Comparison of clinical and perinatal outcomes in early- and late-onset preeclampsia

Madazli, Rıza; Yüksel, Mehmet Aytaç; İmamoğlu, Metehan; Tüten, Abdullah; Öncül, Mahmut; Aydin, Burcu; Demirayak, Gökhan

doi:10.1007/s00404-014-3176-x

Cited by 75 publications

(70 citation statements)

References 19 publications

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“…It has been suggested that the pathogenesis of early‐onset preeclampsia differs from that of late‐onset preeclampsia; therefore, we examined preeclampsia subdivided into early‐onset (<34 weeks of gestation) and late‐onset (34 weeks of gestation or more) preeclampsia.…”

Section: Methodsmentioning

confidence: 99%

Seasonal variation in the hypertensive disorders of pregnancy in Denmark

Thomsen

Henriksen

Uldbjerg

et al. 2020

Acta Obstet Gynecol Scand

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Abbreviations: BMI, body mass index; IVF, in vitro fertilization; OR, odds ratio; S-25OHD, serum 25-hydroxyvitamin D. AbstractIntroduction: Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia, are leading causes of morbidity and mortality for both mother and fetus. It has been proposed that vitamin D affects a number of biological processes involved in the pathogenesis of hypertensive disorders of pregnancy.Therefore, a seasonal variation in the risk of these disorders might be expected in areas such as Denmark with marked seasonal variation in sunlight exposure. In this study, we aimed to evaluate the existence of this association. Material and methods:We used information from a cohort of 50 665 previously healthy, nulliparous women with singleton pregnancies. All women gave birth between 1989 and 2010 at Aarhus University Hospital, Denmark. Logistic regression analyses combined with the cubic spline method were used to estimate the seasonal variation for each outcome: gestational hypertension and preeclampsia, after adjusting for calendar time.Results: Of the 50 665 women included, 8.5% were diagnosed with a hypertensive disorder of pregnancy. The overall tendency was towards increasing risk when conceiving during spring and early summer, peaking midsummer, and subsequently decreasing steadily during late summer and fall to reach the nadir by winter. Seasonal variation was found for; gestational hypertension (P = .01); preeclampsia (P = .001) and early-onset preeclampsia (P = .014). Conclusions:We found a seasonal variation in the risk of the hypertensive disorders of pregnancy in a large cohort of Danish nulliparous women. The highest risk was seen in women with the estimated date of conception in June and August, that is, during summer. Seasonal variation in vitamin D status may explain this association. K E Y W O R D Searly-onset preeclampsia, gestational hypertension, hypertensive disorders of pregnancy, preeclampsia, seasons, vitamin D

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Section: Methodsmentioning

confidence: 99%

Seasonal variation in the hypertensive disorders of pregnancy in Denmark

Thomsen

Henriksen

Uldbjerg

et al. 2020

Acta Obstet Gynecol Scand

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“…Early‐onset preeclampsia confers a high risk of life‐threatening maternal complications and often has severe maternal/fetal consequences, and early delivery is the only treatment. Late‐onset preeclampsia often has a mild clinical presentation, resulting mainly in maternal consequences …”

Section: Introductionmentioning

confidence: 99%

Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases

Zhang

Lin

et al. 2018

J of Clinical Hypertension

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Preeclampsia is a major cause of adverse maternal and perinatal outcomes, but how to identify women and fetuses at increased risk for later adverse events is a challenge. This study aimed to investigate the risk factors for adverse maternal and perinatal outcomes in women with preeclampsia. Data from 1396 women with preeclampsia were retrospectively collected and analyzed. Eighteen candidate risk factors and 12 adverse outcomes were investigated. The following factors were found to be significantly associated with at least one adverse outcome: maternal age 35 years or older, multiple birth, the usage of assisted reproductive technology, living in a rural area, history of pregnancy‐induced hypertension, male fetus, multigravida, or having polycystic ovary syndrome, hemolysis, elevated liver enzymes, and low platelet count syndrome, intrahepatic cholestasis of pregnancy, cardiovascular disease, gestational diabetes mellitus, systemic lupus erythematosus, thyroid disease, or liver disease. Compared with patients without any identified risk factors, patients with preeclampsia with three or more risk factors were at increased risk for severe adverse outcomes. Those findings demonstrated that maternal risk factors could be used as indicators supplementary to clinical symptoms and laboratory test results for the risk assessment in women with preeclampsia.

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“…Light GHp can be asymptomatic or mild dizziness, slightly elevated blood pressure, accompanied by edema or mild proteinuria, severe GHp may cause important organs injury, occur PE or eclampsia. PE and eclampsia are the main cause of adverse maternal and perinatal outcomes, such as intrauterine growth restriction and preterm birth [19,20]. The study by Schokker SA et al [21] showed previous hypertensive disorders of pregnancy was an independent risk factor for later vascular morbidity.…”

Section: Discussionmentioning

confidence: 99%

Effects of blood pressure level management on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension

Wang

Xiong

et al. 2020

Ginekol Pol

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Objectives:This study aims to investigate the effects of blood pressure control level on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension (GHp). Material and methods:A total of 344 pregnant women who initially diagnosed as mild to moderate gestational hypertension were recruited in this study. They were divided into 4 groups according to the stabilized blood pressure level (BPL) during pregnancy. The clinical parameters and the incidence of adverse pregnancy outcomes were compared among the four groups. The association between blood pressure levels and relative factors were analyzed using the χ 2 test. Multivariate logistic regression analysis was adopted for risk factors associated with adverse pregnancy outcomes. Results:The results showed the prevalence of obesity was significantly associated with blood pressure levels of mild-moderate GHp pregnant women (p = 0.029). The incidence of severe GHp, SPE in group A, group B, and group C were statistically significant (p < 0.001, p = 0.041, respectively). In the patients who used drugs to control BPL, the incidence of severe GHp has a significant association with the initial blood pressure levels (p = 0.004). However, no significant difference was found in the incidence of sPE, PE + Upro, and SGA (all p > 0.05). Multivariate logistic regression analyses results showed that the gestational factor BPL was an independent risk factor for the incidence of sGHp. The AMA, primigravida, gestational BPL, and edema were risk factors for the incidence of preeclampsia with proteinuria. To the incidence of sPE, gestational BPL is the independent risk factor. Finally, preeclampsia anamnesis and FGR trend are the high-risk parameters to the incidence of SGA. Conclusions:Timely management and control of blood pressure in pregnant women with mild to moderate GHp were beneficial to reduce the occurrence of severe GHp and sPE, but the incidence of SGA does not affected.

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Comparison of clinical and perinatal outcomes in early- and late-onset preeclampsia

Abstract: EO-PE, especially with abnormal UtA Doppler findings defines a placentation abnormality with higher perinatal adverse outcomes.

Cited by 75 publications

References 19 publications

Seasonal variation in the hypertensive disorders of pregnancy in Denmark

Seasonal variation in the hypertensive disorders of pregnancy in Denmark

Risk factors for adverse maternal and perinatal outcomes in women with preeclampsia: analysis of 1396 cases

Effects of blood pressure level management on maternal and perinatal outcomes in pregnant women with mild to moderate gestational hypertension

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