Risk Factors for Pre-Eclampsia at Antenatal Booking: Systematic Review of Controlled Studies

BMJ. 2005 Mar 12;330(7491):565. doi: 10.1136/bmj.38380.674340.E0. Epub 2005 Mar 2.

Abstract

Objective: To determine the risk of pre-eclampsia associated with factors that may be present at antenatal booking.

Design: Systematic review of controlled studies published 1966-2002.

Data synthesis: Unadjusted relative risks were calculated from published data.

Results: Controlled cohort studies showed that the risk of pre-eclampsia is increased in women with a previous history of pre-eclampsia (relative risk 7.19, 95% confidence interval 5.85 to 8.83) and in those with antiphospholipids antibodies (9.72, 4.34 to 21.75), pre-existing diabetes (3.56, 2.54 to 4.99), multiple (twin) pregnancy (2.93, 2.04 to 4.21), nulliparity (2.91, 1.28 to 6.61), family history (2.90, 1.70 to 4.93), raised blood pressure (diastolic > or = 80 mm Hg) at booking (1.38, 1.01 to 1.87), raised body mass index before pregnancy (2.47, 1.66 to 3.67) or at booking (1.55, 1.28 to 1.88), or maternal age > or = 40 (1.96, 1.34 to 2.87, for multiparous women). Individual studies show that risk is also increased with an interval of 10 years or more since a previous pregnancy, autoimmune disease, renal disease, and chronic hypertension.

Conclusions: These factors and the underlying evidence base can be used to assess risk at booking so that a suitable surveillance routine to detect pre-eclampsia can be planned for the rest of the pregnancy.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Antiphospholipid Syndrome / complications
  • Autoimmune Diseases / complications
  • Birth Intervals
  • Blood Pressure
  • Body Mass Index
  • Epidemiologic Methods
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced / etiology
  • Kidney Diseases / complications
  • Parity
  • Pedigree
  • Pre-Eclampsia / etiology*
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Pregnancy in Diabetics / complications
  • Pregnancy, Multiple
  • Prenatal Care