title: Perinatal outcomes in women with preeclampsia and superimposed preeclampsia: do they differ?
abstract: OBJECTIVE
  The purpose of this study was to determine whether superimposed preeclampsia results in worse perinatal outcomes than preeclampsia.
  
  
  METHODS
  We conducted a retrospective cohort study using our perinatal database (1990-2008). Perinatal outcomes among women with chronic hypertension (n = 1032), superimposed preeclampsia (n = 489), and preeclampsia (n = 4217) were compared with outcomes of control subjects (n = 57,103). Outcomes among women with superimposed preeclampsia were also compared with outcomes of women with preeclampsia. Multivariable analysis was used to control for confounders.
  
  
  RESULTS
  Rates of small-for-gestational age, abruption, stillbirth, and eclampsia were not significantly different with superimposed preeclampsia compared with preeclampsia. Delivery at <34 weeks' gestation (17.3% vs 8.7%; P < .001), cesarean delivery (46.2% vs 36.3%; P < .001), and neonatal intensive care unit admission (16.3% vs 11.4%; P < .002) were significantly higher among women with superimposed preeclampsia. These risks persisted after we controlled for confounders.
  
  
  CONCLUSIONS
  Women with superimposed preeclampsia have higher risks of intervention-related events compared with those with preeclampsia.
authors.affiliation: Division of Maternal-Fetal Medicine and Ultrasound, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: Methodius G
authors.initials: MG
authors.lastname: Tuuli
authors.forename: Roxane
authors.initials: R
authors.lastname: Rampersad
authors.forename: David
authors.initials: D
authors.lastname: Stamilio
authors.forename: George
authors.initials: G
authors.lastname: Macones
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Odibo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D011225:Pre-Eclampsia; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D012189:Retrospective Studies