Case-Control Study of Severe Pre-eclampsia of Early Onset

Moore, Michael C.; Redman, Christopher W.G.

doi:10.1097/00006254-198405000-00007

Cited by 13 publications

(15 citation statements)

References 9 publications

(9 reference statements)

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“…1 2 The lower risk has also been attributed to smoother trophoblastic invasion after modification of maternal spiral arteries during the first pregnancy. 3 We hypothesised that pre-eclampsia is more common in first pregnancies because women who experience pre-eclampsia during their first pregnancy, whom might have an increased risk for genetic or environmental reasons, might decide not to take further risks and have no more pregnancies. In addition, subfecundity has been associated with a higher risk of preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Risk of Preeclampsia in First and Subsequent Pregnancies: Prospective Cohort Study

Hernández–Dı́az

Toh

Cnattingius

2010

Obstetric Anesthesia Digest

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Section: Introductionmentioning

confidence: 99%

Risk of Preeclampsia in First and Subsequent Pregnancies: Prospective Cohort Study

Hernández–Dı́az

Toh

Cnattingius

2010

Obstetric Anesthesia Digest

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“…The Japan Society for the Study of Hypertension in Pregnancy (JSSHP) classifies preeclampsia into early and late onset type according to whether the clinical manifestations occur before or after 32 weeks of gestation, respectively (3). The early onset preeclampsia may differ from the late onset type not only in its high perinatal morbidity but also in its risk factors (4). For example, it has been reported that women with early onset preeclampsia show a greater incidence of infant growth restriction (5,6) and infant morbidity (7) than those with the late onset type.…”

Section: Introductionmentioning

confidence: 99%

Alterations in Placental Growth Factor Levels before and after the Onset of Preeclampsia Are More Pronounced in Women with Early Onset Severe Preeclampsia

et al. 2007

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It has been established that the serum placental growth factor (PlGF) decreases and the soluble fms-like tyrosine kinase-1 (sFlt-1) increases in women with preeclampsia. However, there have been no studies on the relation between preeclampsia onset time and the changes in PlGF and sFlt-1. Furthermore, the PlGF and sFlt-1 levels have not been evaluated using their reference values specific to each gestational age. In this study we reevaluated the serum PlGF and sFlt-1 levels before and after the clinical manifestation of early and late onset severe preeclampsia using the new reference values developed in our recent longitudinal study. Blood specimens were obtained immediately after the clinical manifestation of severe preeclampsia in 34 referred women, and both before and after the clinical manifestation in 8 women receiving a routine checkup at our institute. Both women with early and those with late preeclampsia showed decreased PlGF and increased sFlt-1 levels compared to normotensive controls at 28 and 37 weeks (n =68). However, those with early onset preeclampsia had a higher incidence of low PlGF (<5th percentile on the reference values) and high sFlt-1 ( ≥ 95th percentile) than those with late onset (low PlGF: 93% vs. 55%; high sFlt-1: 100% vs. 60%). log10PlGF (r =0.574, p <0.001) and log10(sFlt-1/PlGF) (r =-0.556, p <0.001) were correlated with the week of onset of preeclampsia. Before the onset of preeclampsia, the incidence rate of low PlGF in the women with early onset preeclampsia was 100% (5/5), whereas that in the women with late onset preeclampsia was 0% (0/2) (p =0.048). Therefore, alterations in the PlGF levels both before and after the onset of preeclampsia may be more pronounced in women with early onset than those with late onset severe

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“…(2) In fact, fertility difficulties have been associated with a higher risk of gestational hypertension and preeclampsia. (6)(7)(8) Thus, it has been suggested that elevated risks of preeclampsia observed in women treated for infertility (9,10) stem from the underlying disorder rather than from the infertility treatments themselves.…”

Section: Introductionmentioning

confidence: 99%

Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations

Hernández–Dı́az

Werler

Mitchell

2007

Fertility and Sterility

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Objective-To investigate the association between infertility treatments and gestational hypertension and preeclampsia. Design-Retrospective observational cohort. Setting-General population, United States and Canada.Patients-5151 women with non-malformed infants participating in the Slone Epidemiology Center Birth Defects Study between 1998 and 2006.Interventions-Women were interviewed within six months after delivery about sociodemographic and medical factors, the onset of gestational hypertension and preeclampsia, and about infertility treatments.Main Outcome Measures-We estimated relative risks and 95% confidence intervals using unconditional logistic regression.Results-The incidence of gestational hypertension was 8.9% (423/4762) among women without infertility treatments, and 15.8% (55/349) among women undergoing infertility treatments. Compared to spontaneous pregnancies, the crude relative risk for gestational hypertension in pregnancies resulting from infertility treatments was 1.9 (95% confidence interval 1.4-2.6). Multivariate adjustment for parity and pre-pregnancy BMI resulted in a relative risk of 1.6 (1.1-2.1). Further adjustment for multiple pregnancies, or restriction of the analyses to singleton pregnancies, moved the relative risk to 1.3. Each specific infertility procedure or drug was associated with a similarly elevated risk, which disappeared after adjustment for multiple gestations. Results were similar for preeclampsia.Corresponding Author: Allen A. Mitchell, M.D., Slone Epidemiology Center, Boston University, 1010 Commonwealth Avenue, Boston, MA 02215, USA, Tel: (617) 734 6006, Fax: (617) 738 5119, e-mail: E-mail: amitchell@slone.bu.edu. Conflict of interest: None CAPSULE:The higher incidence of gestational hypertension and preeclampsia in pregnancies resulting from infertility treatments is largely explained by the higher frequency of multiple gestations.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-Pregnancies resulting from infertility treatments have a higher incidence of gestational hypertension and preeclampsia than spontaneous conceptions. This increased risk is largely explained by the higher frequency of multiple gestations. NIH Public Access

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Case-Control Study of Severe Pre-eclampsia of Early Onset

Cited by 13 publications

References 9 publications

Risk of Preeclampsia in First and Subsequent Pregnancies: Prospective Cohort Study

Risk of Preeclampsia in First and Subsequent Pregnancies: Prospective Cohort Study

Alterations in Placental Growth Factor Levels before and after the Onset of Preeclampsia Are More Pronounced in Women with Early Onset Severe Preeclampsia

Gestational hypertension in pregnancies supported by infertility treatments: role of infertility, treatments, and multiple gestations

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