Document Detail

Association of early-onset pre-eclampsia in first pregnancy with normotensive second pregnancy outcomes: a population-based study.
MedLine Citation:
PMID:  20497414     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate pregnancy outcomes in normotensive second pregnancy following pre-eclampsia in first pregnancy.
DESIGN: Population-based retrospective cohort study.
SETTING: State of Missouri in the USA.
SAMPLE: White European origin or African-American women who delivered their first two non-anomalous singleton pregnancies between 20 and 44 weeks of gestation in Missouri, USA, 1989-2005, without chronic hypertension, renal disease or diabetes mellitus (n = 12 835).
METHODS: Pre-eclampsia or delivery at 34 weeks of gestation or less in first pregnancy was defined as early-onset pre-eclampsia, whereas late-onset pre-eclampsia was defined as pre-eclampsia with delivery after 34 weeks of gestation. Multivariate regression models were fitted to estimate the crude and adjusted odds ratios and 95% confidence intervals.
MAIN OUTCOME MEASURES: Preterm delivery, large and small-for-gestational-age infant, Apgar scores at 5 minutes, fetal death, caesarean section, placental abruption.
RESULTS: Women with early-onset pre-eclampsia in first pregnancy were more likely to be younger, African-American, recipients of Medicaid, unmarried and smokers. Despite a second normotensive pregnancy, women with early-onset pre-eclampsia in their first pregnancy had greater odds of a small-for-gestational-age infant, preterm birth, fetal death, caesarean section and placental abruption in the second pregnancy, relative to women with late-onset pre-eclampsia, after controlling for confounders. Moreover, maternal ethnic origin modified the association between early-onset pre-eclampsia in the first pregnancy and preterm births in the second pregnancy. Having a history of early-onset pre-eclampsia reduces the odds of having a large-for-gestational-age infant in the second pregnancy.
CONCLUSION: A history of early-onset pre-eclampsia is associated with increased odds of adverse pregnancy outcomes despite a normotensive second pregnancy.
J J Chang; L J Muglia; G A Macones
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-25
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  117     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-11     Completed Date:  2010-09-21     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  946-53     Citation Subset:  AIM; IM    
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MeSH Terms
Abruptio Placentae / etiology
Cesarean Section / statistics & numerical data
Fetal Death / etiology
Infant, Newborn
Infant, Small for Gestational Age
Pregnancy Outcome*
Retrospective Studies
Risk Factors
Young Adult
Grant Support

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