Remote prognosis of primiparous women with preeclampsia

Objective: To describe the maternal characteristics of pregnancy and perina tal outcome of primiparous women with preeclampsia. to determine the recurr ence rate and to define the maternal risk factors for preeclampsia in subse quent pregnancies. Methods: A retrospective cohort study. Two groups of pat ients were defined: the study group consisted of 380 primiparous women with preeclampsia, and in a control group of 385 primiparous women without pree clampsia. The patients were followed during their consecutive deliveries. M ultiple logistic regression analysis was used to determine the independent risk factors for the recurrence of preeclampsia in the second pregnancy. Re sults: In the study and the control group there were a total of 1207 and 12 93 deliveries. respectively. Of the 380 primiparous women in study group, 3 05 (80%) were identified as suffering from mild preeclampsia. 64 (17%) from severe preeclampsia. 10 (2.6%) from super imposed preeclampsia and only on e (0.3%) had eclampsia. Primiparous with severe preeclampsia had a signific antly higher rate of preterm delivery then those with mild preeclampsia (34 versus 11% respectively. P<0.0001). In additional the study group had sign ificantly higher rate of perinatal mortality (3.4 versus 0.3%, P=0.013) and perinatal complications. The recurrence rate of preeclampsia was significa ntly higher in the study group (25% versus 1.9%, P<0.0001). When adjusted f or confounding variables. gestational diabetes was strongly associated with the recurrence or preeclampsia in the second pregnancy (OR 3.72 95% CI 1.4 5-9.53). Conclusion: Primiparous women with preeclampsia are at an increase d risk for recurrence in subsequent pregnancies. Gestational diabetes in pr imiparous women with preeclampsia is an independent risk factor for develop ing preeclampsia in the second pregnancy. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.