Poster Session 3
Category: Hypertension
Poster Session 3
Yossi Bart, MD
MFM fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Wissam Akkary, MD
Maternal-Fetal Medicine Fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
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Zakaria Doughan, MD
Research Assistant
Department of Obstetrics and Gynecology, McGovern Medical School at UT Health, Houston
Houston, Texas, United States
Joe Haydamous, MD (he/him/his)
PGY1
Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Department of Obstetrics and Gynecology, McGovern Medical School at UT Health, Houston, Texas, United States
Ahmed Zaki Moustafa, MD, MS (he/him/his)
Assistant Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
University of Texas - Houston, Texas, United States
Sean C. Blackwell, MBA, MD
Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Baha M. Sibai, MD
Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
This study aimed to assess the association between the highest SBP on the first day of admission and adverse maternal and fetal outcomes among patients with early-onset preeclampsia with severe features.
Study Design:
A retrospective cohort study at a Level IV referral center, including patients diagnosed with preeclampsia with severe features between 23w0d and 33w6d (2016–2025). Patients with any component of the primary outcome present at admission were excluded. The primary outcome was a composite adverse outcome (CAO), including placental abruption, fetal death, eclampsia, HELLP syndrome, acute kidney injury, pulmonary edema, heart failure, stroke, and maternal death. Patients were further stratified by diagnostic criteria: those diagnosed based solely on severe-range blood pressure versus those diagnosed by any other combination of the criteria. Poisson regression was used to calculate adjusted relative risk (aRR) with 95% confidence intervals (CI).
Results:
Overall, 465 patients met inclusion criteria. Of those, 49 (10%) had SBP < 160 mmHg, 162 (35%) had SBP of 160-179 mmHg, and 254 (55%) had SBP ≥180 mmHg at admission. CAO occurred in 71 (15%) patients, increasing with SBP severity (6%, 11%, and 19%, respectively; P=0.02). After adjustment for statistically confounding variables, SBP ≥180 mmHg was associated with a 3.37-fold increased risk of CAO compared to SBP < 160 (95% CI 1.10–10.26, Table). Stratified analysis by diagnostic criteria showed a dose-response relationship between SBP and CAO (Figure). Among those diagnosed by blood pressure alone, SBP ≥180 mmHg was associated with an aRR of 1.85 (95% CI 1.02–3.33) for the CAO compared to SBP < 180. In patients meeting any other diagnostic criteria combination, SBP ≥180 mmHg conferred an aRR of 5.65 (95% CI 1.10–28.97) compared to SBP < 160, with 34% developing CAO.
Conclusion:
Among patients with early-onset preeclampsia with severe features, higher admission SBP, particularly ≥180 mmHg, was associated with the CAO rate. This dose-dependent relationship persisted across diagnostic subgroups.