title: Prevalence of hypertensive disorders in women after preeclamptic pregnancy associated with decidual vasculopathy.
abstract: OBJECTIVE
  A subgroup of preeclamptic women has spiral artery lesions termed decidual vasculopathy (DV) which relate to worse clinical outcome. We aimed to determine whether a history of preeclampsia (PE) with DV is associated with adverse overall and future pregnancy outcome, including increased recurrence risk of hypertensive diseases of pregnancy.
  
  
  METHODS
  Via posted survey women with PE and DV (DV positive) in the index pregnancy were compared to those without the lesions (DV negative) on overall and future pregnancy outcome.
  
  
  RESULTS
  DV positive cases showed a higher incidence of chronic hypertension both preconceptionally and at time of survey, adjusted odds ratio 4.8 (2.0-11.9). The DV positive group had a higher overall incidence of pregnancies with gestational hypertension (22% vs 13%, p = 0.04), preterm birth (59% vs 45%, p = 0.02) and a lower birth weight centile (30 vs 39, p = 0.02). There was no difference in outcome of future pregnancies, irrespective of the use of prophylactic aspirin.
  
  
  CONCLUSIONS
  Women with DV-associated PE have a higher overall incidence of adverse obstetric outcome and of chronic hypertension, indicating an underlying vascular pathology, putting them at risk for pregnancy and cardiovascular complications. These women constitute a target group for counseling, monitoring and possibly lifestyle or pharmacological interventions.
authors.affiliation: Department of Obstetrics & Gynecology .
authors.forename: D U
authors.initials: DU
authors.lastname: Stevens
authors.forename: M P
authors.initials: MP
authors.lastname: Smits
authors.forename: J
authors.initials: J
authors.lastname: Bulten
authors.forename: M E A
authors.initials: ME
authors.lastname: Spaanderman
authors.forename: J M G
authors.initials: JM
authors.lastname: van Vugt
authors.forename: S
authors.initials: S
authors.lastname: Al-Nasiry
mesh_terms: D000328:Adult; D003656:Decidua / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000473:pathology; D015994:Incidence; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000453:epidemiology* / Q000473:pathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012008:Recurrence
keywords: Acute atherosis; decidual vasculopathy; maternal morbidity and mortality; neonatal morbidity and mortality; preeclampsia.