PP149. Hypertensive risk factors: Do they influence pregnancy outcome in women affected by new onset pre-eclampsia?

ABSTRACT

INTRODUCTION: Pre-eclampsia (PE) is a leading cause of maternal and foetal mortality and morbidity. Chronic Hypertension (CH) and a previous PE are well known risk factors for PE. If the prevalence of PE in nulliparous is about 2%, it raise up to 7-10% in women with CH or a previous PE. However, the role of these risk factors when PE occurs is still under discussion OBJECTIVES: To detect if maternal history of previous PE and/or Chronic Hypertension (CH) is associated with a worse clinical outcome in women affected by PE. METHODS: Cohort study on 100 consecutive singleton pregnancies complicated by PE referred to our Department from January 2010 to December 2011. PE and CH were defined according to ISSHP criteria. Small for Gestational Age (SGA) was defined as Birth Weight under the 5th percentile per Gestational Age. Patients were divided into two groups depending on positive (Group A, n=25) or negative (Group B, n=75) history for PE and/or Chronic Hypertension (CH). Patients assessed to group A were under prophylactic therapy with ASA 100mg oid. Clinical and perinatal outcomes were reviewed. Adverse Pregnancy Outcome (APO) was defined as Apgar score less than seven at five minutes, pH<7.20; birth weight<5th percentile (SGA), stillbirth or neonatal death. RESULTS: Groups were comparable for Maternal Age (Group A 34years median, IQR 30-36yy; Group B 34years, IQD 28-36yy ) and BMI (Group A 23.7Kg/mq median, IQR 20.8-27.1Kg/mq; Group B 22.4Kg/mq median IQR 20.3-26.0Kg/mq). One case of stillbirth (Group A) and four cases of neonatal death were observed, 1/25 in Group A (4%) and 3/75 (4%) in Group B. No differences were found in Gestational Age (GA) at diagnosis of PE (Group A 32+2w median, IQR 28+0-35+4w; Group B 33+2w median, IQR 30+0-36+1w); GA at delivery (Group A 34+1w median, IQR 31+5-36+5w; Group B 34+2w median, IQR 32+0-36+3w) Birth Weight percentile (Group A 6th percentile median, IQR 2-21th percentile; Group B 5th percentile median, IQR 1-15th percentile), prevalence of Small for Gestational Age (14/25 and 42/75, for Group A and B respectively), prevalence of APO (13/25 and 44/75, for Group A and B respectively). CONCLUSION: Our data suggest that a positive history for PE and/or CH does not influence clinical outcome in women affected by PE. This result could be explained by the administration of prophylactic ASA 100mg oid in this group of patients.