OBJECTIVE: To assess the recurrence risk of late-preterm hypertensive disease of pregnancy, and to determine whether potential risk factors are predictive. DESIGN: Retrospective cohort study. SETTING: Three secondary and three tertiary care hospitals in the Netherlands. POPULATION: We identified women with a hypertensive disorder in the index pregnancy and delivery at 34-37 weeks of gestation, between January 2000 and December 2002. METHODS: Data were extracted from medical files and women were approached for additional information on subsequent pregnancies. An adverse outcome was defined as the recurrence of a hypertensive disorder in the next subsequent pregnancy. MAIN OUTCOME MEASURES: Absolute risk of recurrence and a prediction model containing demographic and clinical factors predictive for adverse outcome. RESULTS: We identified 425 women who matched the criteria, of whom 351 could be contacted. Of these women, 189 (54%) had had a subsequent pregnancy. Hypertensive disorders recurred in 96 (51%, 95% CI 43-58%) women, of whom 17 (9%, 95% CI 5-14%) delivered again before 37 weeks of gestation. Chronic hypertension and maternal age were the strongest predictors for recurrence. Women undergoing recurrence had a nine-fold chance of developing chronic hypertension (37% versus 6%, OR 8.7, 95% CI 3.3-23). CONCLUSIONS: Women with hypertensive disorders and late-preterm delivery have a 50% chance of recurrence, but only a 9% chance of recurrence resulting in delivery before 37 weeks of gestation. Women with chronic hypertension are prone to develop recurrence, and women with a recurrence more often developed chronic hypertension.
OBJECTIVE: To assess the recurrence risk of late-preterm hypertensive disease of pregnancy, and to determine whether potential risk factors are predictive. DESIGN: Retrospective cohort study. SETTING: Three secondary and three tertiary care hospitals in the Netherlands. POPULATION: We identified women with a hypertensive disorder in the index pregnancy and delivery at 34-37 weeks of gestation, between January 2000 and December 2002. METHODS: Data were extracted from medical files and women were approached for additional information on subsequent pregnancies. An adverse outcome was defined as the recurrence of a hypertensive disorder in the next subsequent pregnancy. MAIN OUTCOME MEASURES: Absolute risk of recurrence and a prediction model containing demographic and clinical factors predictive for adverse outcome. RESULTS: We identified 425 women who matched the criteria, of whom 351 could be contacted. Of these women, 189 (54%) had had a subsequent pregnancy. Hypertensive disorders recurred in 96 (51%, 95% CI 43-58%) women, of whom 17 (9%, 95% CI 5-14%) delivered again before 37 weeks of gestation. Chronic hypertension and maternal age were the strongest predictors for recurrence. Women undergoing recurrence had a nine-fold chance of developing chronic hypertension (37% versus 6%, OR 8.7, 95% CI 3.3-23). CONCLUSIONS:Women with hypertensive disorders and late-preterm delivery have a 50% chance of recurrence, but only a 9% chance of recurrence resulting in delivery before 37 weeks of gestation. Women with chronic hypertension are prone to develop recurrence, and women with a recurrence more often developed chronic hypertension.
Authors: John Allotey; Kym Ie Snell; Melanie Smuk; Richard Hooper; Claire L Chan; Asif Ahmed; Lucy C Chappell; Peter von Dadelszen; Julie Dodds; Marcus Green; Louise Kenny; Asma Khalil; Khalid S Khan; Ben W Mol; Jenny Myers; Lucilla Poston; Basky Thilaganathan; Anne C Staff; Gordon Cs Smith; Wessel Ganzevoort; Hannele Laivuori; Anthony O Odibo; Javier A Ramírez; John Kingdom; George Daskalakis; Diane Farrar; Ahmet A Baschat; Paul T Seed; Federico Prefumo; Fabricio da Silva Costa; Henk Groen; Francois Audibert; Jacques Masse; Ragnhild B Skråstad; Kjell Å Salvesen; Camilla Haavaldsen; Chie Nagata; Alice R Rumbold; Seppo Heinonen; Lisa M Askie; Luc Jm Smits; Christina A Vinter; Per M Magnus; Kajantie Eero; Pia M Villa; Anne K Jenum; Louise B Andersen; Jane E Norman; Akihide Ohkuchi; Anne Eskild; Sohinee Bhattacharya; Fionnuala M McAuliffe; Alberto Galindo; Ignacio Herraiz; Lionel Carbillon; Kerstin Klipstein-Grobusch; SeonAe Yeo; Helena J Teede; Joyce L Browne; Karel Gm Moons; Richard D Riley; Shakila Thangaratinam Journal: Health Technol Assess Date: 2020-12 Impact factor: 4.014
Authors: L Brouwers; A J van der Meiden-van Roest; C Savelkoul; T E Vogelvang; A T Lely; A Franx; B B van Rijn Journal: BJOG Date: 2018-08-10 Impact factor: 6.531