title: The diagnosis of pre-eclampsia using two revised classifications in the Finnish Pre-eclampsia Consortium (FINNPEC) cohort.
abstract: The Finnish Pre-eclampsia Consortium (FINNPEC) case-control cohort consisting of 1447 pre-eclamptic and 1068 non-pre-eclamptic women was recruited during 2008-2011 to study genetic background of pre-eclampsia and foetal growth. Pre-eclampsia was defined by hypertension and proteinuria according to the American College of Obstetricians and Gynecologists (ACOG) 2002 classification. The ACOG Task Force Report on Hypertension in Pregnancy (2013) and The International Society for the Study of Hypertension in Pregnancy (ISSHP) (2014) have published new classifications, in which proteinuria is not necessary for diagnosis when specific symptoms are present. For diagnoses based on proteinuria, the ISSHP 2014 criteria raised its threshold to 2+ on dipstick. We studied how the new classifications would affect pre-eclampsia diagnoses in the FINNPEC cohort.
  
  
  
  We re-evaluated pre-eclampsia diagnosis using the ACOG 2013 and the ISSHP 2014 classifications in pre-eclamptic women whose proteinuria did not exceed 1+ on dipstick (n = 68), in women with gestational hypertension (n = 138) and in women with chronic hypertension (n = 66).
  
  
  
  The number of women with pre-eclampsia increased 0.8 % (1459/1447) according to the ACOG 2013 criteria and 0.6 % (1455/1447) according to the ISSHP 2014 criteria. All 68 women with the amount of proteinuria not exceeding 1+ on dipstick diagnosed originally pre-eclamptic met the ACOG 2013 criteria but only 20 women (29.4 %) met the ISSHP 2014 criteria. Seven (5.1 %) and 35 (25.4 %) women with gestational hypertension were diagnosed with pre-eclampsia according to the ACOG 2013 and the ISSHP 2014 criteria, respectively. Correspondingly five (7.6 %) and 21 (31.8 %) women with chronic hypertension were diagnosed with pre-eclampsia according to the ACOG 2 013 and the ISSHP 2014 criteria.
  
  
  
  Only minor changes were observed in the total number of pre-eclamptic women in the FINNPEC cohort when comparing the ACOC 2002 classification with the ACOG 2013 and ISSHP 2014 classifications.
authors: Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors: Jenni
authors: J
authors: Kallela
authors: Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors: Tiina
authors: T
authors: Jääskeläinen
authors: Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors: Eija
authors: E
authors: Kortelainen
authors: Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors: Seppo
authors: S
authors: Heinonen
authors: Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.|Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.|PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors: Eero
authors: E
authors: Kajantie
authors: Department of Biosciences and Nutrition, and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden.|Molecular Neurology Research Program, University of Helsinki, Helsinki, Finland.|Folkhälsan Institute of Genetics, Helsinki, Finland.
authors: Juha
authors: J
authors: Kere
authors: Division of Cardiovascular Medicine, University of Cambridge, Cambridge, UK.
authors: Katja
authors: K
authors: Kivinen
authors: PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.|Department of Government services, National Institute for Health and Welfare, Helsinki, Finland.
authors: Anneli
authors: A
authors: Pouta
authors: Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. hannele.laivuori@helsinki.fi.|Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. hannele.laivuori@helsinki.fi.|Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland. hannele.laivuori@helsinki.fi.
authors: Hannele
authors: 0000-0003-3212-7826
authors: H
authors: Laivuori
mesh_terms: D000328:Adult; D026683:Advisory Committees; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D005387:Finland; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000145:classification*; D011225:Pre-Eclampsia / Q000145:classification / Q000175:diagnosis*; D011247:Pregnancy; D011507:Proteinuria / Q000145:classification*; D012016:Reference Values; D063189:Symptom Assessment / Q000145:classification* / Q000379:methods
keywords: Classification; Criteria; Gestational hypertension; Pre-eclampsia; Proteinuria