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Войти в исследования Pregnancy hypertension · 2026
Predictive value of early pregnancy laboratory markers for recurrence of hypertensive disorders of pregnancy: A retrospective study.
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Salameh Mohammad A, Li Yan, Jordan Deondre, Kattah Andrea G
Аннотация
OBJECTIVE: Recurrence of hypertensive disorders of pregnancy (HDP) is linked to increased complications, but progress in reducing recurrence has been limited. Lasting vascular or metabolic changes after prior HDP may raise risk and could appear as subtle abnormalities in early pregnancy lab values. This study examined associations between early pregnancy labs and HDP recurrence or adverse perinatal outcomes in individuals with a history of HDP.
STUDY DESIGN: We conducted a retrospective study of individuals with an index pregnancy complicated by HDP and a subsequent pregnancy with delivery >20 weeks within a single health system (2010-2022). Early pregnancy labs before 20 weeks including serum creatinine, urine protein-to-creatinine ratio (UPCR), platelet count, and liver enzymes were collected. Multivariable logistic regression assessed associations with HDP recurrence, preterm birth, and low birthweight. Models adjusted for HDP severity and gestational age at index delivery, maternal comorbidities among other factors. Receiver operating characteristic curves evaluated predictive performance.
RESULTS: Among 2,499 pregnancies with HDP history, recurrence occurred in 40.6% of subsequent pregnancies; preterm birth in 11.5%, and low birthweight in 8.1%. Higher platelet count was associated with HDP recurrence (p < 0.01). UPCR and liver enzymes were associated with preterm birth (p < 0.01). Creatinine was not associated with any outcome. All markers showed limited predictive performance.
CONCLUSION: In those with prior HDP, early pregnancy labs were associated with recurrence and adverse outcomes, possibly reflecting ongoing inflammation or metabolic disruption. While not strong predictors alone, these markers may contribute to broader risk stratification strategies to guide counseling in early pregnancy.
STUDY DESIGN: We conducted a retrospective study of individuals with an index pregnancy complicated by HDP and a subsequent pregnancy with delivery >20 weeks within a single health system (2010-2022). Early pregnancy labs before 20 weeks including serum creatinine, urine protein-to-creatinine ratio (UPCR), platelet count, and liver enzymes were collected. Multivariable logistic regression assessed associations with HDP recurrence, preterm birth, and low birthweight. Models adjusted for HDP severity and gestational age at index delivery, maternal comorbidities among other factors. Receiver operating characteristic curves evaluated predictive performance.
RESULTS: Among 2,499 pregnancies with HDP history, recurrence occurred in 40.6% of subsequent pregnancies; preterm birth in 11.5%, and low birthweight in 8.1%. Higher platelet count was associated with HDP recurrence (p < 0.01). UPCR and liver enzymes were associated with preterm birth (p < 0.01). Creatinine was not associated with any outcome. All markers showed limited predictive performance.
CONCLUSION: In those with prior HDP, early pregnancy labs were associated with recurrence and adverse outcomes, possibly reflecting ongoing inflammation or metabolic disruption. While not strong predictors alone, these markers may contribute to broader risk stratification strategies to guide counseling in early pregnancy.