Perinatal outcome in women with recurrent preeclampsia compared with women who develop preeclampsia as nulliparas.
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.
Hnat
Michael D
MD
Department of Obstetrics and Gynecology, University of Cincinnati, USA.
Sibai
Baha M
BM
Caritis
Steve
S
Hauth
John
J
Lindheimer
Marshall D
MD
MacPherson
Cora
C
VanDorsten
J Peter
JP
Landon
Mark
M
Miodovnik
Menachem
M
Paul
Richard
R
Meis
Paul
P
Thurnau
Gary
G
Dombrowski
Mitchell
M
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