Catherine A Bigelow1, Guilherme A Pereira2, Amber Warmsley3, Jennifer Cohen3, Chloe Getrajdman3, Erin Moshier3, Julia Paris3, Angela Bianco3, Stephanie H Factor4, Joanne Stone3. 1. Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA; Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY. 2. Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. 3. Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY. 4. Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, NY; Division of Infectious Disease, Department of Medicine, Mount Sinai School of Medicine, New York, NY.
Abstract
OBJECTIVE: Risk factors for the development of new-onset late postpartum preeclampsia (LPP) in women without any history of preeclampsia are not known. Because identification of women who are at risk may lead to an earlier diagnosis of disease and improved maternal outcomes, this study identified risk factors (associated patient characteristics) for new-onset LPP. STUDY DESIGN: A case-control study of 34 women with new-onset LPP and 68 women without new-onset LPP after normal delivery, who were matched on date of delivery, was conducted at Mount Sinai Hospital, New York, NY. Data were collected by chart review. Exact conditional logistic regression identified patient characteristics that were associated with new-onset LPP. RESULTS: New-onset LPP was associated with age ≥40 years (adjusted odds ratio, 24.83; 95% confidence interval [CI], 1.43-infinity; P = .03), black race (adjusted odds ratio, 78.35; 95% CI, 7.25-infinity; P < .001), Latino ethnicity (adjusted odds ratio, 19.08; 95% CI, 2.73-infinity; P = .001), final pregnancy body mass index of ≥30 kg/m(2) (adjusted odds ratio, 13.38; 95% CI, 1.87-infinity; P = .01), and gestational diabetes mellitus (adjusted odds ratio, 72.91; 95% CI, 5.52-infinity; P < .001). As predictive tests for new-onset LPP, the sensitivity and specificity of having ≥1 of these characteristics was 100% and 59%, respectively, and the sensitivity and specificity of having ≥2 was 56% and 93%, respectively. CONCLUSION: Older age, black race, Latino ethnicity, obesity, and a pregnancy complicated by gestational diabetes mellitus all are associated positively with the development of new-onset LPP. Closer observation may be warranted in these populations.
OBJECTIVE: Risk factors for the development of new-onset late postpartum preeclampsia (LPP) in women without any history of preeclampsia are not known. Because identification of women who are at risk may lead to an earlier diagnosis of disease and improved maternal outcomes, this study identified risk factors (associated patient characteristics) for new-onset LPP. STUDY DESIGN: A case-control study of 34 women with new-onset LPP and 68 women without new-onset LPP after normal delivery, who were matched on date of delivery, was conducted at Mount Sinai Hospital, New York, NY. Data were collected by chart review. Exact conditional logistic regression identified patient characteristics that were associated with new-onset LPP. RESULTS: New-onset LPP was associated with age ≥40 years (adjusted odds ratio, 24.83; 95% confidence interval [CI], 1.43-infinity; P = .03), black race (adjusted odds ratio, 78.35; 95% CI, 7.25-infinity; P < .001), Latino ethnicity (adjusted odds ratio, 19.08; 95% CI, 2.73-infinity; P = .001), final pregnancy body mass index of ≥30 kg/m(2) (adjusted odds ratio, 13.38; 95% CI, 1.87-infinity; P = .01), and gestational diabetes mellitus (adjusted odds ratio, 72.91; 95% CI, 5.52-infinity; P < .001). As predictive tests for new-onset LPP, the sensitivity and specificity of having ≥1 of these characteristics was 100% and 59%, respectively, and the sensitivity and specificity of having ≥2 was 56% and 93%, respectively. CONCLUSION: Older age, black race, Latino ethnicity, obesity, and a pregnancy complicated by gestational diabetes mellitus all are associated positively with the development of new-onset LPP. Closer observation may be warranted in these populations.
Authors: Elena R Rivers; Anthony J Horton; Angela F Hawk; Elizabeth G Favre; Katherine M Senf; Paul J Nietert; Eugene Y Chang; Ann C Foley; Christopher J Robinson; Kyu-Ho Lee Journal: Hypertens Pregnancy Date: 2014-07-02 Impact factor: 2.108
Authors: Shali Mazaki-Tovi; Adi L Tarca; Edi Vaisbuch; Juan Pedro Kusanovic; Nandor Gabor Than; Tinnakorn Chaiworapongsa; Zhong Dong; Sonia S Hassan; Roberto Romero Journal: J Perinat Med Date: 2016-10-01 Impact factor: 1.901
Authors: Shali Mazaki-Tovi; Edi Vaisbuch; Adi L Tarca; Juan Pedro Kusanovic; Nandor Gabor Than; Tinnakorn Chaiworapongsa; Zhong Dong; Sonia S Hassan; Roberto Romero Journal: PLoS One Date: 2015-12-04 Impact factor: 3.240
Authors: Geraldine Skurnik; Shelley Hurwitz; Thomas F McElrath; Lawrence C Tsen; Stacey Duey; Aditi R Saxena; Ananth Karumanchi; Janet W Rich-Edwards; Ellen W Seely Journal: Pregnancy Hypertens Date: 2017-07-24 Impact factor: 2.899