Superimposed versus de novo pre-eclampsia: Is there a difference?
labor complications
maternal characteristics
obstetrical complications
perinatal mortality
placental dysfunction
preterm delivery
small for gestational age
superimposed pre-eclampsia
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Nov 2022
Nov 2022
Historique:
received:
24
09
2021
accepted:
20
01
2022
pubmed:
23
1
2022
medline:
12
10
2022
entrez:
22
1
2022
Statut:
ppublish
Résumé
To investigate whether pre-eclampsia is a single clinical entity or whether de novo pre-eclampsia and superimposed pre-eclampsia are distinct entities, with respect to baseline maternal characteristics, obstetrical complications, and perinatal outcomes. A retrospective cohort study comparing singleton pregnancies complicated with de novo pre-eclampsia (n = 10 979, 93%) and superimposed pre-eclampsia (n = 804, 7%). Maternal baseline characteristics, pregnancy and labor complications, and neonatal outcomes were evaluated in the univariate analysis. Multivariable logistic regression models were performed for the prediction of different pregnancy outcomes while controlling for confounders. In the multivariate regression models controlling for confounders, superimposed pre-eclampsia was found to be a significant risk factor for placental dysfunction, a composite outcome composed of severe pre-eclampsia (rather than mild), placental abruption, oligohydramnios, and small-for-gestational-age neonate (odds ratio [OR] 2.23, 95% confidence interval [CI] 1.90-2.62, P < 0.001), preterm delivery (OR 2.79, 95% CI 2.39-3.26, P < 0.001), and perinatal mortality (OR 1.79, 95% CI 1.11-2.88, P = 0.02). De novo and superimposed pre-eclampsia demonstrated significant differences in most studied variables, suggesting that these may be two distinct clinical syndromes. In our population, superimposed pre-eclampsia was found to be significantly associated with adverse pregnancy outcomes such as placental dysfunction, preterm delivery, and perinatal mortality compared with de novo pre-eclampsia.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
392-397Informations de copyright
© 2022 International Federation of Gynecology and Obstetrics.
Références
Samuels-Kalow ME, Funai EF, Buhimschi C, et al. Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. Am J Obstet Gynecol. 2007;197(5):490.e1-490.e6. doi:10.1016/j.ajog.2007.04.043
Report of the National High Blood Pressure Education Program Working Group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):s1-s22. doi:10.1067/mob.2000.107928
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130-137. doi:10.1053/j.semperi.2009.02.010
Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376(9741):631-644. doi:10.1016/S0140-6736(10)60279-6
Roberts JM, August PA, Bakris G, Barton JR, et al. Hypertension in pregnancy. The American College of Obstetricians and Gynecologists, women’s health care physicians. 2013.
Redman CWG, Sargent IL. Pre-eclampsia, the placenta and the maternal systemic inflammatory response-a review. Placenta. 2003;24:S21-S27. doi:10.1053/plac.2002.0930
Gilbert JS, Ryan MJ, LaMarca BB, Sedeek M, Murphy SR, Granger JP. Pathophysiology of hypertension during preeclampsia: linking placental ischemia with endothelial dysfunction. Am J Physiol-Heart Circ Physiol. 2008;294(2):H541-H550. doi:10.1152/ajpheart.01113.2007
Rezk M, Gamal A, Emara M. Maternal and fetal outcome in de novo preeclampsia in comparison to superimposed preeclampsia: a two-year observational study. Hypertens Pregnancy. 2015;34(2):137-144. doi:10.3109/10641955.2014.982329
