Assessment and Management of Primary Aldosteronism in Pregnancy (AMPA): a Case Control Study


Primary aldosteronism (PA) is a common secondary cause of hypertension. Literature regarding PA in pregnancy has demonstrated poor outcomes. The objective of the study was to compare the management and outcomes of PA in pregnancy to both high and low-risk matched controls. Fifty-nine women with sixty pregnancies were included (20 PA, 20 high-risk and 20 low-risk). Women with PA took a similar number of antihypertensive medications pre-pregnancy compared to the high-risk group. A similar proportion of women in the PA and high-risk groups were prescribed preeclampsia prophylaxis and developed preeclampsia. Even after adjustment for several factors, PA was not independently associated with preeclampsia development. Women with PA had higher antihypertensive requirements and a longer stay in hospital postpartum than the high-risk group (both p=0.02). There was no difference in neonatal adverse outcomes. Four women took epleronone during pregnancy without any adverse effects noted. Women with PA required more anti-hypertensives and had a longer postpartum length of stay than matched high-risk women, but similar rates of preeclampsia. There was no difference in the rate of NICU admissions or adverse outcomes for neonates.

Authors: Elizabeth Downie, Renuka Shanmugalingam, Annemarie Hennessy, Angela Makris
Keywords: pregnancy, preeclampsia, postpartum
DOI Number: 10.1210/clinem/dgac311      Publication Year: 2022

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