title: Prediction of recurrence of hypertensive disorders of pregnancy in the term period, a retrospective cohort study.
abstract: OBJECTIVE
  To assess the recurrence risk of term hypertensive disease of pregnancy and to determine which potential risk factors are predictive of recurrence.
  
  
  METHODS
  We performed a retrospective cohort study in two secondary and one tertiary care hospitals in the Netherlands. We identified women with a hypertensive disorder in the index pregnancy and delivery after 37weeks of gestation between January 2000 and December 2002. Data were extracted from medical files and women were approached for additional information on subsequent pregnancies. Adverse outcome was defined as recurrence of a hypertensive disorder in the next subsequent pregnancy.
  
  
  METHODS
  The absolute risk of recurrence and a prediction model containing demographic and clinical factors predictive of recurrence.
  
  
  RESULTS
  We identified 638 women for potential inclusion, of whom 503 could be contacted. Of these women, 312 (62%) had a subsequent pregnancy. Hypertensive disorders recurred in 120 (38%, 95% CI 33-44) women, of whom 15 (5%, 95% CI 3-7) delivered preterm. Women undergoing recurrence were more at risk to develop chronic hypertension after pregnancy (35% versus 16%, OR 2.8, 95% CI 1.5-5.3). Body mass index, non-White European origin, chronic hypertension, maximum diastolic blood pressure, no use of anticonvulsive medication and interpregnancy interval were predictors for recurrence.
  
  
  CONCLUSIONS
  Women with hypertensive disorders and term delivery have a substantial chance of recurrence, but a small risk of preterm delivery. A number of predictors for recurrence could be identified and women with a recurrence more often developed chronic hypertension.
authors.affiliation: Department of Obstetrics and Gynecology, Erasmus Medisch Centrum, Rotterdam, The Netherlands; Department of Obstetrics and Gynecology, Amphia Ziekenhuis, Breda, The Netherlands. Electronic address: miriamvanoostwaard@gmail.com.
authors.forename: Miriam F
authors.initials: MF
authors.lastname: Van Oostwaard
authors.affiliation: Department of Obstetrics and Gynecology, Atrium Medisch Centrum, Heerlen, The Netherlands.
authors.forename: Josje
authors.initials: J
authors.lastname: Langenveld
authors.affiliation: Julius Centre for Health Sciences and Primary Care, Universitair Medisch Centrum, Utrecht, The Netherlands; Department of Obstetrics and Gynecology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
authors.forename: Ewoud
authors.initials: E
authors.lastname: Schuit
authors.affiliation: Department of Obstetrics and Gynecology, Amphia Ziekenhuis, Breda, The Netherlands.
authors.forename: Kiki
authors.initials: K
authors.lastname: Wigny
authors.affiliation: Department of Obstetrics and Gynecology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
authors.forename: Hilde
authors.initials: H
authors.lastname: Van Susante
authors.affiliation: Department of Obstetrics and Gynecology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
authors.forename: Irene
authors.initials: I
authors.lastname: Beune
authors.affiliation: Department of Obstetrics and Gynecology, Atrium Medisch Centrum, Heerlen, The Netherlands.
authors.forename: Roos
authors.initials: R
authors.lastname: Ramaekers
authors.affiliation: Department of Obstetrics and Gynecology, Amphia Ziekenhuis, Breda, The Netherlands.
authors.forename: Dimitri N M
authors.initials: DN
authors.lastname: Papatsonis
authors.affiliation: The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia.
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Obstetrics and Gynecology, Academisch Medisch Centrum, Amsterdam, The Netherlands.
authors.forename: Wessel
authors.initials: W
authors.lastname: Ganzevoort
keywords: HELLP-syndrome; Hypertension; Preeclampsia; Pregnancy; Recurrence; SGA