[Analysis of maternal and fetal outcomes and related factors of recurrence in women with a history of pre-eclampsia].

Objective: To investigate the maternal and neonatal outcomes of women with a history of pre-eclampsia (PE) and the risk factors for recurrence. Methods: A total of 176 singleton pregnant women with a history of PE who received regular prenatal examination and hospitalized for delivery in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to December 2024 were collected. According to the pregnancy outcome, they were divided into normal pregnancy group (92 cases) and recurrent pregnancy group (84 cases, including 45 cases of recurrent PE and 39 cases of gestational hypertension). The previous pregnancy, general condition and pregnancy outcomes of the current pregnancy were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors of hypertensive disorder in pregnancy in pregnant women with a history of PE. Results: (1) Previous pregnancy: there were no significant differences in the incidence of gestational age≥28 weeks, early onset PE, severe PE, hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP syndrome), delivery mode in the previous pregnancy, neonatal survival rate and fetal growth restriction between the normal pregnancy group and the recurrent pregnancy group (all P>0.05). (2) The current pregnancy: the pre-pregnancy body mass index (BMI) of the normal pregnancy group was significantly lower than that of the recurrent pregnancy group [(23.0±3.8) vs (25.6±4.7) kg/m2, P=0.014], and there were no significant differences in other general data between the two groups (all P>0.05). The neonatal birth weight in the normal pregnancy group was significantly higher than that in the recurrent pregnancy group [(3 280±586) vs (3 020±700) g, P=0.010], and the incidence of fetal growth restriction was significantly lower than that in the recurrent pregnancy group [5.4% (5/92) vs 19.0% (16/84), P=0.005]. However, there were no significant differences in the mode of delivery, gestational age at delivery, full-term delivery rate, the same gender as the previous pregnancy, neonatal asphyxia, placental abruption, and postpartum hemorrhage between the two groups (all P>0.05). (3) Multivariate analysis: after adjusting the confounding factors, including previous gestational age of PE onset, previous early onset PE, previous severe PE, previous HELLP syndrome, maternal age, weight gain during pregnancy, delivery interval, mode of conception, use of low-dose aspirin, and gestational diabetes mellitus, the results showed that pre-pregnancy BMI was an independent risk factor for recurrence of hypertensive disorders in pregnancy (OR=1.12, 95%CI: 1.03-1.22; P=0.008). Conclusions: Women with a history of PE are prone to develop hypertensive disorders in pregnancy again. Controlling pre-pregnancy BMI could significantly reduce the recurrence rate. Attention should be paid to the occurrence of fetal growth restriction during pregnancy.