o5. low-dose aspirin therapy in pregnant women with chronic hypertension

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O4. Predisposing factors for early- and late-onset pre- clampsia S. Ornaghi, A. Tyurmorezova, V. Giardini, P. Algeri, P. Ceruti, E. Vertemati, P. Vergani (Department of Obstetrics and Gynecology, San Gerardo Hospital – University of Milano – Bicocca, Monza, Italy) Objectives: Early (34.0 wks) and late (>34.0 wks) onset preeclampsia (EO–LO PE) are supposed to have different eti- ologies, vascular and inflammatory disfunction respectively. The aim of our study is to evaluate general characteristics of women affected by either EO or LO PE, to identify risk factors for the two forms of disease. Study design: Retrospective cohort study of 197 consecu- tive singleton women diagnosed as preeclamptic at 22.4– 41.4 wks, from 1/2005 to 9/2009, evaluating demographic, clinical, and ultrasonographic (US) variables on hospital admission, in relation to EO vs LO PE. HELLP syndrome and stillbirth cases, and fetus with congenital anomalies were excluded. Obesity was defined as a BMI 30 kg/m 2 . First abnormal uterine arteries (UtA) Doppler, evaluated in wo- men with history of APO (previous PE/IUGR/SGA), was de- fined as mean RI > 0.58 or bilateral Notch within 26.0 wks. IUGR was considered as an US AC < 10th. Results: 136 women had previous APO. EO PE was identi- fied in 98 cases (49.7%). Results of univariate analysis are showed in Table 1. Multivariate analysis weighed for GA at delivery showed age > 35 yrs and UtA Doppler related to EO PE (Table 2), whereas WG > 12 kg to LO PE (p = 0.04; OR = 4.6, CI (95%) = 2.39–8.87). Conclusions: Age > 35 yrs and UtA Doppler appeared risk factors for EO PE, whereas WG > 12 kg for the late form, sup- porting the hypothesis of a different pathogenesis. doi:10.1016/j.preghy.2011.08.036 PREDICTION AND PREVENTION OF PREECLAMPSIA O5. Low-dose aspirin therapy in pregnant women with chronic hypertension E. Baptista, B. Moita, A. Gomes, N. Bento, M.S.J. Pais, E. Marta, P. Moura (Obstetrics Department, Coimbra’s University Hospital, Coimbra, Portugal) Objectives: To determine if low-dose aspirin prophylactic therapy improves obstetric and perinatal outcome in wo- men with chronic hypertension. Materials and methods: The clinical records of 179 preg- nant women with chronic hypertension, between Jan/2005 and Dec/2009, were analysed retrospectively. From these, 65 were submitted to low-dose (100 mg) aspirin therapy (group-A) against 114 without therapy (group-B). Obstetric and perinatal outcome in both groups was analyzed. The main parameters under analysis were: development of pre-eclampsia, HELLP syndrome, intra-uterine growth restriction (IUGR), birthweight and neonatal intensive care unit admission. Results: Mean maternal age was 32.11 years in group-A and 30.74 in group-B (p = n.s.). No statistical significance was observed in pre-eclampsia development (A: 10,76% vs. B: 15,78%; p = n.s.). One case of HELLP syndrome and one case of placental abruption were reported in group B. Statis- tically significant difference in IUGR development was ob- served between both groups (A: 6,15% vs. B: 16,67%; p = 0,032). Mean gestational age at delivery was 37.5 weeks in group-A and 37.2 weeks in group-B (p = n.s.). Caesarean section was performed in 50.77% in group-A and 59.65% in group-B (p = n.s.). Mean birth weight was 3086,4g in group-A and 2948.0 g in group-B (p = n.s.). Neonatal inten- sive care unit admission rate was 16.92% in group-A and 18.42% in group-B (p = n.s.). Placental pathology revealed signs of utero-placental chronic ischemia in 9.23% (group- A) and 9.65% (group-B) (p = n.s.). No significant complica- tions associated to aspirin therapy were reported in any of these groups. Conclusions: In this subgroup of high risk women, low- dose aspirin prophylaxis was effective in reducing incidence of IUGR. The other parameters analysed in this study re- vealed no statistically significant differences. doi:10.1016/j.preghy.2011.08.037 Table 1 Univariate analysis. Variables EO (N = 98) LO (N = 99) p- Value Age > 35 years 47% 22% 0.00 Nulliparity 49% 62% 0.09 History of APO 52% 48% 0.36 Pre-pregnancy BMI (kg/m 2 ) 24.1 ± 5.3 24.5 ± 5.9 0.63 Obesity 14% 15% N.S. I abnormal UtA Doppler 90% (64/ 71) 57% (37/ 65) 0.00 IUGR 48% 15% 0.00 GDM 4% 11% 0.10 End-pregnancy BMI (kg/m 2 ) 28.3 ± 5.0 30.2 ± 5.4 0.02 WG > 12 kg 33% 71% 0.00 5 kg/m 2 BMI increase 29% 65% 0.00 7 kg/m 2 BMI increase 14% 23% 0.13 Admission-to-delivery interval < 48 h 24% 57% 0.00 GA at delivery (weeks) 30.9 ± 2.9 37.6 ± 1.8 0.00 Table 2 Weight estimation regression. EO PE. Variables p-Value OR CI (95%) Age > 35 yrs 0.04 3.10 1.60 – 6.03 I abnormal UtA Doppler 0.00 6.50 2.46–17.56 Current IUGR 0.26 Lectures / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 1 (2011) 238–272 259

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Page 1: O5. Low-dose aspirin therapy in pregnant women with chronic hypertension

O4. Predisposing factors for early- and late-onset pre-clampsiaS. Ornaghi, A. Tyurmorezova, V. Giardini, P. Algeri, P.Ceruti, E. Vertemati, P. Vergani (Department of Obstetricsand Gynecology, San Gerardo Hospital – University ofMilano – Bicocca, Monza, Italy)

Objectives: Early (34.0 wks) and late (>34.0 wks) onsetpreeclampsia (EO–LO PE) are supposed to have different eti-ologies, vascular and inflammatory disfunction respectively.The aim of our study is to evaluate general characteristics ofwomen affected by either EO or LO PE, to identify risk factorsfor the two forms of disease.

