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Clinical Trial
. 2011 Apr;204(4):345.e1-6.
doi: 10.1016/j.ajog.2010.11.027. Epub 2011 Feb 26.

The impact of prior preeclampsia on the risk of superimposed preeclampsia and other adverse pregnancy outcomes in patients with chronic hypertension

Baha M Sibai  1 , Matthew A Koch, Salvio Freire, Joao Luiz Pinto e Silva, Marilza Vieira Cunha Rudge, Sérgio Martins-Costa, Janet Moore, Cleide de Barros Santos, Jose Guilherme Cecatti, Roberto Costa, José Geraldo Ramos, Nancy Moss, Joseph A Spinnato 2nd
Affiliations
Clinical Trial

The impact of prior preeclampsia on the risk of superimposed preeclampsia and other adverse pregnancy outcomes in patients with chronic hypertension

Baha M Sibai et al. Am J Obstet Gynecol. 2011 Apr.

Abstract

Objective: We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia.

Study design: We conducted secondary analysis of 369 women with chronic hypertension (104 with prior preeclampsia) enrolled at 12-19 weeks as part of a multisite trial of antioxidants to prevent preeclampsia (no reduction was found). Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes.

Results: Prepregnancy body mass index, blood pressure, and smoking status at enrollment were similar between groups. The rates of superimposed preeclampsia (17.3% vs 17.7%), abruptio placentae (1.0% vs 3.1%), perinatal death (6.7% vs 8.7%), and small for gestational age (18.4% vs 14.3%) were similar between groups, but preterm delivery <37 weeks was higher in the prior preeclampsia group (36.9% vs 27.1%; adjusted risk ratio, 1.46; 95% confidence interval, 1.05-2.03; P = .032).

Conclusion: In women with chronic hypertension, a history of preeclampsia does not increase the rate of superimposed preeclampsia, but is associated with an increased rate of delivery at <37 weeks.

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