Hypertension and microalbuminuria 5 years after pregnancies complicated by pre-eclampsia

Pre-eclampsia is part of a spectrum of conditions known as the hypertensive disorders of pregnancy. It is claimed that pregnant women with pre-eclampsia or eclampsia are at increased risk of kidney disease and hypertension later in life. We investigated whether Iranian women with a history of pre-eclampsia had higher rates of hypertension and microalbuminuria compared with women with uneventful pregnancy.

Medical records of pregnancies delivered at two hospitals in Ahvaz, between March 2001 and February 2003 were reviewed. Thirty-five pre-eclamptic women were identified and contacted for assessment of hypertension and albuminuria. They were compared with 35 women matched for year of delivery and age who had a pregnancy uncomplicated by hypertension.

The mean follow-up from the index pregnancy was 5.7 years (range, 5.2 to 7.3 years). While only 1 woman (2.9%) in the control group was currently hypertensive, 28.6% of those with a history of pre-eclampsia (n = 10) were hypertensive (P = .003; relative risk, 10.0; 95% confidence interval, 1.35 to 74.00), 7 of whom were receiving antihypertensive medication at the time of evaluation. Among the formerly pre-eclamptic women, 7 had albuminuria (20.0%), whereas none of the controls were albuminuric (P < .001). Microalbuminuria was present in all hypertensive women in the pre-eclampsia group, but not in the only women in the control group with hypertension.

We showed that in patients with a history of pre-eclampsia, there are increased risks of hypertension and microalbuminuria in the long term after pregnancy.