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https://hdl.handle.net/2440/88187
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Type: | Journal article |
Title: | Prediction of recurrence of hypertensive disorders of pregnancy between 34 and 37 weeks of gestation: a retrospective cohort study |
Author: | van Oostwaard, M. Langenveld, J. Bijloo, R. Wong, K. Scholten, I. Loix, S. Hukkelhoven, C. Vergouwe, Y. Papatsonis, D. Mol, B. Ganzevoort, W. |
Citation: | BJOG: an International Journal of Obstetrics and Gynaecology, 2012; 119(7):840-847 |
Publisher: | Wiley |
Issue Date: | 2012 |
ISSN: | 1470-0328 1471-0528 |
Statement of Responsibility: | MF van Oostwaard, J Langenveld, R Bijloo, KM Wong, I Scholten, S Loix, CWPM Hukkelhoven, Y Vergouwe, DNM Papatsonis, BWJ Mol, and W Ganzevoort |
Abstract: | 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. |
Keywords: | HELLP-syndrome; hypertension; pre-eclampsia; pregnancy; recurrence; small for gestational age |
Rights: | © 2012 The Authors |
DOI: | 10.1111/j.1471-0528.2012.03312.x |
Published version: | http://dx.doi.org/10.1111/j.1471-0528.2012.03312.x |
Appears in Collections: | Aurora harvest 2 Obstetrics and Gynaecology publications |
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