title: The role of placental histopathological lesions in predicting recurrence of preeclampsia.
abstract: OBJECTIVE
  We aimed to study the role of placental pathology in the prediction of preeclampsia (PE) recurrence.
  
  
  METHODS
  The medical records and pathological placental reports of all women diagnosed with PE, during 2008-2015, were reviewed. The study population was divided according to the outcome of their subsequent pregnancy: those who did (recurrence group) or did not (no-recurrence group) develop recurrent PE. Data regarding maternal characteristics and placental maternal/fetal vascular malperfusion lesions, of the initial pregnancies, were compared. Two prediction models were generated for PE recurrence.
  
  
  RESULTS
  Compared to the no-recurrence group (n = 130), the recurrence group (n = 96) was characterized by lower gestational age (p < 0.001), longer inter-pregnancy interval (p = 0.012), and higher rate of severe features (p < 0.001). By logistic regression analysis composite maternal (aOR = 3.05, 95%CI 1.39-6.71, p = 0.005), fetal (aOR = 9.31, 95%CI 3.9-22.1, p < 0.001), and concurrent maternal + fetal (aOR = 13.94, 95%CI 5.08-38.21, p < 0.001), vascular malperfusion lesions were found to be independently associated with recurrence. A clinical prediction model accounted for 20.8% of PE recurrence (R2= 0.208, AUC = 0.732), while a clinical-pathological model accounted for 34.2% of recurrence (R2= 0.342, AUC = 0.80).
  
  
  CONCLUSIONS
  Placental maternal and fetal vascular malperfusion lesions are independently associated with increased risk for PE recurrence. A clinical-pathological prediction model for recurrence of PE is superior to a prediction model based merely on clinical factors. © 2016 John Wiley & Sons, Ltd.
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. masolbarak@gmail.com.
authors: Eran
authors: E
authors: Weiner
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Yossi
authors: Y
authors: Mizrachi
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Ehud
authors: E
authors: Grinstein
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Ohad
authors: O
authors: Feldstein
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Noa
authors: N
authors: Rymer-Haskel
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Elchanan
authors: E
authors: Juravel
authors: Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Letizia
authors: L
authors: Schreiber
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Jacob
authors: J
authors: Bar
authors: Departments of Obstetrics and Gynecology and Pathology, the Edith Wolfson Medical Center, Holon, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Michal
authors: M
authors: Kovo
mesh_terms: D000328:Adult; D001721:Birth Intervals; D002821:Chorioamnionitis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007249:Inflammation / Q000473:pathology; D016015:Logistic Models; D015999:Multivariate Analysis; D010920:Placenta / Q000473:pathology*; D010922:Placenta Diseases / Q000453:epidemiology / Q000473:pathology*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013927:Thrombosis / Q000453:epidemiology / Q000473:pathology*; D014652:Vascular Diseases / Q000453:epidemiology / Q000473:pathology*; D055815:Young Adult