OP 3 Assessment of the added value of early pregnancy 24-h ambulatory blood pressure monitoring for the prediction of pre-eclampsia in women with chronic hypertension

Abstract

Introduction Whilst pre-eclampsia (PE) is highly prevalent amongst women with chronic hypertension, early identification of women at the highest risk is currently not possible. In this study we sought to explore the added value of ambulatory blood pressure monitoring (ABPM) for the prediction of pre-eclampsia. Methods We performed a prospective exploratory study. Women were recruited (⩽20 weeks) from the Manchester Antenatal Vascular Services (MAViS) research clinic and fitted with a Spacelabs monitor. Blood pressure (BP) readings were not revealed to the woman during the monitoring period. The BP was recorded every 30 min during the day (08:00–22:00 h) and hourly at night (22:00–08:00 h). Drug ingestion time, sleep and wake periods were self-reported [JM1]. Parameters calculated from the exported readings included: average daytime and night-time BP, maximum daytime and nighttime BP. Multivariable logistic regression was performed using AUC and likelihood ratio testing to compare model fit. Results 79 women underwent 24-h ABPM of whom 19 (25%) women developed PE. Age ( p = 0.11), BMI and clinic visit BP (136.3 ± 12.8 vs 133.0 ± 16.7 and 86.8 ± 8.7 vs 88.3 ± 12.0) were not different between the groups; PE was more common in women of non-white ethnicity ( p Conclusion Despite equivalent clinic BPs, ABPM parameters demonstrated modest prediction for PE, particularly measurements obtained overnight. On going work is continuing to explore the association between BP variability and PE to fully assess the added value of ABPM in high-risk pregnancies.