title: The Pulmonary Edema Preeclampsia Evaluation (PEPE) Study.
abstract: BACKGROUND
  Women with preeclampsia may develop pulmonary edema, but the reasons for this are largely unknown.
  
  
  METHODS
  We performed a case-control study of women with preeclampsia at two major obstetrical centres in Toronto, ON, between 2005 and 2012. Cases (n = 28) were women with preeclampsia who had pulmonary edema on a chest CT or plain X-ray during the index delivery hospitalization. Control subjects (n = 64) were those with preeclampsia but no diagnosis of pulmonary edema or heart failure in the index hospitalization for delivery. Study variables were abstracted from each woman's paper chart and electronic medical record. Multivariable logistic regression with backward elimination was used to select a final set of significant predictors.
  
  
  RESULTS
  Approximately one half of the cases of pulmonary edema occurred antepartum. Each 10 × 10(9)/L reduction in platelet count (OR 1.32; 95% CI 1.06 to 1.65) or 10 µmol/ L increase in peak serum uric acid concentration (OR 1.19; 95% CI 1.06 to 1.34) was significantly associated with pulmonary edema, as was receiving magnesium sulphate (OR 10.42; 95% CI 1.39 to 78.22). Multiparity (OR 0.03; 95% CI 0.004 to 0.29) and each 500 mL increase in the volume of intravenous crystalloids received (OR 0.60; 95% CI 0.37 to 0.98) were associated with a lower risk of pulmonary edema.
  
  
  CONCLUSIONS
  We identified several preliminary risk factors for pulmonary edema in women with preeclampsia. Additional work is needed to better understand the role of these and other factors predicting the development of pulmonary edema in women with preeclampsia.
authors: Department of Medicine, Mt. Sinai Hospital, University of Toronto, Toronto ON; Obstetrical Medicine Program, University of Toronto, Toronto ON.
authors: Shital
authors: S
authors: Gandhi
authors: Department of Medicine, Western University, London ON.
authors: Dongmei
authors: D
authors: Sun
authors: Institute for Clinical Evaluative Sciences, Toronto ON.
authors: Alison L
authors: AL
authors: Park
authors: Department of Medicine, Mt. Sinai Hospital, University of Toronto, Toronto ON; Obstetrical Medicine Program, University of Toronto, Toronto ON.
authors: Michelle
authors: M
authors: Hladunewich
authors: Department of Medicine, Mt. Sinai Hospital, University of Toronto, Toronto ON; Obstetrical Medicine Program, University of Toronto, Toronto ON; Department of Medicine, Western University, London ON.
authors: Candice K
authors: CK
authors: Silversides
authors: Obstetrical Medicine Program, University of Toronto, Toronto ON; Institute for Clinical Evaluative Sciences, Toronto ON; Department of Medicine and Obstetrics and Gynaecology, St. Michael's Hospital, Toronto ON.
authors: Joel G
authors: JG
authors: Ray
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011225:Pre-Eclampsia; D011247:Pregnancy; D011654:Pulmonary Edema / Q000209:etiology*; D012307:Risk Factors
keywords: heart failure; hypertension; preeclampsia; pregnancy; pulmonary edema