Objective: To identify factors associated with persistent hypertension one-year postpartum after pregnancy complicated by gestational hypertension or preeclampsia. Study Design: A retrospective case-control study of postpartum patients who had a diagnosis of gestation hypertension or preeclampsia during a recent pregnancy and attended one-year postpartum annual exam and blood pressure check between 2014 and 2019 in a single academic medical center. Cases were defined as persons with persistent hypertension one year postpartum, using the 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, defining stage I hypertension as systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥80 mmHg. Controls were defined as non-pregnant persons with normal blood pressure (BP) at one year postpartum. Using bivariate and multivariate analyses, demographic, clinical and labor characteristics were compared between persons who had persistent hypertension one-year postpartum and controls. Results: Of the 595 persons included in this analysis, 268 (45.0%) had persistent hypertension one year postpartum. Bivariate analyses demonstrated that older maternal age, higher body mass index (BMI) at first prenatal visit, at delivery, and one year postpartum, mild-range BP (compared to normal BP) prior to discharge, and patients with elevated BP at 6-week postpartum visit, were more likely to have persistent hypertension one-year postpartum. In contrast, nulliparity was associated with lower risk of having persistent hypertension at one-year postpartum. Multivariate logistic regression demonstrated that mild range BP prior to discharge (aOR 1.78, 95%CI 1.16-2.72), elevated BPs at 6 weeks postpartum (aOR 2.01, 95% CI 1.36-3.00), and higher BMI at one-year postpartum (aOR 1.07, 95%CI 1.00-1.14), remained to be significantly associated with higher odds of persistent hypertension one-year postpartum, while nulliparity remained to be associated with lower odds of persistent hypertension one-year postpartum (aOR 0.55, 95%CI 0.36-0.84) Conclusion: In this cohort, 45% of patients with gestational hypertension or preeclampsia had persistent hypertension one-year postpartum by the 2017 ACC/AHA hypertension definition. Patients that had mildly elevated BPs in the immediate postpartum period as well as at 6 weeks postpartum, and higher BMI one year postpartum, had higher risk of having at least stage I HTN one year following pregnancy complicated by gestational hypertension or preeclampsia.

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The Edinburg postpartum depression scale (EPDS) is a valuable tool to screen for perinatal depression. Recognizing depression after diagnosis of fetal anomaly is important to protect mother and baby from adverse outcomes. Our objective is to assess the impact of fetal intervention (FI) on mothers diagnosed with fetal anomaly. STUDY DESIGN: Retrospective review of patients with confirmed fetal anomaly receiving prenatal care at our center from January 2018 to January 2020. FI was offered for open neural tube defects, fetal anemia, congenital diaphragmatic hernia, pleural effusion, bladder obstruction, and twin-twin transfusion syndrome. EPDS surveys were administered during perinatal care. Patients were separated into two groups: Fetal anomaly-intervention (FA-FI) and no intervention (FA-non FI). Women with elevated EPDS scores (! 10) or indication for assessment were referred to psychiatry. Fisher's exact test and logistic regression analyses were performed, with statistical significance defined as p<0.05. RESULTS: 462 patients met criteria, 77 in the FA-FI and 385 in the FA-non FI group. There was no significant difference in mean EPDS scores between FA-FI and FA-non FI, antenatal [5.48 (AE4.60), 5.95 (AE5.53), p ¼ 0.25] or postnatal [6.44 (AE4.56), 6.62 (AE5.93), p ¼ 0.39]. However, women with a diagnosis of cardiac anomaly who underwent FI had greater antenatal EPDS scores [7.75 (AE1.50) vs. 5.49 (AE5.21), p ¼ 0.02]. Positive psychiatric history was a significant predictor of depression (p < 0.0001). Neither intervention (p ¼ 0.24) nor anomaly (p ¼ 0.43) were predictive of depression. The FAnon FI group had a higher EPDS score in the postnatal period in patients followed and treated by psychiatry [8.29 (AE4.60) vs 12.18 (AE5.97), p ¼ 0.007; 6.33 (AE3.33) vs 10.58 (AE4.49), p ¼ 0.01]. CONCLUSION: Type of anomaly or need for intervention were not predictive of depression in the perinatal period. The greatest predictor of depression is a history of a pre-existing psychiatric disorder. For patients with fetal anomaly, not receiving FI, depression presents in the postnatal period during psychiatric treatment.

D)(Fig 1). We tested the hypothesis that measurable SA function differs between races. STUDY DESIGN: In an IRB-approved prospective longitudinal observational study, we defined a supernormal population (parity¼0, no co-morbidities or pregnancy complications) to control covariables. S and D were quantified in all trimesters, with a compound ultrasound technique: In B-flow mode, STIC/4D image blocks of individual SA were acquired systematically in the placental bed. S and D diameters were measured via M-Mode. At the first trimester visit, serum analytes (PAPP-A, PlGF, AFP) were obtained. At each visit, BMI, mean arterial blood pressure, mean uterine artery-PI, gestational age (GA), race and age were recorded. Quality control included formal training, written criteria for image acceptance and screening of every image by senior study personnel, all blinded to patient characteristics/outcome. Longitudinal analysis utilized a linear mixed-effects model with random intercept and random slope. RESULTS: A total of 645 SA were measured serially in 43 women (15 each) at 11-32 weeks. Women self-assigned race as Black ( 24), White (14) or Asian (5). S and D diameters rose with GA (p<0.001 for both). S was significantly higher in W than B and A (Fig 2 ) The model showed significant interaction between S and PAPP-A (p<0.0001). CONCLUSION:The study shows B-flow/M-mode can detect and quantify SA remodeling and illustrates the normal loss of mural tone of these vessels as pregnancy advances. Even when pregnancy outcome is normal, black women show less remodeling, a potential clue to their liability for placental dysfunction across pregnancy and the puerperium.

Hemagglutinin (HA) and neuraminidase (NA) are glycoproteins encoded by several types of viral particles. Most notably, they exercise complementary chemical functions during infection and propagation of influenza A. This research focuses on the primary structure information of the proteins, applying a computational model from previous research. Data for multiple influenza A subtypes are illustrated via information signatures and phase plots. These illuminate new ways of evaluating molecules for their virulence potential. The results further point to mutation strategies for attenuating the functions.