Do Antihypertensives Protect From Developing Superimposed Preeclampsia?

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

1-28-2021

DOI

10.1016/j.ajog.2020.12.171

Journal Title

American Journal of Obstetrics and Gynecology

Department

Obstetrics and Gynecology

Abstract

Objective

To determine if different types of antihypertensives used prior to pregnancy and in early gestation are protective against superimposed preeclampsia (PEC) in patients with chronic hypertension (blood pressure of >/=140/90 prior to 20 weeks of gestation).

Study Design

This was a multi-center retrospective cohort study of 322 pregnant women with chronic hypertension delivered between 2014-2019. The subjects were divided into 3 cohorts: no superimposed PEC, early onset PEC ( < 34 weeks gestation) or late onset PEC (>34 weeks gestation). Data were collected on maternal and neonatal demographics. The primary outcome was to compare antihypertensives used prior to pregnancy, and in early gestation, and the onset of superimposed disease per each drug.

Results

Maternal and fetal demographics are shown in Table 1. One hundred eighty-five subjects (57%) had chronic hypertension with no PEC, 45 (14%) had chronic hypertension with early PEC, and 92 had chronic hypertension with late onset PEC (28%). There was no association between the use of antihypertensive medications and the development of superimposed PEC, regardless of type of medication (Table 2). The cohort with early onset superimposed disease had lower estimated fetal weights prior to delivery (p<0.001), had a higher incidence of receiving antenatal steroids for fetal lung maturity (p<0.001), and a higher incidence of umbilical artery flow compromise than those with no or late onset disease (p=0.006).

Conclusion

The use of antihypertensive medications prior to pregnancy was not associated with timing of onset or development of superimposed preeclampsia, regardless of medication type.

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