Risk factors of superimposed preeclampsia in women with essential chronic hypertension treated before pregnancy

PLoS One. 2013 May 6;8(5):e62140. doi: 10.1371/journal.pone.0062140. Print 2013.

Abstract

Objective: To determine risk factors of superimposed preeclampsia in women with essential chronic hypertension receiving antihypertensive therapy prior to conception.

Methods: A retrospective study of 211 patients that analyzed risk factors of superimposed preeclampsia at first prenatal visit. Variables with a p<.1 at univariate analysis were included in a logistic regression analysis. P<.05 was considered as significant.

Results: Superimposed preeclampsia occurred in 49 (23.2%) women. In logistic regression analysis, previous preeclampsia [OR: 4.05 (1.61-10.16)], and mean arterial blood pressure of 95 mmHg or higher [OR: 4.60 (1.94-10.93)] were associated with increased risk of superimposed preeclampsia. When both variables were present, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio for superimposed preeclampsia were 43%, 94%, 70%, 85%, and 7.71 (95% CI: 3.20-18.57), respectively.

Conclusion: In essential chronic hypertensive women, previous preeclampsia and mean arterial blood pressure of 95 mmHg or higher are associated with increased risks of superimposed preeclampsia.

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use
  • Aspirin / therapeutic use
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / drug therapy
  • Pre-Eclampsia / etiology*
  • Pre-Eclampsia / physiopathology
  • Pre-Eclampsia / prevention & control
  • Pregnancy
  • Pregnancy Complications, Cardiovascular* / drug therapy
  • Pregnancy Outcome
  • ROC Curve
  • Retrospective Studies
  • Risk Factors

Substances

  • Antihypertensive Agents
  • Aspirin

Grant support

These authors have no support or funding to report.