THE BASEL POSTPARTUM HYPERTENSION COHORT (BASEL-PPHT): BLOOD PRESSURE OUTCOMES AT THREE MONTHS POSTPARTUM CORRELATED TO FIRST TRIMESTER PREECLAMPSIA SCREENING RESULTS

Objective: Preeclampsia (PE) contributes to increased cardiovascular risk in women. The Fetal Medicine Foundation (FMF) first-trimester PE screening stratifies women into high or low risk for developing preterm PE (pPE) based on maternal characteristics and anamnestic risk factors combined with biophysical, biochemical, and ultrasound markers. In this analysis, we compare postpartum blood pressure (BP) outcomes of individuals with PPHT who were determined to be high or low risk for pPE in the first-trimester screening. Design and method: The Basel-PPHT registry consists of participants who developed some form of hypertensive disorder of pregnancy. For this trial, a risk at first trimester combined screening of more than 1:100 was considered high risk. We analyzed baseline characteristics, cardiovascular risk factors, and BP outcomes for high and low risk groups. At three months postpartum (V3) 24-hour ambulatory (BP) (mean ± SD), office blood pressure (AOBPM), and albuminuria to creatinine ratio (ACR) were compared between the groups. Results: 90/400 PPHT participants had a first-trimester combined screening. Fifty-one percent (n=46) were stratified as low risk. The mean maternal age was 35.4 (±5) years. Women with a high risk for pPE had higher preconception weight, 78.3 kg (±23) compared to low-risk women, 67.6 (±13.6), p=0.01. Women in the high-risk group had more preexisting hypertension (27.3% vs 2.2%, p<0.001) than those in the low-risk group, and there were no significant differences in c-section rates (59.1% vs 69.6%, p=0.2). At V3, 24-hour mean systolic and diastolic, awake diastolic, asleep systolic and diastolic BP, as well as systolic and diastolic AOBPM were significantly higher in the high-risk in comparison to the low-risk group (Table 1).Conclusions: The FMF algorithm designed to identify high-risk pregnancies for pPE, may be a useful additional tool for postpartum BP assessment. In this cohort of women with PPHT, participants in the high-risk group showed significantly higher blood pressure than the low-risk group three months after delivery. Therefore, the results of the FMF may provide additional information for physicians caring for women with postpartum hypertension.