Pre-eclampsia causes adverse maternal outcomes across the gestational spectrum |
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| Affiliation: | 1. Department of Renal Medicine, St George Hospital, Sydney, Australia;2. Department of Women’s Health, St George Hospital, Sydney, Australia;3. School of Women’s and Children’s Health, University of NSW, Australia;4. Department of Medicine, University of NSW, Australia;1. UNIFESO – Centro Universitário Serra dos Órgãos, Av. Alberto Torres 111-Alto, Teresópolis, RJ CEP 25964-004, Brazil;2. Curso de Pós-Graduação em Ciências Cardiovasculares – Universidade Federal Fluminense (UFF), HUAP, Rua Marques do Paraná 303-Centro, Niterói, RJ CEP 24033-900, Brazil;1. Department of Pharmacology, Institute of Biosciences, Universidade Estadual Paulista (UNESP), Botucatu/SP, Brazil;2. Department of Pharmacology, Faculty of Medicinal Sciences, University of Campinas, State University of Campinas, Campinas/SP, Brazil;3. Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto/SP, Brazil;4. Department of Pharmacology, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto/SP, Brazil;1. Department of Obstetrics and Gynecology, Tor Vergata University, Rome, Italy;2. Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy;3. Department of Cardiology, San Sebastiano Martire Hospital, Frascati, Rome, Italy;4. AFaR (Fatebenefratelli Association for Research), Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy;5. Department of Physiology, Tor Vergata University, Rome, Italy;1. Worldwide Epidemiology, GlaxoSmithKline, Gateway West, Singapore;2. Worldwide Epidemiology, GlaxoSmithKline, Stockley Park, United Kingdom;3. Department of Veterans Affairs, Durham VA Medical Center, North Carolina, USA |
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| Abstract: | ObjectiveTo determine if women with early onset pre-eclampsia (EOP) have worse maternal outcomes than those who present later. Specifically, we aimed to determine whether term preeclamptic women and their infants have better outcomes than either their late pre-term or early onset counterparts.Study designBetween 1991 and 2011, 4657 pregnancies complicated by hypertension were recorded in our database; 2148 (45%) had pre-eclampsia (PE). Six hundred ninety six cases (32%) that had accurate data for the gestation at which PE developed were analysed. Pre-eclampsia was defined as per the International Society for the Study of Hypertension in Pregnancy guidelines. Maternal outcomes included (1) episodes of severe hypertension, (2) proteinuria, (3) acute kidney injury, (4) abnormal liver function, (5) thrombocytopenia and (6) neurological complications. Perinatal outcomes were also analysed.ResultsEighty seven (13%) of 696 cases had EOP; 226 (32%) had late pre-term PE and 383 (55%) term PE. Maternal age was similar amongst the three groups. Women with late pre-term and term PE had similar rates of maternal and foetal outcomes. Compared with term PE, women with EOP had similar rates of adverse maternal outcomes, however their babies had significantly increased rates of morbidity and mortality.ConclusionPre-eclampsia causes significant maternal organ involvement regardless of gestation at onset. Outcomes for babies of women with EOP are significantly worse than for those who present later. Overall, women presenting with PE after 34 weeks have generally good maternal and foetal outcomes in a unit equipped to manage such cases. |
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| Keywords: | Pre-eclampsia Early onset Maternal outcomes |
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