224
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 175–239
unaffected controls (n = 6,766). Multiple regression analysis was used to examine which maternal characteristics provided a significant contribution in the prediction of AIx-75, PWV and SBPAo. Each value was expressed as a multiple of the median (MoM) after adjustment for those characteristics. Pearson correlation analysis was used to examine the association between log10AIx-75 MoM, log10PWV MoM, log10 SBPAo MoM, log10uterine artery PI MoM and log10PAPP-A MoM with gestational age at delivery. Results: In the PE group there was an increase in AIx-75 (1.13, IQR 0.96–1.33 MoM vs 1.00, IQR 0.87–1.16 MoM, p < 0.0001), PWV (1.11, IQR 0.97–1.17 MoM vs 1.00, IQR 0.90–1.12 MoM, p < 0.0001), and SBPAo (1.09, IQR 1.02– 1.20 MoM vs. 1.00, IQR 0.94–1.08 MoM, p < 0.0001). In those that subsequently developed GH, compared to unaffected controls, there was no significant difference in the uterine artery PI, PAPP–A or PWV but AIx–75 and SBPAo were increased (p < 0.0001). In the GDM group there was an increase in PWV (1.06, IQR 0.96–1.19 MoM vs. 1.00, IQR 0.90–1.13 MoM, p = 0.001) and SBPAo (1.03, IQR 0.98–1.14 vs. 1.00, IQR 0.94–1.08, p < 0.0001), but no significant difference in the AIx–75 (1.02, IQR 0.89–1.22 MoM vs. 1.00, IQR 0.87–1.17 MoM, p = 0.118). Compared to women who had term delivery, women who had iatrogenic PTD had significantly higher AIx–75 (1.08, IQR 0.91–1.27 MoM vs. 1.00, IQR 0.86–1.16 MoM, p < 0.001) and SBPAo (1.06 MoM, IQR 0.98–1.15 vs. 1.00, IQR 0.93–1.07, p < 0.001). Conclusion: A high proportion of women who develop PE, GDM or iatrogenic PTD have increased SBPAo and arterial stiffness that is apparent from the first trimester of pregnancy.
Disclosure of interest
Objectives: To investigate whether the level of free PlGF is a significant predictor of length of pregnancy in women with hypertension. Methods: In this case-control study a single sample was taken between the 22nd and 34th completed gestational weeks from 130 pregnant women with a final diagnosis of: pre-eclampsia (PE), HELLP-syndrome, superimposed preeclampsia (SIPE), chronic hypertension (CHT), gestational hypertension (GHT), and normal healthy pregnancy (Control). Plasma was analysed for PlGF using the TriageÒ PlGF assay (Alere, San Diego). A positive PlGF test was defined as below the 5th centile of normal healthy pregnancy. Hazard ratios for length-of-pregnancy were calculated for a positive PlGF test in a multivariate Cox proportional hazards model adjusting for two covariates, the gestational age at sample collection and a final diagnosis of proteinuric hypertension (PE, HELLP, and SIPE). Results: Median PlGF concentration was significantly lower in women with hypertension than in controls. Women with proteinuric hypertension had the lowest levels of PlGF. A positive PlGF test predicted delivery before 35 weeks in 93.7% women, and delivery before 37 weeks in 90.5% women. A positive PlGF test was associated with a significantly higher risk of imminent delivery. PlGF was a significant and independent predictor of women destined to deliver early because of maternal or fetal complication (adjusted Hazard Ratio of 3.43, 95%CI of 1.97 to 5.98). Conclusion: A positive PlGF test is significant predictor of length of pregnancy, independent of other diagnostic criteria. PlGF has the potential to identify increased risk without the limitation of non-specificity which exists with other diagnostic parameters.
