title: Formerly eclamptic women have lower nonpregnant blood pressure compared with formerly pre-eclamptic women: a retrospective cohort study.
abstract: OBJECTIVE
  To compare nonpregnant blood pressure and circulating metabolic factors between formerly pre-eclamptic women who did and did not deteriorate to eclampsia.
  
  
  METHODS
  Retrospective observational cohort study.
  
  
  METHODS
  Tertiary referral centre.
  
  
  METHODS
  Formerly pre-eclamptic women with (n = 88) and without (n = 698) superimposed eclampsia.
  
  
  METHODS
  Women who experienced pre-eclampsia with or without superimposed eclampsia during their pregnancy or puerperium were tested for possible underlying cardiovascular risk factors at least 6 months postpartum. We measured blood pressure and determined cardiovascular and metabolic risk markers in a fasting blood sample. Groups were compared using Mann-Whitney U test, Spearman's Rho test or Fisher's Exact test (odds ratios).
  
  
  METHODS
  Differences in postpartum blood pressures and features of the metabolic syndrome between formerly pre-eclamptic and formerly eclamptic women.
  
  
  RESULTS
  Formerly pre-eclamptic women who developed eclampsia differed from their counterparts without eclampsia by a lower blood pressure (P < 0.01) with blood pressure correlating inversely with the likelihood of having experienced eclampsia (P < 0.001). In addition, formerly eclamptic women had higher circulating C-reactive protein levels than formerly pre-eclamptic women (P < 0.05). All other circulating metabolic factors were comparable. Finally, 40% of all eclamptic cases occurred in the puerperium.
  
  
  CONCLUSIONS
  Formerly pre-eclamptic women with superimposed eclampsia have lower nonpregnant blood pressure compared with their counterparts without neurological sequelae with blood pressure negatively correlated to the occurrence of eclampsia. As about 40% of all eclamptic cases occur postpartum, routine blood pressure monitoring postpartum should be intensified.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht, the Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: Schreurs
authors.affiliation: Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Vermont, Burlington, VT, USA.|Department of Neurological Sciences, University of Vermont, Burlington, VT, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Cipolla
authors.affiliation: Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht, the Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Al-Nasiry
authors.affiliation: Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht, the Netherlands.
authors.forename: L L H
authors.initials: LL
authors.lastname: Peeters
authors.affiliation: Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht, the Netherlands.
authors.forename: M E A
authors.initials: ME
authors.lastname: Spaanderman
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D004461:Eclampsia; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology*; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology; D049590:Postpartum Period / Q000502:physiology*; D011225:Pre-Eclampsia; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Blood pressure; eclampsia; pre-eclampsia