Risk factors and outcome of Preeclampsia

To determine differences between groups with hypertension in pregnancy and assess risk factors associated with preeclampsia.

In the period 2008-10 at the Department of Nephrology in Skopje, Macedonia, a prospective and a longitudinal study study comprising 134 pregnant women was carried out. They had regular monthly check-ups in pregnancy and after delivery (1-8), when groups were defined as gestational hypertension, pre-existing hypertension, superimposed preeclampsia, and preeclampsia. A total of 134 women were regularly controlled by 24-hour ambulatory monitoring of blood pressure (24ABPM), blood and urine, D-dimers, and a resistance index of the Doppler of the umbilical artery (RI a.umb), and a questionnaire on risk factors was filled in for every pregnant woman.

Superimposed preeclampsia was found in 22 (16.4%) and preeclampsia was found in 20 women (14.9%). Daily diastolic blood pressure of 24-hour blood pressure monitoring at the last check-up before delivery was significantly higher in the group with superimposed preeclampsia (SP) 87.6±9.5 and in the group with preeclampsia (PE) 87.9±7.7 mm Hg. Previous preeclampsia (OR=3.28), primiparity (OR=2.35), methyldopa (OR=3.76), number of check-ups (OR=2.3), positive family history (OR=1.4) and in vitro fertilisation (OR=1.15) were found as risk factors associated with the occurrence of preeclampsia and preeclampsia superimposed on preexisting hypertension.

Early determination of risk factors should prompt more frequent check-ups in hypertensive pregnancies in order to determine timely delivery and avoid adverse outcomes in the mother and child.