Recurrence risk of preeclampsia in a linked population-based cohort: Effects of first pregnancy maximum diastolic blood pressure and gestational age.
Pregnancy Hypertens
; 15: 32-36, 2019 Jan.
Article
in En
| MEDLINE
| ID: mdl-30825924
ABSTRACT
OBJECTIVE:
To estimate preeclampsia occurrence and recurrence risk in the 2nd pregnancy and analyze associated risk factors such as 1st pregnancy maximum diastolic blood pressure (maxDBP) and gestational age at delivery (GA). STUDYDESIGN:
Linked cohort of 1st and 2nd pregnancies of 272,551 women from the Dutch Perinatal Registry collected between 2000 and 2007. We defined preeclampsia as hypertension (maxDBP ≥90â¯mmHg or documented hypertension) plus proteinuria (≥300â¯mg/24â¯h) and analyzed its 2nd pregnancy occurrence with logistic regression. Early and late onset preeclampsia were defined by delivery before and after the 34th week, respectively.RESULTS:
Preeclampsia prevalences in the 1st and 2nd pregnancies were 2.5% and 0.9%, respectively. Women with prior preeclampsia had a 10.5% risk of recurrence. For women with term 1st pregnancies and maxDBP <80â¯mmHg, the 2nd pregnancy preeclampsia rate was 0.2% (95% CI 0.17%-0.23%), while for those whom presented maxDBP ≥110â¯mmHg it was 4.2% (95% CI 3.6%-4.8%). First pregnancy late onset preeclampsia was associated with increased preeclampsia recurrence risk proportional to 1st pregnancy maxDBP in women with a maxDBP between 100 and 109â¯mmHg the recurrence risk was 8.3%, while for women with a maxDBP ≥110â¯mmHg this risk was 11% (difference 2.7%; 95% CI 1.0%-4.4%). In 1st pregnancy early onset preeclampsia corresponding rates were 14.8% and 19.3% (difference 4.5%; 95% CI -1.3%-9.7%).CONCLUSION:
Preeclampsia recurrence risk is 10%. Preeclampsia risk in the 2nd pregnancy increases proportionally to 1st pregnancy maxDBP. Earlier onsets of 1st pregnancy preeclampsia further increase recurrence risk.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pre-Eclampsia
/
Blood Pressure
/
Gestational Age
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Language:
En
Journal:
Pregnancy Hypertens
Year:
2019
Document type:
Article