None declared. Disclosure of interest doi:10.1016/j.preghy.2012.04.085
None declared. OS085. Decreased maternal circulating PLGF is a significant predictor of length of pregnancy in women with hypertensive disorders of pregnancy N. Gullai *, B. Stenczer, A. Molvarec, Z. Veresh, B. Nagy, J. Rigo Jr (First Dept. of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary) Introduction: Diagnosis of the presence of disease and prediction of the rate of progression of disease in women with hypertensive disorders of pregnancy remains a clinical problem. Better methods are needed to determine the magnitude of risk to support patient counseling and clinical management. Group
N
Median 25th%
Control GHT CHT PE HELLP SIPE
27 18 25 23 20 17
331 168 64 12 12 16
doi:10.1016/j.preghy.2012.04.086
OS086. Methylation status of the HOXA13 promoter region in placental tissue of pregnancies complicated by early onset severe preeclampsia M.P. Rambaldi *, A. Pieralli, S. Ottanelli, C. Serena, S. Simeone, G. Mello, F. Mecacci (Obstetric and gynecology – High risk pregnancy unit, AOU Careggi, Florence, Italy) Introduction: Compromised placental function and morphology found in early onset preeclampsia as well as a modified phenotype of the fetus may derive from a deviation in
163 28 13 12 12 12
75th%
⁄
633 527 145 12 12 53
n/a 0.0199 0.0000 0.0000 0.0000 0.0000
p-value
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 175–239
unaffected controls (n = 6,766). Multiple regression analysis was used to examine which maternal characteristics provided a significant contribution in the prediction of AIx-75, PWV and SBPAo. Each value was expressed as a multiple of the median (MoM) after adjustment for those characteristics. Pearson correlation analysis was used to examine the association between log10AIx-75 MoM, log10PWV MoM, log10 SBPAo MoM, log10uterine artery PI MoM and log10PAPP-A MoM with gestational age at delivery. Results: In the PE group there was an increase in AIx-75 (1.13, IQR 0.96–1.33 MoM vs 1.00, IQR 0.87–1.16 MoM, p < 0.0001), PWV (1.11, IQR 0.97–1.17 MoM vs 1.00, IQR 0.90–1.12 MoM, p < 0.0001), and SBPAo (1.09, IQR 1.02– 1.20 MoM vs. 1.00, IQR 0.94–1.08 MoM, p < 0.0001). In those that subsequently developed GH, compared to unaffected controls, there was no significant difference in the uterine artery PI, PAPP–A or PWV but AIx–75 and SBPAo were increased (p < 0.0001). In the GDM group there was an increase in PWV (1.06, IQR 0.96–1.19 MoM vs. 1.00, IQR 0.90–1.13 MoM, p = 0.001) and SBPAo (1.03, IQR 0.98–1.14 vs. 1.00, IQR 0.94–1.08, p < 0.0001), but no significant difference in the AIx–75 (1.02, IQR 0.89–1.22 MoM vs. 1.00, IQR 0.87–1.17 MoM, p = 0.118). Compared to women who had term delivery, women who had iatrogenic PTD had significantly higher AIx–75 (1.08, IQR 0.91–1.27 MoM vs. 1.00, IQR 0.86–1.16 MoM, p < 0.001) and SBPAo (1.06 MoM, IQR 0.98–1.15 vs. 1.00, IQR 0.93–1.07, p < 0.001). Conclusion: A high proportion of women who develop PE, GDM or iatrogenic PTD have increased SBPAo and arterial stiffness that is apparent from the first trimester of pregnancy.
Disclosure of interest
Objectives: To investigate whether the level of free PlGF is a significant predictor of length of pregnancy in women with hypertension. Methods: In this case-control study a single sample was taken between the 22nd and 34th completed gestational weeks from 130 pregnant women with a final diagnosis of: pre-eclampsia (PE), HELLP-syndrome, superimposed preeclampsia (SIPE), chronic hypertension (CHT), gestational hypertension (GHT), and normal healthy pregnancy (Control). Plasma was analysed for PlGF using the TriageÒ PlGF assay (Alere, San Diego). A positive PlGF test was defined as below the 5th centile of normal healthy pregnancy. Hazard ratios for length-of-pregnancy were calculated for a positive PlGF test in a multivariate Cox proportional hazards model adjusting for two covariates, the gestational age at sample collection and a final diagnosis of proteinuric hypertension (PE, HELLP, and SIPE). Results: Median PlGF concentration was significantly lower in women with hypertension than in controls. Women with proteinuric hypertension had the lowest levels of PlGF. A positive PlGF test predicted delivery before 35 weeks in 93.7% women, and delivery before 37 weeks in 90.5% women. A positive PlGF test was associated with a significantly higher risk of imminent delivery. PlGF was a significant and independent predictor of women destined to deliver early because of maternal or fetal complication (adjusted Hazard Ratio of 3.43, 95%CI of 1.97 to 5.98). Conclusion: A positive PlGF test is significant predictor of length of pregnancy, independent of other diagnostic criteria. PlGF has the potential to identify increased risk without the limitation of non-specificity which exists with other diagnostic parameters.
None declared. Disclosure of interest doi:10.1016/j.preghy.2012.04.085
None declared. OS085. Decreased maternal circulating PLGF is a significant predictor of length of pregnancy in women with hypertensive disorders of pregnancy N. Gullai *, B. Stenczer, A. Molvarec, Z. Veresh, B. Nagy, J. Rigo Jr (First Dept. of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary) Introduction: Diagnosis of the presence of disease and prediction of the rate of progression of disease in women with hypertensive disorders of pregnancy remains a clinical problem. Better methods are needed to determine the magnitude of risk to support patient counseling and clinical management. Group
N
Median 25th%
Control GHT CHT PE HELLP SIPE
27 18 25 23 20 17
331 168 64 12 12 16
doi:10.1016/j.preghy.2012.04.086
OS086. Methylation status of the HOXA13 promoter region in placental tissue of pregnancies complicated by early onset severe preeclampsia M.P. Rambaldi *, A. Pieralli, S. Ottanelli, C. Serena, S. Simeone, G. Mello, F. Mecacci (Obstetric and gynecology – High risk pregnancy unit, AOU Careggi, Florence, Italy) Introduction: Compromised placental function and morphology found in early onset preeclampsia as well as a modified phenotype of the fetus may derive from a deviation in
163 28 13 12 12 12
75th%
⁄
633 527 145 12 12 53
n/a 0.0199 0.0000 0.0000 0.0000 0.0000
p-value
