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Poster Session 3

(793) Evaluating the Potential Relationship between sFlt-1:PIGF and Hypertension Across Pregnancy and early Postpartum

Friday, January 31, 2025
10:30 AM – 12:30 PM  

    Submitting Author and Presenting Author(s)

  • Julia L. Berkowitz, BA, MD (she/her/hers)

    Cardiology Fellow
    UMass Medical Center
    UMass Medical Center, Massachusetts, United States

    • Coauthor(s)

  • SJ

    Stephen Juraschek, MD, PhD

    Physician, Associate Professor of Medicine and Nutrition
    Beth Israel Deaconess Medical Center
    Boston, Massachusetts, United States

  • LK

    Lara Kovell, MD

    Associate Professor
    UMass Memorial Health
    Worcester, Massachusetts, United States

Objective:

Hypertensive disorders of pregnancy are major contributors to adverse maternal outcomes including stroke, cardiovascular disease, and death. Vascular biomarkers, including the ratio of soluble fms-like tyrosine kinase 1 and placental growth factor (Sflt-1: PIGF) are independent predictors of gestational hypertension and preeclampsia. The aim of this study is to examine the trend in Sflt-1: PIGF in pregnancy and post-partum in women with and without hypertension (HTN).

Study Design:

In a prospective, 1:1 case-control design, we enrolled pregnant women with HTN and without HTN (control group) between 24-32 weeks gestation from 2019-2022. HTN was defined by a clinical diagnosis or baseline blood pressure (BP) ≥140/90 mm Hg. The control group had a systolic BP < 120 mm Hg and no HTN diagnosis. Serum was collected at baseline, at delivery admission, and postpartum day 1. Mixed effects tobit models were used to compare Sflt-1:PIGF across HTN groups and over time, adjusted for age and BMI.

Results:

At baseline, the HTN group had higher sFLT-1(pg/mL): PIGF (pg/mL) (mean (SD): 3.9 (0.9)) versus the control group (2.1 (0.5)). Both groups had a significant increase in mean sFLT-1:PIGF at the delivery admission (HTN: 20.7 (5.3); Control: 27.0 (7.2)) and postpartum (HTN: 56.7 (13.9); Control:  42.0 (10.6)); however, no significant difference was seen between these groups (see Figure 1). Across pregnancy and the early postpartum period, there was no significant difference in the mean sFLT-1: PIGF ratio between the HTN and control groups (HTN: 13.06 (2.73); Control: 10.44 (2.24)).

Conclusion:

While women with HTN had greater baseline sFLt-1: PIGF than controls, no significant differences were found during delivery admission or postpartum. All women demonstrated a significant increase in sFLt-1:PIGF during pregnancy with elevations continuing postpartum.

Future studies examining the impacts of HTN on subclinical cardiovascular injury and long-term maternal outcomes are needed.