Predicting transformation from gestational hypertension to preeclampsia in clinical practice: A possible role for 24 hour ambulatory blood pressure monitoring

Davis, GK; Mackenzie, C; Brown, MA; Homer, CS; Holt, J; McHugh, L; Mangos, G

Predicting transformation from gestational hypertension to preeclampsia in clinical practice: A possible role for 24 hour ambulatory blood pressure monitoring

Davis, GK Mackenzie, C Brown, MA Homer, CS

Holt, J McHugh, L Mangos, G

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Publication Type:: Journal Article
Citation:: Hypertension in Pregnancy, 2007, 26 (1), pp. 77 - 87
Issue Date:: 2007-01-01

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Field	Value	Language
dc.contributor.author	Davis, GK	en_US
dc.contributor.author	Mackenzie, C	en_US
dc.contributor.author	Brown, MA	en_US
dc.contributor.author	Homer, CS https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Holt, J	en_US
dc.contributor.author	McHugh, L	en_US
dc.contributor.author	Mangos, G	en_US
dc.date.issued	2007-01-01	en_US
dc.identifier.citation	Hypertension in Pregnancy, 2007, 26 (1), pp. 77 - 87	en_US
dc.identifier.issn	1064-1955	en_US
dc.identifier.uri	http://hdl.handle.net/10453/4498
dc.description.abstract	Objective: To identify parameters that may assist clinicians in predicting which women will develop preeclampsia (PE) after initially presenting with gestational hypertension (GH). Methods: 118 women were recruited to the study with GH or PE. They were divided into three groups based on their diagnosis at delivery- (1) GH, (2) PE from the time of presentation, (3) those with an initial diagnosis of GH who progressed to PE. Women underwent 24 hour ambulatory blood pressure monitoring (ABPM) and had serum estrogen, progesterone, β-HCG, leptin and adiponectin measured as possible predictors of transformation of GH to PE. Results: Women who presented with GH, and progressed to PE, presented four weeks earlier (33 vs 37 weeks, p < 0.001) than those who did not progress. Women with PE, either as their initial diagnosis or after progression from GH, were delivered earlier (p < 0.001) and had more small for gestational age (SGA) babies than women with GH at delivery (p < 0.05). Those who developed PE after presenting with GH generally had higher blood pressures than those who remained as GH, significant for awake and 24 hour systolic blood pressures (p < 0.05). β-HCG, estrogen, progesterone or leptin values were similar across the groups. Adiponectin was higher in women with established PE at presentation compared to women with GH (p = 0.02) but adiponectin failed to discriminate those women with an initial diagnosis of GH who progressed to PE. Conclusion: 24 hr ABPM may provide a non-invasive method of identifying this 'at risk' GH population, particularly in the case of early presentation.	en_US
dc.relation.ispartof	Hypertension in Pregnancy	en_US
dc.relation.isbasedon	10.1080/10641950601147952	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Placenta	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Hypertension, Pregnancy-Induced	en_US
dc.subject.mesh	Pre-Eclampsia	en_US
dc.subject.mesh	Disease Progression	en_US
dc.subject.mesh	Leptin	en_US
dc.subject.mesh	Blood Pressure Monitoring, Ambulatory	en_US
dc.subject.mesh	Sensitivity and Specificity	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Adiponectin	en_US
dc.title	Predicting transformation from gestational hypertension to preeclampsia in clinical practice: A possible role for 24 hour ambulatory blood pressure monitoring	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	26	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
dc.location.activity	ISI000245948800008	en_US
dc.location.activity	Brisbane, Australia
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	26	en_US

Abstract:

Objective: To identify parameters that may assist clinicians in predicting which women will develop preeclampsia (PE) after initially presenting with gestational hypertension (GH). Methods: 118 women were recruited to the study with GH or PE. They were divided into three groups based on their diagnosis at delivery- (1) GH, (2) PE from the time of presentation, (3) those with an initial diagnosis of GH who progressed to PE. Women underwent 24 hour ambulatory blood pressure monitoring (ABPM) and had serum estrogen, progesterone, β-HCG, leptin and adiponectin measured as possible predictors of transformation of GH to PE. Results: Women who presented with GH, and progressed to PE, presented four weeks earlier (33 vs 37 weeks, p < 0.001) than those who did not progress. Women with PE, either as their initial diagnosis or after progression from GH, were delivered earlier (p < 0.001) and had more small for gestational age (SGA) babies than women with GH at delivery (p < 0.05). Those who developed PE after presenting with GH generally had higher blood pressures than those who remained as GH, significant for awake and 24 hour systolic blood pressures (p < 0.05). β-HCG, estrogen, progesterone or leptin values were similar across the groups. Adiponectin was higher in women with established PE at presentation compared to women with GH (p = 0.02) but adiponectin failed to discriminate those women with an initial diagnosis of GH who progressed to PE. Conclusion: 24 hr ABPM may provide a non-invasive method of identifying this 'at risk' GH population, particularly in the case of early presentation.

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http://hdl.handle.net/10453/4498