Chronic hypertension diagnosed in a previous pregnancy is associated with recurrent preeclampsia

A history of preeclampsia is a significant risk factor for recurrence, especially in cases of early-onset or severe preeclampsia. Additional maternal risk factors present in the subsequent pregnancy include advanced maternal age, interval between pregnancies, and newly diagnosed chronic hypertension. However, the impact of chronic hypertension diagnosed during the previous pregnancy on recurrence risk remains underexplored.

Ninety-four women with a history of preeclampsia were followed into their subsequent pregnancies. The association of clinical parameters in their previous pregnancy and the subsequent pregnancy outcomes was analysed.

Among the 94 women, 56 (60%) did not develop any current hypertensive disorders of pregnancy (HDP), while 4 (5%) developed chronic hypertension, 12 (13%) developed gestational hypertension, and 22 (24%) developed recurrent preeclampsia. Notably, among the 10 women who were diagnosed with chronic hypertension in the previous pregnancy, 80% developed recurrent HDP, compared to 36% of those without it (odds ratio [OR], 7.200; 95% confidence interval [CI], 1.538-34.71; P = 0.0133). In addition, 87% of women with recurrent hypertensive disorders had a cesarean section in their previous pregnancy, compared to 68% of those without recurrence (OR, 3.126; 95% CI, 1.077-8.279; P = 0.0356).

Women with preeclampsia complicated by chronic hypertension diagnosed in their previous pregnancies and those who underwent cesarean section in their previous pregnancies are at increased risk for recurrent HDP, including recurrent preeclampsia.