507: Angiogenic profile stratified by race in uncomplicated women and those with hypertensive disorders of pregnancy

Race specific assessment of pregnancy is important as it allows the identification of women who are at an increased risk of certain pathology and enhanced monitoring. This study explored the association between angiogenic markers (soluble fms-like tyrosine kinase-1 [sFlt1] and placental growth factor [PlGF]) in African American (AA) and white women who were normotensive and those with hypertensive disorders of pregnancy (HDP). Normotensive women and those HDP were enrolled upon admission and blood samples were collected within 96 hours prior to delivery. Angiogenic markers were measured on an automated platform. Data was collected from medical records. For analysis patients were stratified into having a HDP or not. Data was collected on a total of 608 women, of which 477 (78%) were black and 131 (22%) were white. Age, infant birthweight and the prevalence of nulliparity was significantly higher in white women as compared to AA women (Table 1). On the contrary, body mass index was significantly higher in AA women as compared to white women (median BMI 28.1 vs 25.8; p=0.01). Other interventions including antepartum medication administration was similar between groups. When comparing angiogenic profiles, the median PlGF was significantly higher (p=0.001) and the median sFlt1/PlGF was lower (p=0.03) among AA women as compared to white women, regardless of hypertensive status. No difference was seen between sFlt1 and racial group (p=0.80). Consistent with previous studies by our group and others, abnormal angiogenic factors were observed among patients with a HDP. When stratifying by hypertensive status (within or without a HDP), the relationship between PlGF and race persisted. Unexpectedly, this was most pronounced among normotensive women, as AA women experienced a higher median PlGF of 245 pg/mL (interquartile range 133-495) as compared to a median PlGF of 151 pg/mL (IQR: 75-250) in white women (Table 2). This study demonstrates a significant association between PlGF and race. Additional evaluation of the role of angiogenic markers during assessment for HDP in AA women as compared to white women and disease severity is needed. Factors other than angiogenic factors needs to be evaluated to explain higher prevalence of HDP in AA women.View Large Image Figure ViewerDownload Hi-res image Download (PPT)