title: Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas.
abstract: OBJECTIVE
  To compare the rates and perinatal outcome in women who experienced preeclampsia in a previous pregnancy to those in women who developed preeclampsia as nulliparas.
  
  
  METHODS
  This is a secondary analysis of data from 2 separate multi-center trials of aspirin for prevention of preeclampsia. Women who had preeclampsia in a previous pregnancy (n = 598) were compared with nulliparous women (n = 2934). Outcome variables were rates of preeclampsia, preterm delivery at <37 and <35 weeks of gestation, small-for-gestational-age infant, abruptio placentae, and perinatal death. Data were compared by using chi-square analysis and Wilcoxon rank sum test.
  
  
  RESULTS
  The rates of preeclampsia and of severe preeclampsia were significantly higher in the previous preeclamptic group as compared to the nulliparous group (17.9% vs 5.3%, P <.0001, and 7.5% vs. 2.4%, P <.0001, respectively). Women who had recurrent preeclampsia experienced more preterm deliveries before 37 and 35 weeks of gestation than nulliparous women who developed preeclampsia. In addition, among women who developed severe preeclampsia, those with recurrent preeclampsia had higher rates of preterm delivery both before 37 weeks (67% vs 33%, P =.0004) and before 35 weeks of gestation (36% vs 19%, P =.041), and higher rates of abruptio placentae (6.7% vs 1.5%) and fetal death (6.7% vs 1.4%) than did nulliparous women.
  
  
  CONCLUSIONS
  Compared to nulliparous women, women with preeclampsia in a previous pregnancy had significantly higher rates of preeclampsia and adverse perinatal outcomes associated with preterm delivery as a result of preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, University of Cincinnati, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hnat
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
authors.forename: Steve
authors.initials: S
authors.lastname: Caritis
authors.forename: John
authors.initials: J
authors.lastname: Hauth
authors.forename: Marshall D
authors.initials: MD
authors.lastname: Lindheimer
authors.forename: Cora
authors.initials: C
authors.lastname: MacPherson
authors.forename: J Peter
authors.initials: JP
authors.lastname: VanDorsten
authors.forename: Mark
authors.initials: M
authors.lastname: Landon
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Richard
authors.initials: R
authors.lastname: Paul
authors.forename: Paul
authors.initials: P
authors.lastname: Meis
authors.forename: Gary
authors.initials: G
authors.lastname: Thurnau
authors.forename: Mitchell
authors.initials: M
authors.lastname: Dombrowski
mesh_terms: D000037:Abruptio Placentae / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008499:Medical Records; D015337:Multicenter Studies as Topic; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology*; D010298:Parity; D011225:Pre-Eclampsia / Q000150:complications* / Q000453:epidemiology; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic