[287-POS]: Recurrence of hypertensive disorders of pregnancy, an individual patient data meta-analysis

Objectives For women who suffered hypertensive disorders of pregnancy (HDP), information on recurrence rates is crucial in the decision to conceive again. Recurrence rates vary from a few percent up to 65%. We used Individual Participant Data (IPD) meta-analysis to assess the recurrence of HDP, thus increasing statistical power. We aim to calculate the absolute recurrence risk of HDP and to determine risk factors of recurrence. Methods We searched Pubmed and Embase for studies with a cohort design that included women with a history of a HDP. We approached principal investigators for original patient data that were merged into one database. Adverse outcome was defined as recurrence of a HDP in the subsequent pregnancy. Results We obtained data of 99,415 women that had been included in 22 studies. The recurrence rate of a HDP was 20.7% (95%CI: 20.4–20.9). Concomitant HELLP syndrome and a SGA child in the first pregnancy increased recurrence of HDP (Fig. 1). Furthermore decreasing gestational age in the index pregnancy increased the chance recurrence and recurrent premature delivery. Multiple pregnancy at the index pregnancy was protective for recurrence as compared to singleton pregnancy (OR 0.53; 95%CI 0.40–0.70). In general, if HDP recurred it was milder. Previously normotensive women had a fourfold risk of developing chronic hypertension after recurrence of HDP. Conclusions Among women that suffer hypertension in pregnancy, the recurrence rate in a next pregnancy is low and the course of disease is milder for most women with recurrent disease. These reassuring data should be used for shared decision making in women who consider a new pregnancy after a pregnancy complicated by hypertension. Disclosures M.F. van Oostwaard: None. J. Langenveld: None. E. Schuit: None. D.N. Papatsonis: None. B.J. Mol: None. W. Ganzevoort: None.