Pregnancy hypertension · 2026
Divergent profiles in early and late postpartum preeclampsia.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Matot Ran, Narkis Bar, Geron Yossi, Hendin Natav, Houri Ohad, Hazan Shiri Barabash, Hadar Eran, Shmueli Anat
Аннотация
OBJECTIVE: To investigate the differential clinical characteristics and perinatal outcomes of early (≤48 h) versus late (>48 h-6 wk) postpartum preeclampsia (PP-PE) in a large retrospective cohort.
STUDY DESIGN: Single-centre retrospective cohort study. Women with severe-feature PP-PE were classified as early (n = 121) or late (n = 26). Controls were healthy postpartum women (n = 658) and those with severe ante-partum PE (AP-PE; n = 494). Multivariable logistic regression adjusted for age, parity and other significant covariates.
MAIN OUTCOME MEASURES: Comparing maternal comorbidities, mode of delivery and obstetrical complications.
RESULTS: Versus healthy controls, PP-PE showed more chronic hypertension (26.5% vs 13.2%, p < 0.01), gestational hypertension (13.6% vs 1.7%, p < 0.01) and gestational diabetes (22.4% vs 12.3%, p < 0.01). Early PP-PE had higher Cesarean (74.4% vs 46.2%, p = 0.02) and preterm birth rates (33.1% vs 16.0%, p = 0.09) than late PP-PE. Early disease independently increased odds of Cesarean (adjusted odds ratio [aOR] 9.3, 95% CI 4.8-17.8) and prematurity (aOR 3.5, 1.9-6.3); late disease was strongly linked to chronic hypertension (aOR 4.6, 1.9-10.8). Compared with AP-PE, chronic hypertension was lower in early PP-PE (23.1% vs 43.5%, p < 0.01) but similar in late PP-PE; small for gestational age infants were fewer in late PP-PE (3.8% vs 15.0%, p = 0.01).
CONCLUSIONS: Our findings suggest that early and late PP-PE may reflect distinct clinical phenotypes. While early PP-PE shares features with placental dysfunction, late PP-PE appears more closely linked to chronic hypertension. These differences warrant further investigation in larger prospective studies.
STUDY DESIGN: Single-centre retrospective cohort study. Women with severe-feature PP-PE were classified as early (n = 121) or late (n = 26). Controls were healthy postpartum women (n = 658) and those with severe ante-partum PE (AP-PE; n = 494). Multivariable logistic regression adjusted for age, parity and other significant covariates.
MAIN OUTCOME MEASURES: Comparing maternal comorbidities, mode of delivery and obstetrical complications.
RESULTS: Versus healthy controls, PP-PE showed more chronic hypertension (26.5% vs 13.2%, p < 0.01), gestational hypertension (13.6% vs 1.7%, p < 0.01) and gestational diabetes (22.4% vs 12.3%, p < 0.01). Early PP-PE had higher Cesarean (74.4% vs 46.2%, p = 0.02) and preterm birth rates (33.1% vs 16.0%, p = 0.09) than late PP-PE. Early disease independently increased odds of Cesarean (adjusted odds ratio [aOR] 9.3, 95% CI 4.8-17.8) and prematurity (aOR 3.5, 1.9-6.3); late disease was strongly linked to chronic hypertension (aOR 4.6, 1.9-10.8). Compared with AP-PE, chronic hypertension was lower in early PP-PE (23.1% vs 43.5%, p < 0.01) but similar in late PP-PE; small for gestational age infants were fewer in late PP-PE (3.8% vs 15.0%, p = 0.01).
CONCLUSIONS: Our findings suggest that early and late PP-PE may reflect distinct clinical phenotypes. While early PP-PE shares features with placental dysfunction, late PP-PE appears more closely linked to chronic hypertension. These differences warrant further investigation in larger prospective studies.