[The recurrence of hypertensive disorders during pregnancy between 34 and 37 weeks of gestation]

Abstract

Item does not contain fulltextOBJECTIVE: To assess the recurrence risk of late preterm hypertensive disease of pregnancy and to determine whether potential risk factors are predictive. DESIGN: Retrospective cohort study. METHODS: Our study cohort included 425 women with a pregnancy-related hypertensive disorder who had delivered between 34 and 37 weeks of gestation at three different academic and three tertiary care hospitals in the Netherlands during the 2000-2002 period. Data were collected from medical files and by telephone interviews with the women. An adverse outcome was defined as the recurrence of a hypertensive disorder during the subsequent pregnancy. We also designed a prediction model containing demographic and clinical factors predictive for an adverse outcome. RESULTS: Of the 425 women who met the inclusion criteria, 351 could be contacted, of whom 189 (54%) had had a subsequent pregnancy. Pregnancy-related hypertensive disorders had recurred in 96 (51%; 95% CI: 43-58) women. Seventeen women (9%; 95% CI: 5-14) had delivered again before the 37th week. Pre-existing hypertension and maternal age were the strongest predictors for recurrence. Women who had experienced a recurrence had a 9-fold chance of developing chronic hypertension (37 vs. 6%; OR 8.7; 95% CI: 3.3-23). CONCLUSION: Women with hypertensive disorders and late preterm deliveries have a 50% chance of recurrence of the disorder and a 9% chance of recurrent premature delivery. Women with pre-existing hypertension or who are older are prone to recurrence. Women with a recurrent hypertensive disorder during a subsequent pregnancy often later develop chronic hypertension