{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:46:44Z","timestamp":1768571204537,"version":"3.49.0"},"posted":{"date-parts":[[2025,7,23]]},"group-title":"Obstetrics and Gynecology","reference-count":38,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,7,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We investigated the independent and comparative association of a history of hypertensive disease of pregnancy and elevated serum soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1\/PlGF) ratio during the second half of pregnancy with the development of HTN up to 15 years after delivery.<\/jats:p>\n                  <jats:p>Study Design: N=1,238 singleton pregnancies were part of a prospective birth cohort study that enrolled patients from 2006-2008. Serum sFlt-1\/PlGF was collected at a median of 26.0 and 35.1 weeks gestation. Adjusted Cox proportional hazard models estimated hazard ratios and 95%CI for the time to diagnosis for Stage 1 and Stage 2 HTN within 15 years PP in association with diagnoses of HDP and interquartile range of sFlt-1\/PlGF. We adjusted for confounders.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the n=993 women, n=260 (29.18%) were diagnosed with stage 1 and n=169 (17.0%) with Stage 2 HTN within 15 years of delivering.A history of PE or a history of gestational hypertension were both significantly associated with developing HTN later in life with adjusted hazard ratios of 2.17 (95% CI, 1.44-3.28) and 3.50 (95% CI, 2.21-5.54). There was no significant association between the hazard of developing HTN and the sFlt\/PlGF ratio. However, mean PlGF levels during pregnancy in those who remained normotensive in the follow-up were higher at 546.7 pg\/mL (SD= 369.5) compared to 513.7 pg\/mL (SD=389.9) in the group with stage 1 and stage 2 HTN combined and 471.7 pg\/mL (SD=471.7) in the stage 2 only group (p=0.008 and p=0.001).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients followed for up to 15 years after delivery, a clinical history of hypertensive disease of pregnancy was significantly associated with the hazard of developing HTN later in life, while elevated sFlt-1\/PlGF biomarker levels were not.However, mean PlGF levels in the latter half of pregnancy were significantly lower in those who developed HTN later in life.<\/jats:p>\n                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