Population-based trends and risk factors of early- and late-onset preeclampsia in Taiwan 2001–2014

Abstract

BackgroundPreeclampsia, a multisystem disorder in pregnancies complicates with maternal and fetal morbidity. Early- and late-onset preeclampsia, defined as preeclampsia developed before and after 34 weeks of gestation, respectively. The early-onset disease was less prevalent but associated with poorer outcomes. Moreover, the risk factors between early -and late- onset preeclampsia could be differed owing to the varied pathophysiology. In the study, we evaluated the incidences, trends, and risk factors of early- and late- onset preeclampsia in Taiwan.MethodsThis retrospective population-based cohort study included all ≧20 weeks singleton pregnancies resulting in live-born babies or stillbirths in Taiwan between January 1, 2001 and December 31, 2014 (n = 2,884,347). The data was collected electronically in Taiwanese Birth Register and National Health Insurance Research Database. The incidences and trends of early- and late-onset preeclampsia were assessed through Joinpoint analysis. Multivariate logistic regression was used to analyze the risk factors of both diseases.ResultsThe age-adjusted overall preeclampsia rate was slightly increased from 1.1%(95%confidence interval [CI], 1.1–1.2) in 2001 to 1.3% (95%CI, 1.2–1.3) in 2012 with average annual percentage change (AAPC) 0.1%/year (95%CI, 0–0.2%). However, the incidence was remarkably increased from 1.3% (95%CI, 1.3–1.4) in 2012 to 1.7% (95%CI, 1.6–1.8) in 2014 with AAPC 1.3%/year (95%CI,0.3–2.5). Over the study period, the incidence trend in late-onset preeclampsia was steadily increasing from 0.7% (95%CI, 0.6–0.7) in 2001 to 0.9% (95%CI, 0.8–0.9) in 2014 with AAPC 0.2%/year (95%CI, 0.2–0.3) but in early-onset preeclampsia was predominantly increase from 0.5% (95%CI, 0.4–0.5) in 2012 to 0.8% (95%CI, 0.8–0.9) in 2014 with AAPC 2.3%/year (95%CI, 0.8–4.0). Advanced maternal age, primiparity, stroke, diabetes mellitus, chronic hypertension, and hyperthyroidism were risk factors of preeclampsia. Comparing early- and late-onset diseases, chronic hypertension (ratio of relative risk [RRR], 1.71; 95%CI, 1.55–1.88) and older age (RRR, 1.41; 95%CI 1.29–1.54) were more strongly associated with early-onset disease, whereas primiparity (RRR 0.71, 95%CI, 0.68–0.75) had stronger association with late-onset preeclampsia.ConclusionsThe incidences of overall, and early- and late-onset preeclampsia were increasing in Taiwan from 2001 to 2014, predominantly for early-onset disease. Pregnant women with older age and chronic hypertension had significantly higher risk of early-onset preeclampsia.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1845-7) contains supplementary material, which is available to authorized users.

Clinical presentation and outcomes of pre-eclampsia and eclampsia at a national hospital, Kenya: A retrospective cohort study

“…Obstetric risk factors such as prior experience of pre-eclampsia, eclampsia and chronic hypertension may elevate a woman's risk for EO-PE. Similar to other studies [23][24][25], Our findings show that while more women who experience LO-PE had gestational diabetes and a family history of hypertension, women with EO-PE had higher rates of chronic hypertension. Severe pre-eclampsia, high sBP (>180), and high creatinine levels were all associated with EO-PE as reported elsewhere [26,27].…”

Retrospective cohort study: Clinical presentation and outcomes of pre-eclampsia and eclampsia at Kenyatta National Hospital, Nairobi, Kenya

“…Severe pre-eclampsia, high sBP (>180), and high creatinine levels were all associated with EO-PE. Almost half of EO-PE women had sBP over 180mmHg, while just over one third of LO-PE women had similar blood pressure rates, and the majority in both groups experienced severe pre-eclampsia-but more often among EO-PE women, similar to other studies [34][35][36][37] . There was no significant difference between the two cohorts of women (EO-PE versus LO-PE) for severity of pre-eclampsia in our study.…”

Hyperthyroidism as a Potential Risk Factor for Placental Abruption: A Case Control Study

“…Previous reports on population-based and case-control studies demonstrated hyperthyroidism to be associated with a high risk of preeclampsia [5][6][7][8] and placental abruption [9]. The impact of interventions for hyperthyroidism before and during pregnancy on pregnancy outcomes remains uncertain [10].…”