Higher daytime systolic blood pressure, prepregnancy body mass index and an elevated sFlt-1/PlGF ratio predict the development of hypertension in normotensive pregnant women

Almudena Lara-Barea; Begona Sanchez-Lechuga; Manuel Aguilar-Diosdado; Cristina Lopez-Tinoco

doi:10.1530/endoabs.110.EP855

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Endocrine Abstracts (2025) 110 EP855 | DOI: 10.1530/endoabs.110.EP855

ECEESPE2025 ePoster Presentations Metabolism, Nutrition and Obesity (164 abstracts)

Higher daytime systolic blood pressure, prepregnancy body mass index and an elevated sFlt-1/PlGF ratio predict the development of hypertension in normotensive pregnant women

Almudena Lara-Barea ¹ , Begoña Sánchez-Lechuga ¹ , Manuel Aguilar-Diosdado ¹ & Cristina López-Tinoco ¹

Author affiliations

¹Puerta del Mar Hospital, Endocrinology and Nutrition Department, Cádiz, Spain

JOINT2433

Background: The risk of hypertensive disorders of pregnancy (HDP) varies in women with gestational diabetes mellitus (GDM), depending on the degree of insulin resistance and is also influenced by obesity. The aim of this study was to evaluate clinical features, blood pressure (BP) profiles and inflammatory markers, to identify patients with an elevated risk of developing HDP.

Methods: A total of 146 normotensive pregnant women were studied. We analysed the relationships of BP profiles detected by ambulatory blood pressure monitoring (ABPM) with serum biomarkers and angiogenic factors and their association with the development of HDP.

Results: Fourteen (9.6%) women developed HDP. The table shows the association between the development of HDP, biomarkers’ levels and ABPM parameters. Multivariate analysis showed that a higher sFlt-1/PlGF ratio was associated with an increased risk of developing HDP [Or=2.02; IC 95%: 1.35–3.05]. Furthermore, higher daytime systolic BP [Or=1.27; IC 95% 1.00–1.26] and prepregnancy body mass index (BMI) [Or=1.14; IC 95%: 1.01–1.30] significantly increased the risk of developing HDP.

Table 1. Pearson correlation coefficients between hip geometry variables and fat mass at different sites
Variable	HDP (n = 14)	Non-HDP (n = 132)	p Value
Cytokines and biomarkers levels * Adiponectin, (pg/ml)	10.22 ± 2.54	13.08 ± 2.93	0.06
Resistin (pg/ml)	7.43 ± 3.82	8.28 ± 3.28	0.37
PAI-1 (pg/ml)	8.04 ± 4.08	8.69 ± 3.48	0.51
Leptin (pg/ml)	10.97 ± 0.82	10.2 ± 1.11	0.018
HGF (pg/ml)	6.65 ± 1.07	7.03 ± 1.23	0.41
MCP-1 (pg/ml)	5.24 ± 0.60	4.9 ± 0.55	0.044
TNFα (pg/ml)	0.35 ± 2.02	0.59 ± 1.13	0.49
sFlt-1 (pg/ml)	7.56 ± 0.93	7.25 ± 0.97	0.26
PIGF (pg/ml)	3.18 ± 1.79	5.1 ± 1.12	0.002
sFlt-1/PlGF ratio	4.37 ± 2.2	2.2 ± 1.43	0.003
BP parameters 24h SBP (mmHg) *	113.1 ± 14.4	104.2 ± 7.9	0.04
24h DBP (mmHg) *	69.7 ± 9.2	64.1 ± 5.6	0.04
Daytime SBP (mmHg) *	115.7 ± 13.4	106.7 ± 8.6	0.001
Daytime DBP (mmHg) *	72.3 ± 8.2	66.6 ± 6.0	0.002
Nocturnal SBP (mmHg) *	107.5 ± 17.5	98.7 ± 7.8	0.08
Nocturnal DBP (mmHg) *	63.5 ± 12.1	58.5 ± 5.6	0.15
Pathological circadian pattern ^†	9 (64.3%)	62 (46.9%)	0.17

Conclusions: Higher daytime systolic BP values, prepregnancy BMI and the sFlt-1/PlGF ratio are useful for identifying normotensive pregnant women with an increased risk of developing HDP.