title: Maternal morbidity associated with early-onset and late-onset preeclampsia.
abstract: OBJECTIVE
  To examine temporal trends in early-onset compared with late-onset preeclampsia and associated severe maternal morbidity.
  
  
  METHODS
  The study included all singleton deliveries in Washington State between 2000 and 2008 (N=670,120). Preeclampsia onset was determined using hospital records linked to birth certificates. Severe maternal morbidity was defined as any potentially life-threatening condition. Logistic regression was used to obtain adjusted odds ratios (aOR) and 95% confidence intervals (95% CI).
  
  
  RESULTS
  The preeclampsia rate was 3.0 per 100 singleton births, and increased slightly from 2.9 to 3.1 between 2000 and 2008. Rates of early-onset and late-onset disease were 0.3% and 2.7%, respectively. The temporal increase was significant only for early-onset disease (4.5%/year; 95% CI 2.3-5.8%) after adjustment for changes in maternal characteristics. Maternal death rates were higher among women with early-onset (42.1/100,000 deliveries) and late-onset preeclampsia (11.2/100,000) compared with women without preeclampsia (4.2/100,000). The rate of severe maternal morbidity (excluding obstetric trauma) was 12.2 per 100 deliveries in the early-onset group (aOR 3.7, 95% CI 3.2-4.3), 5.5 per 100 deliveries in the late-onset group (aOR 1.7, 95% CI 1.6-1.9), and approximately 3 per 100 in women without preeclampsia. Early-onset preeclampsia conferred a substantially higher risk of cardiovascular, respiratory, central nervous system, renal, hepatic, and other morbidity. However, rates of obstetric trauma were significantly lower among women with preeclampsia.
  
  
  CONCLUSIONS
  Women with early-onset and late-onset preeclampsia have significantly higher rates of specific maternal morbidity compared with women without early-onset and late-onset disease.
  
  
  METHODS
  : II.
authors.affiliation: Department of Obstetrics and Gynaecology and the School of Population and Public Health, University of British Columbia, and the Children's & Women's Hospital and Health Centre of British Columbia, Vancouver, British Columbia, and the Department of Obstetrics & Gynaecology, University of Alberta, Edmonton, Alberta, Canada; and the Department of Obstetrics and Gynaecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Sarka
authors.initials: S
authors.lastname: Lisonkova
authors.forename: Yasser
authors.initials: Y
authors.lastname: Sabr
authors.forename: Chantal
authors.initials: C
authors.lastname: Mayer
authors.forename: Carmen
authors.initials: C
authors.lastname: Young
authors.forename: Amanda
authors.initials: A
authors.lastname: Skoll
authors.forename: K S
authors.initials: KS
authors.lastname: Joseph
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D036861:Delivery, Obstetric / Q000379:methods / Q000401:mortality; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D008428:Maternal Mortality / Q000639:trends*; D016017:Odds Ratio; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011247:Pregnancy; D047928:Premature Birth; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D014861:Washington / Q000453:epidemiology; D055815:Young Adult