title: Pre-eclampsia causes adverse maternal outcomes across the gestational spectrum.
abstract: OBJECTIVE
  To determine if women with early onset pre-eclampsia (EOP) have worse maternal outcomes than those who present later. Specifically, we aimed to determine whether term preeclamptic women and their infants have better outcomes than either their late pre-term or early onset counterparts.
  
  
  METHODS
  Between 1991 and 2011, 4657 pregnancies complicated by hypertension were recorded in our database; 2148 (45%) had pre-eclampsia (PE). Six hundred ninety six cases (32%) that had accurate data for the gestation at which PE developed were analysed. Pre-eclampsia was defined as per the International Society for the Study of Hypertension in Pregnancy guidelines. Maternal outcomes included (1) episodes of severe hypertension, (2) proteinuria, (3) acute kidney injury, (4) abnormal liver function, (5) thrombocytopenia and (6) neurological complications. Perinatal outcomes were also analysed.
  
  
  RESULTS
  Eighty seven (13%) of 696 cases had EOP; 226 (32%) had late pre-term PE and 383 (55%) term PE. Maternal age was similar amongst the three groups. Women with late pre-term and term PE had similar rates of maternal and foetal outcomes. Compared with term PE, women with EOP had similar rates of adverse maternal outcomes, however their babies had significantly increased rates of morbidity and mortality.
  
  
  CONCLUSIONS
  Pre-eclampsia causes significant maternal organ involvement regardless of gestation at onset. Outcomes for babies of women with EOP are significantly worse than for those who present later. Overall, women presenting with PE after 34 weeks have generally good maternal and foetal outcomes in a unit equipped to manage such cases.
authors.affiliation: Department of Renal Medicine, St George Hospital, Sydney, Australia; Department of Medicine, University of NSW, Australia. Electronic address: Franziska.pettit@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Pettit
authors.affiliation: Department of Renal Medicine, St George Hospital, Sydney, Australia; Department of Medicine, University of NSW, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Mangos
authors.affiliation: Department of Women's Health, St George Hospital, Sydney, Australia; School of Women's and Children's Health, University of NSW, Australia.
authors.forename: G
authors.initials: G
authors.lastname: Davis
authors.affiliation: Department of Women's Health, St George Hospital, Sydney, Australia; School of Women's and Children's Health, University of NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Henry
authors.affiliation: Department of Renal Medicine, St George Hospital, Sydney, Australia; Department of Medicine, University of NSW, Australia.
authors.forename: M A
authors.initials: MA
authors.lastname: Brown
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology / Q000628:therapy; D008423:Maternal Age; D009517:New South Wales; D010298:Parity; D011225:Pre-Eclampsia / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters / Q000502:physiology; D011446:Prospective Studies; D047929:Term Birth / Q000502:physiology
keywords: Early onset; Maternal outcomes; Pre-eclampsia