37. Association of levels of antepartum angiogenic factors with severe postpartum hypertension

Introduction Postpartum hypertension (PPHTN) often arises from an existing hypertensive disorder of pregnancy (HDP). Limited data exists about antecedent presentation and risk factors of PPHTN, especially among high risk groups such as African American (AA) women. We studied the association between levels of antepartum angiogenic biomarkers (soluble fms-like tyrosine kinase-1 [sFlt1] and placental growth factor [PlGF]) and risk of severe PPHTN among predominantly AA women. Methods Women with HDP were enrolled upon admission and blood was collected within 96 h of delivery. sFlt1 and PlGF were measured on an automated platform. PPHTN was defined as severe if systolic blood pressures (SBP) was ⩾160 or diastolic blood pressure (DBP) ⩾110 and mild if SBP ⩾140 or DBP ⩾90. Descriptive statistics are reported and assessed with a Wilcoxon Rank Sum or chi-square test, as appropriate. Univariate and multivariable logistic regression was used to assess the association between PPHTN and angiogenic factors, reporting the area under the receiver operating curve (AUC). Results A total of 375 women were enrolled, with 279 (74.4%) AA and 151 (40.3%) who met criteria for severe PPHTN. About half (52.9%) of women with severe PPHTN also had pre-eclampsia with severe features prior to delivery. The sFlt1/PlGF ratio was significantly higher for both severe and mild PPHTN compared to women with normal postpartum BPs (73.5, 46.0 and 13.0 respectively, p-values  Conclusion Severe PPHTN is frequent in women presenting with antepartum HDP in this patient population. There is a significant association between antepartum angiogenic biomarkers and severe PPHTN. Further studies need to evaluate the mechanisms of such association.