Target organ changes at 
6 months and 2 years following pre-eclampsia
- the p4 study

Jaime Worboys^1,2, George Mangos^1,2, Lynne Roberts^1,2,3, Franziska Pettit^1,2, Mark Brown^1,2, Amanda Henry^1,2,3, Lily Xu¹, Greg Davis^1,2 

1. St George Hospital, Gray Street, Kogarah, NSW, Australia
2. University of NSW, Randwick, NSW, Australia
3. University of Technology Sydney, Broadway, Ultimo, NSW Australia
4. Sydney Children’s Hospital, Randwick, NSW, Australia
5. Burnett Institute, Melbourne, VIC, Australia

Background

Preeclampsia commonly involves the kidneys and liver, and increases the risk of future cardiac and renal disease. The impact of preeclampsia on future liver function is unknown. We report cardiac, renal and hepatic function at 6-months and 2-years postpartum in women with prior normotensive pregnancy (NP) or preeclampsia (PE). 

Methods

In the ongoing, prospective P4 study, 302NP women and 90PE women were assessed at 6-months, and 94NP women and 39PE women at 2-years postpartum. Demographic data and medical history were recorded. At each assessment, biometric measures, blood and urine samples were collected, and blood pressure monitoring was performed. Transthoracic echocardiograms were performed in a sub-group (6-months n= 54NP, 43PE).

Results

PE had greater left ventricular mass index (51.6v57.7, NP v PE, p=0.006) at 6-months. E/A ratio was lower (1.6v1.4, NPvPE, p=0.015) and E/E’ ratio was higher (7.4v8.8, NPvPE, p=0.002) at 6-months. Peripheral pulse pressure was higher in PE at 6-months (39.7v42.7mmHg, NPvPE, p,0.001) but not 2-years (40.4v40.5mmHg, p=0.95)

Urinary albumin:creatinine ratio was higher in PE at 6-months (1.9v2.2, NPvPE, p=0.017) but not at 2-years (1.0v0.8, NPvPE, p=0.62).

ALP (77.6v83.3 U/L, NPvPE, p=0.03) and GGT (14.5v20U/L, NPvPE, p= 0.009) were higher at 6-months. There were no differences at 2-years. 

Conclusion

Preeclampsia was associated with differences in BMI, blood pressure, cardiac structure and diastolic function, ACR, pulse pressure and LFTs at 6-months but not at 2-years post-partum. The 6-month difference may be relevant to future risk of metabolic, cardiovascular and renal disease in these women.