Objective: To determine if the clinical or biochemical markers used in pregnancy can be applied as early predictors of gestational hypertension.
Design: Prospective cohort study. Population: 315 pregnant women referred from the Prenatal Diagnosis Unit between weeks 10–13 of pregnancy and followed up to the childbirth.
Methods: Biomarkers were measured in serum specimens in the first and second trimester of pregnancy. Blood pressure (BP) was measured in the first, second and third trimester.
Results: The cumulative incidence of gestational hypertension was 6.01%. In the first trimester gestational hypertension predictors were uric acid greater than 3.15 mg/dl (P = 0.01), BMI greater than 24 kg/m2 (P = 0.003) SBP at least 120 mmHg (P = 0.02) and DBP at least 71 mmHg (P = 0.007). After applied multivariate analysis just uric acid and SBP were statistically significant.
Conclusion: In our cohort of healthy pregnant women uric acid above 3.15 mg/dl and SBP at least 120 mmHg are consistent predictors of gestational hypertension in the first trimester. The most important implication of our study is the possibility to identify in the first trimester women at risk to develop gestational hypertension using available markers.
aHypertension Unit. Hospital Clínico San Carlos
bDepartment of Clinical Chemistry
cDepartment of Epidemiology and Preventive Medicine
dDepartment of Gynecology and Obstetrics, Hospital Clínico San Carlos. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
Correspondence to Nieves Martell-Claros, Hypertension Unit. Hospital Clínico San Carlos. Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/Prof. Martín Lagos s/n. 28040 Madrid, Spain. Tel: +34629112113/34913303395; fax: +34913303280; e-mail: firstname.lastname@example.org,email@example.com
Abbreviations: MoM, multiple of the median; PAPP-A, pregnancy-associated plasma protein A; PE, pre-eclampsia; ß-HCG, free-β human chorionic gonadothrophin
Received 30 January, 2013
Revised 1 July, 2013
Accepted 16 July, 2013