Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies.
OBJECTIVE
To determine the risk of pre-eclampsia associated with factors that may be present at antenatal booking.


METHODS
Systematic review of controlled studies published 1966-2002.


RESULTS
Unadjusted relative risks were calculated from published data.


RESULTS
Controlled cohort studies showed that the risk of pre-eclampsia is increased in women with a previous history of pre-eclampsia (relative risk 7.19, 95% confidence interval 5.85 to 8.83) and in those with antiphospholipids antibodies (9.72, 4.34 to 21.75), pre-existing diabetes (3.56, 2.54 to 4.99), multiple (twin) pregnancy (2.93, 2.04 to 4.21), nulliparity (2.91, 1.28 to 6.61), family history (2.90, 1.70 to 4.93), raised blood pressure (diastolic > or = 80 mm Hg) at booking (1.38, 1.01 to 1.87), raised body mass index before pregnancy (2.47, 1.66 to 3.67) or at booking (1.55, 1.28 to 1.88), or maternal age > or = 40 (1.96, 1.34 to 2.87, for multiparous women). Individual studies show that risk is also increased with an interval of 10 years or more since a previous pregnancy, autoimmune disease, renal disease, and chronic hypertension.


CONCLUSIONS
These factors and the underlying evidence base can be used to assess risk at booking so that a suitable surveillance routine to detect pre-eclampsia can be planned for the rest of the pregnancy.
Duckitt
Kirsten
K
Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford OX3 9DU. Kduckitt@doctors.org.uk
Harrington
Deborah
D
D000367:Age Factors; D016736:Antiphospholipid Syndrome / Q000150:complications; D001327:Autoimmune Diseases / Q000150:complications; D001721:Birth Intervals; D001794:Blood Pressure; D015992:Body Mass Index; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D007674:Kidney Diseases / Q000150:complications; D010298:Parity; D010375:Pedigree; D011225:Pre-Eclampsia / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000150:complications; D011272:Pregnancy, Multiple; D011295:Prenatal Care
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