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Early predictors of gestational hypertension in a low-risk cohort. Results of a pilot study

Martell-Claros, Nievesa; Blanco-Kelly, Fionab; Abad-Cardiel, Maríaa; Torrejón, María J.b; Alvarez-Alvarez, Beatriza; Fuentes, Manuel E.c; Ortega, Doloresb; Arroyo, Manuelb; Herraiz, Miguel A.d

doi: 10.1097/HJH.0b013e32836523f6

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:,

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

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins