PREDICTORS OF PREECLAMPSIA IN WOMEN AT HIGH-RISK

OBJECTIVE: We assessed several variables as predictors for pre-eclamps ia risk in a group of women at high risk. STUDY DESIGN: We studied 250 3 women with either diabetes mellitus, chronic hypertension, multifeta l gestation, or pre-eclampsia in a previous pregnancy who participated in a multicenter study comparing aspirin and placebo in preventing pr e-eclampsia. We evaluated multiple variables for predicting pre-eclamp sia risk with use of univariate and multivariable analysis. RESULTS: P arity and mean arterial pressure at randomization were most predictive of pre-eclampsia risk. The risk was 8% with a mean arterial pressure at enrollment of <75 mm Hg versus 27% with a mean arterial pressure >8 5 mm Hg (relative risk and 95% confidence interval 3.3 [2.4 to 4.4]). The risk of pre-eclampsia was 26% in nulliparous patients versus 17% i n parous subjects (relative risk and 95% confidence interval 1.5 [1.3- 1.8]). CONCLUSIONS: The finding that second-trimester mean arterial pr essure affects pre-eclampsia risk suggests that the pathophysiologic p rocess of preeclampsia is initiated before that time.