Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis.

The purpose of this report is to compare subsequent pregnancy outcome and incidence of chronic hypertension and diabetes on follow-up in two groups of patients. Group 1 included 406 young women who had severe preeclampsia-eclampsia in their first pregnancies. Group 2 consisted of 409 young, well-matched women who remained normotensive during their first pregnancies. All patients were followed up for a minimum of 2 years (range 2 to 24). The preeclamptic-eclamptic group had a higher incidence of preeclampsia in their second pregnancies (46.8% versus 7.6%, p less than 0.0001) and in subsequent pregnancies (20.7% versus 7.7%, p less than 0.001) when compared with the normotensive group. The overall incidence of chronic hypertension was significantly higher in the preeclamptic-eclamptic group (14.8% versus 5.6%, p less than 0.001). Most of the difference occurred in patients followed up greater than or equal to 10 years. Within the preeclamptic-eclamptic group, patients having preeclampsia-eclampsia at less than or equal to 30 weeks' gestation and those having recurrent preeclampsia in their second pregnancies had a significantly higher incidence of subsequent chronic hypertension (p less than 0.001) than was found in the other patients. Within the normotensive group, patients remaining normotensive in subsequent pregnancies had the lowest incidence of chronic hypertension.