Pettit FM, Mangos GJ, Davis G, Henry A, Brown MA. 180-POS. Pregnancy Hypertens Int J Womens Cardiovasc Health. 2015;5(1):92-93. doi:10.1016/j.preghy.2014.10.186
Garovic VD. The role of angiogenic factors in the prediction and diagnosis of preeclampsia superimposed on chronic hypertension. Hypertension. 2012;59(3):555-557. doi:10.1161/HYPERTENSIONAHA.111.184192
Tuuli MG, Rampersad R, Stamilio D, Macones G, Odibo AO. Perinatal outcomes in women with preeclampsia and superimposed preeclampsia: do they differ? Am J Obstet Gynecol. 2011;204(6):508.e1-508.e7. doi:10.1016/j.ajog.2011.01.065
Valent AM, DeFranco EA, Allison A, et al. Expectant management of mild preeclampsia versus superimposed preeclampsia up to 37 weeks. Am J Obstet Gynecol. 2015;212(4):515.e1-515.e8. doi:10.1016/j.ajog.2014.10.1090
Roberts JM. Pearson Gail, cutler Jeff, Lindheimer Marshall. Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension. 2003;41(3):437-445. doi:10.1161/01.HYP.0000054981.03589.E9
Ray JG, Burrows RF, Burrows EA, Vermeulen MJ. MOS HIP: McMaster outcome study of hypertension in pregnancy. Early Hum Dev. 2001;64(2):129-143. doi:10.1016/S0378-3782(01)00181-5
Hu WS, Feng Y, Dong MY, He J. Comparing maternal and perinatal outcomes in pregnancies complicated by preeclampsia superimposed chronic hypertension and preeclampsia alone. CEOG. 2016;43:212-215. doi:10.12891/ceog2065.2016
Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and Management of Preeclampsia. JAMA. 2002;287(24):3183-3186. doi:10.1001/jama.287.24.3183
George EM, Granger JP. Endothelin: key mediator of hypertension in preeclampsia. Am J Hypertens. 2011;24(9):964-969. doi:10.1038/ajh.2011.99
Rangaswami J, Naranjo M, McCullough PA. Preeclampsia as a form of type 5 cardiorenal syndrome: an underrecognized entity in Women’s cardiovascular health. Cardiorenal Med. 2018;8(2):160-172. doi:10.1159/000487646
Hariharan N, Shoemaker A, Wagner S. Pathophysiology of hypertension in preeclampsia. Microvasc Res. 2017;109:34-37. doi:10.1016/j.mvr.2016.10.002
Chappell Lucy C., Enye Stephen, seed Paul, Briley Annette L., Poston Lucilla, Shennan Andrew H. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension. Hypertension 2008;51(4):1002-1009. 10.1161/HYPERTENSIONAHA.107.107565
Boriboonhirunsarn D, Pradyachaipimol A, Viriyapak B. Incidence of superimposed preeclampsia among pregnant Asian women with chronic hypertension. Hypertens Pregnancy. 2017;36(2):226-231. doi:10.1080/10641955.2017.1311340
Panaitescu AM, Baschat AA, Akolekar R, Syngelaki A, Nicolaides KH. Association of chronic hypertension with birth of small-for-gestational-age neonate. Ultrasound Obstet Gynecol. 2017;50(3):361-366. doi:10.1002/uog.17553
Vreeburg SA, Jacobs DJ, Dekker GA, Heard AR, Priest KR, Chan A. Hypertension during pregnancy in South Australia, part 2: risk factors for adverse maternal and/or perinatal outcome - results of multivariable analysis. Aust N Z J Obstet Gynaecol. 2004;44(5):410-418. doi:10.1111/j.1479-828X.2004.00268.x
Pierce BT, Pierce LM, Wagner RK, et al. Hypoperfusion causes increased production of interleukin 6 and tumor necrosis factor α in the isolated, dually perfused placental cotyledon. Am J Obstet Gynecol. 2000;183(4):863-867. doi:10.1067/mob.2000.108887
Barbosa IRC, Silva WBM, Cerqueira GSG, Novo NF, Almeida FA, Novo JLVG. Maternal and fetal outcome in women with hypertensive disorders of pregnancy: the impact of prenatal care. Ther Adv Cardiovasc Dis. 2015;9(4):140-146. doi:10.1177/1753944715597622