Predictors of pre-eclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units.
OBJECTIVE
We assessed several variables as predictors for pre-eclampsia risk in a group of women at high risk.


METHODS
We studied 2503 women with either diabetes mellitus, chronic hypertension, multifetal gestation, or pre-eclampsia in a previous pregnancy who participated in a multicenter study comparing aspirin and placebo in preventing pre-eclampsia. We evaluated multiple variables for predicting pre-eclampsia risk with use of univariate and multivariable analysis.


RESULTS
Parity and mean arterial pressure at randomization were most predictive of pre-eclampsia risk. The risk was 8% with a mean arterial pressure at enrollment of <75 mm Hg versus 27% with a mean arterial pressure >85 mm Hg (relative risk and 95% confidence interval 3.3 [2.4 to 4.4]). The risk of pre-eclampsia was 26% in nulliparous patients versus 17% in parous subjects (relative risk and 95% confidence interval 1.5 [1.3-1.8]).


CONCLUSIONS
The finding that second-trimester mean arterial pressure affects pre-eclampsia risk suggests that the pathophysiologic process of preeclampsia is initiated before that time.
Caritis
S
S
National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units, Bethesda, Maryland, USA.
Sibai
B
B
Hauth
J
J
Lindheimer
M
M
VanDorsten
P
P
Klebanoff
M
M
Thom
E
E
Landon
M
M
Paul
R
R
Miodovnik
M
M
Meis
P
P
Thurnau
G
G
Dombrowski
M
M
McNellis
D
D
Roberts
J
J
D000328:Adult; D001241:Aspirin / Q000627:therapeutic use; D001794:Blood Pressure; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications; D010298:Parity; D010919:Placebos; D011225:Pre-Eclampsia / Q000209:etiology* / Q000517:prevention & control; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications; D011272:Pregnancy, Multiple; D012307:Risk Factors
D010919:Placebos; D001241:Aspirin