title: Recurrent pre-eclampsia in women with metabolic syndrome and low plasma volume: a retrospective cohort study.
abstract: OBJECTIVE
  To determine the prevalence of recurrent pre-eclampsia in women with a history of pre-eclampsia with both metabolic syndrome and low plasma volume postpartum, as compared with women without either entity.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Three tertiary referral hospitals in the Netherlands.
  
  
  METHODS
  Women with a history of pre-eclampsia.
  
  
  METHODS
  In 196 women with a history of pre-eclampsia we determined the presence or absence of metabolic syndrome using the World Health Organization criteria and measured plasma volume with the (125) I-human serum albumin indicator dilution technique. We compared the prevalence of recurrent pre-eclampsia in four groups, classified according to presence or absence of metabolic syndrome and low or normal plasma volume, calculating odds ratios (OR), adjusted for confounders.
  
  
  METHODS
  Recurrence of pre-eclampsia in the subsequent pregnancy.
  
  
  RESULTS
  The prevalence of recurrent pre-eclampsia was 12% (12/99) in women without metabolic syndrome with normal plasma volume, versus 47% (8/17) in women with both metabolic syndrome and low plasma volume: OR 6.44 (95% CI 2.09-19.90), adjusted OR 7.90 (95% CI 2.30-27.16). Recurrent pre-eclampsia was present in 44% (10/23) and 25% (14/57) of women with isolated metabolic syndrome and low plasma volume, respectively.
  
  
  CONCLUSIONS
  In the concomitant presence of metabolic syndrome and low plasma volume, the prevalence of recurrent pre-eclampsia was nearly 50%, which is four times as high as the prevalence in women without either entity.
  
  
  CONCLUSIONS
  Metabolic syndrome and low plasma volume raise the risk of recurrent pre-eclampsia to nearly 50%.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Stekkinger
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.
authors.forename: R R
authors.initials: RR
authors.lastname: Scholten
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Centre, Nijmegen, the Netherlands.
authors.forename: W M
authors.initials: WM
authors.lastname: Heidema
authors.affiliation: Research School GROW, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: M E A
authors.initials: ME
authors.lastname: Spaanderman
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D010953:Plasma Volume / Q000502:physiology*; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Metabolic syndrome; plasma volume; pre-eclampsia; recurrence