Abstract P138: Post-partum Maternal Vascular Function Is Reduced In Preeclampsia And Preterm Births: A Pilot Study

Abstract

Introduction: Women with a history of preeclampsia (PreE) or preterm (PreT) birth are at elevated risk of future hypertension, ischemic heart disease, and stroke. Mechanisms for this increased risk are unknown. Flow-mediated dilation of the brachial artery (FMD) is an established surrogate for cardiovascular risk. Hypothesis: In this pilot study, we hypothesize that maternal vascular dysfunction associated with PreE is reversible, and the extent of recovery is predicated on specific maternal characteristics. Methods: In this prospective study, subjects were recruited to three groups: PreE with delivery at 27-34 weeks; PreT delivery at 27-34 weeks without preeclampsia; and healthy controls at 39-40 weeks. Vascular function (FMD), nutrition (validated questionnaire), and physical activity (accelerometers) data were collected at 1-2 days post-partum and 3 months. Results: Fourteen subjects were enrolled (mean age 32±6 years). Systolic blood pressure was higher for PreE subjects (average 131±6) compared to controls (109 ± 9, p=0.004) and PreT (110±8, p=0.008) at visit 1. This difference resolved at visit 2. Though non-significant, FMD (mean±SE) was higher in controls compared to PreE and PreT groups at visit 1 (7.7%±0.8 v. 7.4%±0.7 and 6.9%±1.0, Figure 1). FMD remains depressed at 3 months, but subject follow-up was impacted by the Covid 19 pandemic. Alternate Healthy Eating Index scores were non-significantly higher in the PreT group than PreE and controls. PreT subjects were less sedentary and more physically active (higher moderate-vigorous physical activity, higher total steps). Conclusions: Maternal FMD is reduced immediately post-partum in PreE and PreT births. The PreT group had lower FMD despite better nutrition and physical activity scores. This is a pilot study, and we are not powered for significance. Data from our small cohort support the ability to collect meaningful data in these understudied populations which could inform future studies of long-term cardiovascular risk.