The P4 Study: Subsequent Pregnancy Maternal Physiology after Hypertensive and Normotensive Pregnancies


R Kennedy^1,3, L Roberts^1,2,4, A Henry^1,2

1. School of Women’s and Children’s Health, UNSW Medicine, Sydney Australia
2. Department of Women’s and Children’s Health, St George Hospital, Sydney, Australia  
3. St George and Sutherland Clinical School, UNSW Medicine, Sydney, Australia  
4. Faculty of Health, University of Technology, Sydney, Australia 

Background

Hypertensive disorders of pregnancy (HDP) are amongst the most common serious medical complications of pregnancy and are associated with increased risk of  cardiovascular and metabolic disease later in life.

Methods

Prospective sub-study of the P4 Study. Women studied six months after normotensive (NP) versus hypertensive (HP) pregnancy and in the subsequent pregnancy (SP) (11 – 13 weeks gestation).

Results

31 women (21 NP, 10 HP). Women after HP had higher six months postpartum and SP blood pressure (BP). Women of Caucasian ethnicity had higher SP systolic (p = 0.002) and diastolic (p = 0.009) BP. A longer inter-pregnancy interval (IPI) contributed to poorer fat% in the SP (p = 0.03).

Discussion

Women with a history of HDP maintained higher BP than those without. Caucasian ethnicity was associated with higher SP BP, and longer IPI’s with higher fat%. These factors may reflect a higher long-term cardiovascular risk for women with a history of HDP.