg from 20 weeks’ gestation to 12 weeks postpartum w/o proteinuria. Hypertension at physical examination was defined as average sBP P140 mmHg or average dBP P90 mmHg or treatment with antihypertensive agents. [Exclusion criteria] The women with chronic hypertension before pregnancy and those pregnant and nursing when the physical examination was done. Results: There were 37 HDP cases and 23 cases of subsequent hypertension (HDP:5, normotensive control:18). The odds ratio for subsequent hypertension is sBP:1.11 (95%CI: 1.04–1.17), dBP:1.13 (1.05–1.22) and mBP:1.15 (1.06– 1.24). Despite adding HDP to confounding factors, the odds ratio is still sBP:1.10 (1.04–1.17), dBP:1.12 (1.04–1.22) and mBP:1.14 (1.05–1.23). Conclusions: Postnatal BP may predict subsequent hypertension 5 years post-delivery, independent HDP. Disclosures: A. Mito: None. N. Arata: None. D. Qiu: None. N. Sakamoto: None. Y. Ohya: None. A. Murashima: None. A. Ichihara: None. M. Kitagawa: None. doi:10.1016/j.preghy.2014.10.112