Pre-eclampsia in the second pregnancy

Does previous outcome matter?

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: To assess the effect of initial pregnancy outcome and gestational age on the risk of pre-eclampsia in the second pregnancy.
Study design: We conducted an observational study using routinely collected data from the Aberdeen Maternity and Neonatal Databank between 1986 and 2006. Cases were women who developed pre-eclampsia in their second pregnancy and controls were normotensive in their second pregnancy. Crude and adjusted odds ratios were produced for each of the risk factors using logistic regression.

Results: Inter-pregnancy intervals of 6 years or more were associated with increased incidence of pre-eclampsia (19.4% vs. 14.7%). A change of partner had a protective effect while an increase in BMI increased the risk of pre-eclampsia. A history of pre-eclampsia was associated with 5 times higher risk {adjusted O.R. 5.12 (95% C.I. 4.42-6.48)} of pre-eclampsia in the second pregnancy. Compared to a term delivery, a previous second trimester pregnancy loss was associated with a 4 times higher risk {adjusted O.R. 4.22 (95% C.I. 2.54-7.03)} of pre-eclampsia in the next pregnancy. Previous very preterm and preterm births were associated with adjusted odds ratios of 2.32 (95% C.I. 1.62-3.32) and 1.62 (95% C.I. 1.46-1.72) respectively. The risk of pre-eclampsia was no higher in women with a previous history of fetal death after 20 weeks than those with a previous live birth, after adjusting for pre-eclampsia in the first pregnancy.

Conclusion: Only initial deliveries beyond 37 weeks, irrespective of outcome, were protective against pre-eclampsia in the second pregnancy.
Original languageEnglish
Pages (from-to)130-134
Number of pages5
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Volume144
Issue number2
DOIs
Publication statusPublished - Jun 2009

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Pre-Eclampsia
Pregnancy
Odds Ratio
Birth Intervals
Fetal Death
Premature Birth
Live Birth
Second Pregnancy Trimester
Pregnancy Outcome
Gestational Age
Observational Studies
Logistic Models
Databases
Incidence

Keywords

  • pre-eclampsia
  • second pregnancy
  • preterm delivery
  • stillbirth

Cite this

@article{09bf827ec0f043aab023b4cb2c6fc959,
title = "Pre-eclampsia in the second pregnancy: Does previous outcome matter?",
abstract = "Objective: To assess the effect of initial pregnancy outcome and gestational age on the risk of pre-eclampsia in the second pregnancy.Study design: We conducted an observational study using routinely collected data from the Aberdeen Maternity and Neonatal Databank between 1986 and 2006. Cases were women who developed pre-eclampsia in their second pregnancy and controls were normotensive in their second pregnancy. Crude and adjusted odds ratios were produced for each of the risk factors using logistic regression.Results: Inter-pregnancy intervals of 6 years or more were associated with increased incidence of pre-eclampsia (19.4{\%} vs. 14.7{\%}). A change of partner had a protective effect while an increase in BMI increased the risk of pre-eclampsia. A history of pre-eclampsia was associated with 5 times higher risk {adjusted O.R. 5.12 (95{\%} C.I. 4.42-6.48)} of pre-eclampsia in the second pregnancy. Compared to a term delivery, a previous second trimester pregnancy loss was associated with a 4 times higher risk {adjusted O.R. 4.22 (95{\%} C.I. 2.54-7.03)} of pre-eclampsia in the next pregnancy. Previous very preterm and preterm births were associated with adjusted odds ratios of 2.32 (95{\%} C.I. 1.62-3.32) and 1.62 (95{\%} C.I. 1.46-1.72) respectively. The risk of pre-eclampsia was no higher in women with a previous history of fetal death after 20 weeks than those with a previous live birth, after adjusting for pre-eclampsia in the first pregnancy.Conclusion: Only initial deliveries beyond 37 weeks, irrespective of outcome, were protective against pre-eclampsia in the second pregnancy.",
keywords = "pre-eclampsia, second pregnancy, preterm delivery, stillbirth",
author = "Sohinee Bhattacharya and Campbell, {Doris M} and Smith, {Norman C}",
year = "2009",
month = "6",
doi = "10.1016/j.ejogrb.2009.03.008",
language = "English",
volume = "144",
pages = "130--134",
journal = "European Journal of Obstetrics & Gynecology and Reproductive Biology",
issn = "0301-2115",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Pre-eclampsia in the second pregnancy

T2 - Does previous outcome matter?

