Levels of blood pressure, cardiovascular biomarkers and their correlations in women with previous pre-eclamptic pregnancy within 7 years postpartum: a cross-sectional study in Thailand.

Abstract

OBJECTIVE:

To assess the levels of blood pressure, cardiovascular biomarkers and their correlations measured within 7 years postpartum in women with previous pre-eclamptic pregnancies compared with women with previous normotensive pregnancies.

DESIGN:

Cross-sectional study.

SETTING:

Two tertiary hospitals in the southern region of Thailand.

PARTICIPANTS:

Women with pre-eclamptic and normotensive pregnancies in the past 7 years were enrolled from 1 October 2019 to 30 April 2021. Eligible women were interviewed, examined for body mass index (BMI) and blood pressure, and donated morning spot urine and blood samples.

PRIMARY OUTCOME MEASURES:

Serum high-sensitivity C reactive protein, creatinine, fasting blood glucose (FBS), glycated haemoglobin (HbA1c), low-density lipoprotein (LDL) cholesterol, urine microalbumin to creatinine ratio (UACR) and sodium were measured. Group differences in biomarkers were tested using unpaired t-test, Wilcoxon rank-sum test or χ2 test. The levels of blood pressure and biomarkers between the two study groups at <2 years, 2-4 years and >4 years were also compared. The correlations between blood pressure and biomarkers were analysed using Pearson's correlation and partial correlation methods.

RESULTS:

From 206 women included in the analysis, 88 had pre-eclamptic pregnancies and 118 had normotensive pregnancies. Compared with women with previous normotensive pregnancies, women with previous pre-eclamptic pregnancies had significantly increased rates of hypertension (31.8% vs 7.6%, p<0.001) and obesity (55.7% vs 40.7%, p=0.038), as well as higher serum levels of FBS (p<0.001), HbA1c (p<0.001), LDL cholesterol (p=0.03), creatinine (p<0.001) and UACR (p<0.001). Correlation coefficients of BMI, serum creatinine and UACR with blood pressure ranged from 0.27 to 0.31.

CONCLUSION:

The risk of hypertension after a pre-eclamptic pregnancy increased. Blood pressure measurement combined with BMI, serum creatinine and UACR screening at least once during 7 years postpartum is suggested for early detection of cardiovascular risk.

• Authors: Jarawee Sukmanee, Penkae Rothmanee, Wilaiwan Sriwimol, Annetine Staff, Tippawan Liabsuetrakul
• Journal: BMJ open (BMJ Open) Vol. 12 Issue 6 Pg. e055534 (06 15 2022) ISSN: 2044-6055 [Electronic] England
• PMID: 35705351 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Biomarkers
• Glycated Hemoglobin A
• Creatinine

Topics

• Biomarkers
• Blood Pressure (physiology)
• Creatinine
• Cross-Sectional Studies
• Female
• Glycated Hemoglobin
• Humans
• Hypertension
• Postpartum Period (physiology)
• Pre-Eclampsia (diagnosis)
• Pregnancy (physiology)
• Thailand (epidemiology)