Pregnancy outcome of late-onset recurrent preeclampsia

Abstract

The purpose of the study was to assess the obstetric outcome of late-onset recurrent preeclampsia. The clinical data of multiparous women with late-onset preeclampsia either at current or in past pregnancy who delivered at Yonsei University Health System between May, 2001 and April, 2010 were collected retrospectively. The patients were divided into three groups: patients with late-onset recurrent preeclampsia, patients with late-onset preeclampsia subsequent to normotensive pregnancy, and normal pregnant women with a history of preeclampsia. Maternal variables included age, gestational weeks at diagnosis of preeclampsia, gestational weeks at delivery, time between diagnosis of preeclampsia and delivery, delivery mode, operative indications if performed, mean systolic and diastolic blood pressure, laboratory values including urine protein detected by dipstick, platelet count, aspartate aminotransferase, albumin, creatinine, and uric acid, and complications including preterm labor, preterm delivery, placental abruption, renal failure, and pulmonary edema. Neonatal variables included birthweight, intrauterine growth restriction, fetal distress, 5-minute Apgar score, neonatal intensive care unit admission and fetal death. Of 87 women, 25 patients were diagnosed as late-onset recurrent preeclampsia, 15 were normal pregnant women with history of preeclampsia, and 47 were late-onset preeclampsia subsequent to normotensive pregnancy. Preterm labor, preterm delivery and cesarean section due to fetal distress were significantly more frequent in patients with late-onset recurrent preeclampsia than in those with normal pregnancy and a history of preeclampsia. Neonatal birthweight was significantly lower with more intrauterine growth restriction, and neonatal intensive care unit admission rate was significantly higher in the recurrent preeclampsia group than in the normal group. Between the late-onset recurrent preeclampsia group and the late-onset preeclampsia subsequent to normotensive pregnancy group, the incidences of preterm labor and preterm delivery were significantly higher in recurrent preeclampsia patients. However, no difference was seen in terms of fetal outcome. Thus, late-onset preeclampsia patients with history of preeclampsia may be treated with close attention and follow-up of maternal and fetal conditions throughout pregnancy as preeclampsia occurring after normotensive pregnancy.