AU - Bhattacharya, Sohinee

AU - Campbell, Doris M

AU - Smith, Norman C

PY - 2009/6

Y1 - 2009/6

N2 - Objective: To assess the effect of initial pregnancy outcome and gestational age on the risk of pre-eclampsia in the second pregnancy.Study design: We conducted an observational study using routinely collected data from the Aberdeen Maternity and Neonatal Databank between 1986 and 2006. Cases were women who developed pre-eclampsia in their second pregnancy and controls were normotensive in their second pregnancy. Crude and adjusted odds ratios were produced for each of the risk factors using logistic regression.Results: Inter-pregnancy intervals of 6 years or more were associated with increased incidence of pre-eclampsia (19.4% vs. 14.7%). A change of partner had a protective effect while an increase in BMI increased the risk of pre-eclampsia. A history of pre-eclampsia was associated with 5 times higher risk {adjusted O.R. 5.12 (95% C.I. 4.42-6.48)} of pre-eclampsia in the second pregnancy. Compared to a term delivery, a previous second trimester pregnancy loss was associated with a 4 times higher risk {adjusted O.R. 4.22 (95% C.I. 2.54-7.03)} of pre-eclampsia in the next pregnancy. Previous very preterm and preterm births were associated with adjusted odds ratios of 2.32 (95% C.I. 1.62-3.32) and 1.62 (95% C.I. 1.46-1.72) respectively. The risk of pre-eclampsia was no higher in women with a previous history of fetal death after 20 weeks than those with a previous live birth, after adjusting for pre-eclampsia in the first pregnancy.Conclusion: Only initial deliveries beyond 37 weeks, irrespective of outcome, were protective against pre-eclampsia in the second pregnancy.

AB - Objective: To assess the effect of initial pregnancy outcome and gestational age on the risk of pre-eclampsia in the second pregnancy.Study design: We conducted an observational study using routinely collected data from the Aberdeen Maternity and Neonatal Databank between 1986 and 2006. Cases were women who developed pre-eclampsia in their second pregnancy and controls were normotensive in their second pregnancy. Crude and adjusted odds ratios were produced for each of the risk factors using logistic regression.Results: Inter-pregnancy intervals of 6 years or more were associated with increased incidence of pre-eclampsia (19.4% vs. 14.7%). A change of partner had a protective effect while an increase in BMI increased the risk of pre-eclampsia. A history of pre-eclampsia was associated with 5 times higher risk {adjusted O.R. 5.12 (95% C.I. 4.42-6.48)} of pre-eclampsia in the second pregnancy. Compared to a term delivery, a previous second trimester pregnancy loss was associated with a 4 times higher risk {adjusted O.R. 4.22 (95% C.I. 2.54-7.03)} of pre-eclampsia in the next pregnancy. Previous very preterm and preterm births were associated with adjusted odds ratios of 2.32 (95% C.I. 1.62-3.32) and 1.62 (95% C.I. 1.46-1.72) respectively. The risk of pre-eclampsia was no higher in women with a previous history of fetal death after 20 weeks than those with a previous live birth, after adjusting for pre-eclampsia in the first pregnancy.Conclusion: Only initial deliveries beyond 37 weeks, irrespective of outcome, were protective against pre-eclampsia in the second pregnancy.

KW - pre-eclampsia

KW - second pregnancy

KW - preterm delivery

KW - stillbirth

U2 - 10.1016/j.ejogrb.2009.03.008

DO - 10.1016/j.ejogrb.2009.03.008

M3 - Article

VL - 144

SP - 130

EP - 134

JO - European Journal of Obstetrics & Gynecology and Reproductive Biology

JF - European Journal of Obstetrics & Gynecology and Reproductive Biology

SN - 0301-2115

IS - 2

ER -