PS-C32-1: DEMOGRAPHIC, ANTHROPOMETRIC AND BIOCHEMICAL CORRELATES AS EARLY PREDICTIVE INDICES OF HYPERTENSIVE DISORDERS IN PREGNANT WOMEN FROM NIGERIA

Abstract

Objective: this study was conducted to evaluate maternal demographic, anthropometric and biochemical indices to predict Hypertensive Disorders of Pregnancy (HDP) at early stage. Design and method: Non-hypertensive pregnant women (n = 521) of < 20 weeks gestation, attending antenatal clinics of four different tertiary health facilities in Nigeria enrolled into this longitudinal study. From this, 471 participants were followed up to delivery. Demographic data were obtained through a semi-structured questionnaire while BMI and Percentage Body Fat (PBF) were determined using standard methods. Blood and urine samples were collected at baseline, second and third trimesters. Placental Growth Factor (PLGF), leptin and insulin were analysed in serum using ELISA. Triglycerides, total cholesterol, HDLc, uric acid, creatinine and Fasting Plasma Glucose (FPG) in plasma were analysed spectrophotometrically. Urinalysis was performed using dipstick while LDLc was calculated. Data were analysed using Chi-square, ANOVA and Cox proportional hazard model at < 0.05. Results: Ten (2.1%) and 24 (5.1%) of the pregnant women developed HDP at second and third trimester. From the 34 that developed HDP, 19 (55.9%), 12 (35.3%), 2 (5.9%) and 1 (2.9%) developed Preeclampsia-Eclampsia, Gestational Hypertension, Chronic Hypertension and Preeclampsia Superimposed on Chronic Hypertension, respectively. Maternal age and marital age of HDP women (32.4 ± 5.0; 28.9 ± 4.3 years) were respectively higher than normotensive (30.5 ± 4.4; 27.2 ± 3.7 years). Risk of HDP was higher at marital age of 35–42 years compared with 13–25 years (HR = 8.44, 95% CI: 2.01–35.35). Body mass index (30.4 ± 1.6 vs. 26.6 ± 0.3Kg/m2) and PBF (40.6 ± 1.5 vs. 36.0 ± 0.5) were higher in HDP women than normotensive. Reduced PLGF level (HR = 0.77, 95% CI: 0.64–0.94) in second trimester increased risk of HDP. Leptin (6.9 ± 1.9 vs. 14.1 ± 1.5ng/mL) in first trimester and insulin (1.5 ± 0.5 vs. 10.5 ± 1.5 μIU/mL and 7.9 ± 3.2 vs. 17.5 ± 2.1 μIU/mL) in first and second trimesters were lower in HDP than normotensive women, respectively. Uric acid (2.8 ± 0.1 vs. 4.2 ± 0.8 mg/dL) and creatinine (0.8 ± 0.01 vs. 2.6 ± 1.7 mg/dL) were significantly decreased in normotensive compared with HDP women in first trimester. The FPG (78.1 ± 2.6: 73.0 ± 1.4: 71.4 ± 1.5 mg/dL) was significantly reduced from first, second to third trimesters in normotensive women. In HDP women FPG (76.1 ± 4.1; 74.5 ± 6.7 vs. 65.8 ± 5.5 mg/dL) was increased in second and third trimesters, respectively compared to first trimester. Increased LDLc (HR = 1.28, 95% CI: 1.04–1.58) was associated with increased risk of HDP in second trimester. Conclusions: Maternal age, obesity, decreased levels of placental growth factor, leptin, insulin, uric acid; increased levels of fasting plasma glucose and low density lipoprotein cholesterol are critical risk factors for early prediction of hypertensive disorders during pregnancy.