Physiology, Psychology and Paediatric Follow Up Study (P4 Study) – Study
Gregory K Davis1,2,3,
Lynne Roberts1,3, A/Prof
George Mangos 1,2, Amanda
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.
2University of New South Wales, Randwick,
NSW 2031. Australia
3University of Technology Sydney, Ultimo
NSW 2007. Australia
4Sydney Children’s Hospital, Randwick, NSW
5Black Dog Institute, Randwick, NSW 2031.
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
determine the prevalence of these risk factors
determine whether they are at increased risk of psychological morbidity.
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.
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
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
treatment affect babies six months after preeclampsia or gestational
Gregory K Davis1,2,3, Lynne Roberts1,3,
Maria Craig1,2,4, Mark A Brown1,2
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
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.
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.
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.
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.