Greg Davis
St George Hospital 

 ABSTRACT

Postpartum Physiology, Psychology and Paediatric Follow Up Study (P4 Study) – Study Protocol
Gregory K Davis1,2,3, Lynne Roberts1,3, A/Prof George Mangos 1,2, Amanda Henry1,2, Franziska Pettit1,2, Anthony O’Sullivan1,2, Caroline SE Homer1,3, Maria Craig1,2,4, Samuel B Harvey1,2,5, Mark A Brown1,2

1St George Hospital, Kogarah, NSW 2217. Australia
2University of New South Wales, Randwick, NSW 2031. Australia
3University of Technology Sydney, Ultimo NSW 2007. Australia
4Sydney Children’s Hospital, Randwick, NSW 2031. Australia
5Black Dog Institute, Randwick, NSW 2031. Australia

Aims:

1) To define normal ranges for BP and cardiovascular risk factors and psychological measures in women six months, two and five years after pregnancy

2) In women who have had hypertension in pregnancy:

a.     To determine the prevalence of these risk factors

b.    To determine whether they are at increased risk of psychological morbidity.

c.     To determine whether their babies have more physical or developmental impairment than babies from normal pregnancies.

Methods: Women are asked to participate if they have given birth in the preceding six months. Exclusion criteria include serious maternal disease prior to pregnancy or congenital anomaly in the pregnancy. Recruitment has commenced for 300 women with prior normotensive pregnancy, 100 who had preeclampsia (PE) and 100 who had gestational hypertension (GH), and their babies. They are assessed at six months, two and five years after birth.

At each assessment, women have extensive physiological testing, blood and urine samples and psychological status assessed using validated self-report questionnaires. The babies have their physical health and behavioural development assessed.

Results: Recruitment began in July 2013 and 210 women completed their six month assessments to the end of 2015, 161 who were normotensive in pregnancy and 49 hypertensive (40 PE, 9 GH). Both groups were similar in age, ethnicity, level of education and body mass index. Other abstracts will be presented with progress results in more detail.

Conclusions: When complete, this study will re-define normal BP and other physiological parameters for young parous women, permitting a more sensitive assessment of postpartum BP and other cardiovascular risk markers in women who have had GH or PE. It will also determine the extent, if any, of psychological disorders in these women and developmental or other concerns in their babies.


Does antihypertensive treatment affect babies six months after preeclampsia or gestational hypertension?
Gregory K Davis1,2,3, Lynne Roberts1,3, Maria Craig1,2,4, Mark A Brown1,2
1St George Hospital, Kogarah, NSW 2217. Australia, 2University of New South Wales, Randwick, NSW 2031. Australia, 3University of Technology Sydney, Ultimo NSW 2007. Australia. 4Sydney Children’s Hospital, Randwick, NSW 2031. Australia

Aims: To compare the physical health and development of the infants at six months after birth of women who were normotensive in pregnancy and those who had gestational hypertension (GH) or preeclampsia (PE), with specific analysis of babies of women who received antihypertensive medication.

Methods: Infants are recruited as part of the Postpartum Physiology, Psychology and Paediatric Study (P4 Study) – a longitudinal follow up study of normotensive and hypertensive women and their babies. It is planned to recruit 300 women who were normotensive, 100 who had GH and 100 who had PE and their babies. Women and their babies are assessed at six months, two and five years after birth. Mother-infant bonding is assessed with a validated self-report questionnaire completed by the mother. The infants are examined by a paediatrician and their behavioural development is assessed with an age appropriate Ages and Stages Questionnaire completed by their mother.

Results: To date, 161 babies of women who were normotensive in pregnancy and 49 of hypertensive (40 PE, 9 GH) pregnancies have been studied. As expected, women with hypertension gave birth earlier and had smaller babies. However, by six months there were no differences in the physical health or development of the babies, or in mother-infant bonding, between normotensive and hypertensive groups. Specifically, no abnormalities have been found to date in babies of mothers who received antihypertensives.

Conclusions: Preliminary findings suggest that use of antihypertensives to treat PE or GH does not result in longer term problems for babies delivered from these pregnancies. Our P4 Study will allow more detailed analysis of greater numbers of babies out to two and five years postpartum so as to give reassurance to mothers and clinicians about this issue.