Prediction of maternal and fetal complications in preeclampsia.
BACKGROUND
Preeclampsia is associated with an increased risk for maternal and fetal morbidity. The aim of this study was to identify factors predicting for maternal or fetal complications.


METHODS
One hundred and eleven patients with preeclampsia were included. Endpoint variables were maternal and fetal complications. Any of the diagnosis eclampsia, hemolysis elevated liver low platelet (HELLP) syndrome, oliguria or placental abruption was considered a maternal complication. Fetal complications were: small for gestational age (SGA) infant, umbilical artery pH<7.10 and admittance of the infant to a neonatal intensive care unit (NICU). Independent variables were maternal age, parity, gestational age, renal function, platelet count, liver enzymes and blood pressure. Logistic regression analysis was used for statistical evaluation.


RESULTS
The following independent significant predictors were identified: Maternal complication (n=10) was predicted only by diastolic blood pressure; odds ratio (OR) 1.13 (95% confidence interval 1.01-1.25). SGA (n=21) was associated with maternal prepregnancy weight, OR 0.94 (0.89-0.99) and gestational age at debut of preeclampsia, OR 0.97 (0.94-0.99). NICU admittance (n=31) was only predicted by gestational age at delivery, OR 0.80 (0.67-0.96). No association was found between any of the independent variables and a low umbilical artery pH (n= 10).


CONCLUSIONS
In the surveillance of patients with established preeclampsia, the value of serial blood and urine sampling, which is common practice in many obstetrical units, might be questioned.
Nisell
H
H
Department of Obstetrics and Gynecology, Huddinge University Hospital, Karolinska Institute, Sweden.
Palm
K
K
Wolff
K
K
D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D005260:Female; D005315:Fetal Diseases / Q000209:etiology*; D005316:Fetal Distress / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology; D017359:HELLP Syndrome / Q000209:etiology; D006801:Humans; D007362:Intensive Care Units; D009846:Oliguria / Q000209:etiology; D011225:Pre-Eclampsia / Q000150:complications* / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors