758 Hypertensive disease of pregnancy (HDP) among high risk women with stage 1 hypertension

Abstract

per week and 91 were in the top 90th percentile (High ASB), consuming >21 ounces per week. Sixty percent of the cohort consumed no ASB. Demographic characteristics were similar between groups. No significant differences were found for primary or secondary outcomes after adjusting for potential confounding variables. CONCLUSION: Most patients consumed some SSB, no ASB, and there were no differences in pregnancy outcomes between the highest consumers in both groups. Beverage consumption is an important aspect of maternal dietary quality and evidence-based recommendations are needed to guide consumption in pregnancy.

Aspirin for the prevention of pre‐eclampsia in women with pre‐existing diabetes: Systematic review

“…For women with pre-existing DM, pre-eclampsia developed in 18% of those receiving aspirin compared to 22% in the placebo group (P = 0.38; relative risk 0.9 (0.6-1.2)). 24 Testani et al 25 reported a sub-analysis of this same dataset of women in a published conference abstract. Participants with pre-existing DM with stage 1 hypertension defined as systolic blood pressure (BP) 130-139 mmHg or diastolic BP 80-89 mmHg (2017 American College of Cardiology/American Heart Association (ACC/AHA) Hypertension Guidelines 26 ), compared to those normotensive in early pregnancy, had a relative risk of developing a hypertensive disease of pregnancy (defined here as gestational HT, pre-eclampsia, and pre-eclampsia with severe features) of 2.4 (95% CI 1.6-3.5; P < 0.05) if randomised to placebo, and 1.1 (95% CI 0.6-1.7) if randomised to aspirin.…”

“…The study by Caritis et al, 30 which represents the largest single study that included women with DM, used the relatively low dose of 60 mg aspirin daily commencing at a relatively late gestation of 13-26 weeks, two possible contributing factors to their non-significant result. Additionally, the varied preeclampsia risk in women with DM may be affected by diabetes type, disease progression or presence of comorbidities, with Testani et al 25 demonstrating that women with DM with stage 1 hypertension have more than double the risk of pre-eclampsia compared to normotensive women with DM. The severity of diabetes, baseline glycaemic control and presence of comorbidities including chronic kidney disease, is likely to have an impact on pre-eclampsia outcome; however, this information is unknown for the women with DM reported in the published RCTs to date.…”

Prediction and prevention of preeclampsia in women with preexisting diabetes: the role of home blood pressure, physical activity, and aspirin

“…The largest RCT reporting data on more than 2,500 women, of which 471 had preexisting diabetes, did not demonstrate a beneficial effect of 60 mg/day of prophylactic aspirin initiated between 13 and 26 gestational weeks ( 117 ) ( Table 3 ). Meanwhile, a published conference abstract of a secondary analysis of this RCT ( 117 ) showed a beneficial effect of 60 mg/day aspirin initiated between 13 and 26 gestational weeks in the subgroup of women with preexisting diabetes and hypertension ( 121 ).…”

“…Overall, the evidence from RCTs of a beneficial effect of routine prophylactic aspirin to prevent preeclampsia in women with preexisting diabetes is lacking ( 116 – 120 ), and a convincing effect has not been shown in real world cohort studies ( 24 , 102 , 121 , 126 , 127 ).…”