Evaluation of outcomes and risk factors for recurrent preeclampsia in a subsequent pregnancy

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY Archives of Gynecology and Obstetrics Pub Date : 2024-09-27 DOI:10.1007/s00404-024-07751-4
Qingwen Nie, Boxin Zhou, Yafei Wang, Minqing Ye, Dunjin Chen, Fang He
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Abstract

Purpose

The aim was to evaluate the pregnancy outcomes and identify risk factors for recurrent preeclampsia (PE).

Methods

Retrospective analysis of patients discharged with PE between January 1, 2010, and January 1, 2023, from two tertiary referral hospitals. They were classified into recurrent and non-recurrent groups based on the presence of PE in subsequent pregnancies.

Results

Among 519 women who had a subsequent pregnancy after a history of PE, 153 developed recurrent PE while 366 did not. The recurrent cases included 81 preterm PE, of which 41 were early-onset PE (EOPE). Recurrent PE correlated significantly with prior EOPE, HELLP syndrome, placental abruption, and stillbirth, as well as with current chronic hypertension (CH) and type 2 diabetes. The recurrent group showed a 5.8-fold higher risk of preterm birth (PTB) compared to the non-recurrent group (50.7% vs. 8.7%). Notably, 58.1% of the PTBs in the non-recurrent group were spontaneous. Logistic regression identified previous EOPE (aOR: 4.22 [95% CI: 2.50–7.13]) and current CH (aOR: 1.86 [95% CI: 1.09–3.18]) as independent contributors for recurrent PE. Furthermore, recurrent preterm PE shared the same risk factors: previous EOPE (aOR: 5.27 [95% CI: 2.82–9.85]) and current CH (aOR: 2.99 [95% CI: 1.57–5.71]). The morbidity of CH in subsequent pregnancy peaked at 31.9% when women with a history of EOPE delivered within three years.

Conclusion

Previous EOPE and current CH were sequentially crucial risk factors for the development of PE and preterm PE during the next pregnancy. This may clarify risk stratification in prenatal management for women with a history of PE.

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评估再次怀孕时子痫前期复发的结果和风险因素。
目的:旨在评估妊娠结局并确定子痫前期(PE)复发的风险因素:对两家三级转诊医院2010年1月1日至2023年1月1日期间出院的子痫前期患者进行回顾性分析。方法:对两家三级转诊医院 2010 年 1 月 1 日至 2023 年 1 月 1 日期间出院的 PE 患者进行回顾性分析,并根据其后次妊娠是否出现 PE 将其分为复发组和非复发组:结果:在 519 名曾患过 PE 后再次怀孕的妇女中,有 153 人复发 PE,366 人未复发。复发性 PE 包括 81 例早产 PE,其中 41 例为早发性 PE(EOPE)。复发性 PE 与之前的 EOPE、HELLP 综合征、胎盘早剥、死胎以及目前的慢性高血压(CH)和 2 型糖尿病密切相关。与非复发性组(50.7% 对 8.7%)相比,复发性组的早产(PTB)风险高出 5.8 倍。值得注意的是,在非复发性组中,58.1% 的早产是自发性的。逻辑回归发现,既往 EOPE(aOR:4.22 [95% CI:2.50-7.13])和当前 CH(aOR:1.86 [95% CI:1.09-3.18])是导致 PE 复发的独立因素。此外,复发性早产 PE 还具有相同的风险因素:既往 EOPE(aOR:5.27 [95% CI:2.82-9.85])和当前 CH(aOR:2.99 [95% CI:1.57-5.71])。有 EOPE 病史的妇女在三年内分娩时,其妊娠合并心脏病的发病率最高,达到 31.9%:结论:既往的EOPE和目前的CH是下一次妊娠发生PE和早产PE的关键风险因素。结论:既往 EOPE 和当前 CH 是导致下一次妊娠发生 PE 和早产 PE 的先后关键风险因素,这可以明确对有 PE 病史的妇女进行产前管理时的风险分层。
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来源期刊
CiteScore
4.70
自引率
15.40%
发文量
493
审稿时长
1 months
期刊介绍: Founded in 1870 as "Archiv für Gynaekologie", Archives of Gynecology and Obstetrics has a long and outstanding tradition. Since 1922 the journal has been the Organ of the Deutsche Gesellschaft für Gynäkologie und Geburtshilfe. "The Archives of Gynecology and Obstetrics" is circulated in over 40 countries world wide and is indexed in "PubMed/Medline" and "Science Citation Index Expanded/Journal Citation Report". The journal publishes invited and submitted reviews; peer-reviewed original articles about clinical topics and basic research as well as news and views and guidelines and position statements from all sub-specialties in gynecology and obstetrics.
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