Study design: Retrospective cohort study of 197 consecu-tive singleton women diagnosed as preeclamptic at 22.4–41.4 wks, from 1/2005 to 9/2009, evaluating demographic,clinical, and ultrasonographic (US) variables on hospitaladmission, in relation to EO vs LO PE. HELLP syndrome andstillbirth cases, and fetus with congenital anomalies wereexcluded. Obesity was defined as a BMI 30 kg/m2. Firstabnormal uterine arteries (UtA) Doppler, evaluated in wo-men with history of APO (previous PE/IUGR/SGA), was de-fined as mean RI > 0.58 or bilateral Notch within 26.0 wks.IUGR was considered as an US AC < 10th.

Results: 136 women had previous APO. EO PE was identi-fied in 98 cases (49.7%). Results of univariate analysis areshowed in Table 1. Multivariate analysis weighed for GA atdelivery showed age > 35 yrs and UtA Doppler related to

EO PE (Table 2), whereas WG > 12 kg to LO PE (p = 0.04;OR = 4.6, CI (95%) = 2.39–8.87).

Conclusions: Age > 35 yrs and UtA Doppler appeared riskfactors for EO PE, whereas WG > 12 kg for the late form, sup-porting the hypothesis of a different pathogenesis.

doi:10.1016/j.preghy.2011.08.036

PREDICTION AND PREVENTION OF PREECLAMPSIA

O5. Low-dose aspirin therapy in pregnant women withchronic hypertensionE. Baptista, B. Moita, A. Gomes, N. Bento, M.S.J. Pais,E. Marta, P. Moura (Obstetrics Department, Coimbra’sUniversity Hospital, Coimbra, Portugal)

Objectives: To determine if low-dose aspirin prophylactictherapy improves obstetric and perinatal outcome in wo-men with chronic hypertension.

Materials and methods: The clinical records of 179 preg-nant women with chronic hypertension, between Jan/2005and Dec/2009, were analysed retrospectively. From these,65 were submitted to low-dose (100 mg) aspirin therapy(group-A) against 114 without therapy (group-B). Obstetricand perinatal outcome in both groups was analyzed. Themain parameters under analysis were: development ofpre-eclampsia, HELLP syndrome, intra-uterine growthrestriction (IUGR), birthweight and neonatal intensive careunit admission.

Results: Mean maternal age was 32.11 years in group-Aand 30.74 in group-B (p = n.s.). No statistical significancewas observed in pre-eclampsia development (A: 10,76% vs.B: 15,78%; p = n.s.). One case of HELLP syndrome and onecase of placental abruption were reported in group B. Statis-tically significant difference in IUGR development was ob-served between both groups (A: 6,15% vs. B: 16,67%;p = 0,032). Mean gestational age at delivery was 37.5 weeksin group-A and 37.2 weeks in group-B (p = n.s.). Caesareansection was performed in 50.77% in group-A and 59.65% ingroup-B (p = n.s.). Mean birth weight was 3086,4g ingroup-A and 2948.0 g in group-B (p = n.s.). Neonatal inten-sive care unit admission rate was 16.92% in group-A and18.42% in group-B (p = n.s.). Placental pathology revealedsigns of utero-placental chronic ischemia in 9.23% (group-A) and 9.65% (group-B) (p = n.s.). No significant complica-tions associated to aspirin therapy were reported in any ofthese groups.

Conclusions: In this subgroup of high risk women, low-dose aspirin prophylaxis was effective in reducing incidenceof IUGR. The other parameters analysed in this study re-vealed no statistically significant differences.

doi:10.1016/j.preghy.2011.08.037

Table 1Univariate analysis.

Variables EO(N = 98)

LO(N = 99)

p-Value

Age > 35 years 47% 22% 0.00Nulliparity 49% 62% 0.09History of APO 52% 48% 0.36Pre-pregnancy BMI (kg/m2) 24.1 ± 5.3 24.5 ± 5.9 0.63Obesity 14% 15% N.S.I abnormal UtA Doppler 90% (64/

71)57% (37/65)

0.00

IUGR 48% 15% 0.00GDM 4% 11% 0.10End-pregnancy BMI (kg/m2) 28.3 ± 5.0 30.2 ± 5.4 0.02WG > 12 kg 33% 71% 0.005 kg/m2 BMI increase 29% 65% 0.007 kg/m2 BMI increase 14% 23% 0.13Admission-to-delivery

interval < 48 h24% 57% 0.00

GA at delivery (weeks) 30.9 ± 2.9 37.6 ± 1.8 0.00

Table 2Weight estimation regression. EO PE.

Variables p-Value OR CI (95%)

Age > 35 yrs 0.04 3.10 1.60 – 6.03I abnormal UtA Doppler 0.00 6.50 2.46–17.56Current IUGR 0.26

Lectures / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 1 (2011) 238–272 259