Risk Factors for Early- and Late-Onset Superimposed Preeclampsia

Area of Science:

• Obstetrics and Gynecology
• Nephrology
• Maternal-Fetal Medicine

Background:

• Chronic hypertension in pregnancy increases the risk of superimposed preeclampsia (SIPE).
• Risk factors for early- and late-onset SIPE are not well-defined.
• Understanding these differences is crucial for timely intervention and improved maternal outcomes.

Purpose of the Study:

• To investigate and differentiate the risk factors for early- and late-onset SIPE in pregnant individuals with chronic hypertension.
• To identify specific clinical characteristics associated with each SIPE onset type.

Main Methods:

• Retrospective case-control study involving 839 pregnant individuals with chronic hypertension.
• Comparison of patient characteristics between early-onset SIPE, late-onset SIPE, and no SIPE groups.
• Logistic regression analysis to determine adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for identified risk factors.

Main Results:

• Early-onset SIPE was associated with serum creatinine ≥ 0.7 mg/dL (aOR: 2.89), increased creatinine (aOR: 1.33), nulliparity (aOR: 1.77), and pregestational diabetes (aOR: 1.70).
• Late-onset SIPE was associated with nulliparity (aOR: 1.53) and pregestational diabetes (aOR: 1.74).
• Compared to late-onset SIPE, early-onset SIPE showed significant associations with serum creatinine ≥ 0.7 mg/dL (aOR: 2.90) and increased creatinine (aOR: 1.33).

Conclusions:

• Kidney dysfunction, indicated by serum creatinine levels, appears to be a significant risk factor for early-onset SIPE.
• Nulliparity and pregestational diabetes are common risk factors for both early- and late-onset SIPE.
• Identifying these distinct risk factors may aid in developing strategies to reduce SIPE incidence and improve pregnancy outcomes.