Pregnancy hypertension · 2025
Subsequent pregnancy following severe hypertensive disorders of pregnancy.
СтатьяНазвание и аннотация: Перевод в очереди
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Dori-Dayan Nimrod, Zloto Keren, Yoeli-Ullman Rakefet, Mazaki-Tovi Shali, Tsur Abraham, Bar-Adon Sonya, Ofir Keren, Sivan Eyal, Sibai Baha M, Bartal Michal Fishel
Аннотация
BACKGROUND: The impact of the severity of hypertensive disorders of pregnancy (HDP), as defined by current criteria, on future pregnancy outcomes is inadequately described.
OBJECTIVE: This study evaluated the outcomes of subsequent pregnancies following an initial pregnancy complicated by HDP and assessed the influence of disease severity on the recurrence of HDP (rHDP). This was a retrospective study. Data were analyzed for individuals with singleton first pregnancy complicated by HDP and a documented subsequent singleton pregnancy. The primary outcome was rHDP.
RESULTS: 1035 individuals met inclusion criteria, of whom 981 (95 %) without severe features (SF) while 54 (5 %) had HDP with SF in the first pregnancy. HDP recurred in 32.6 % of subsequent pregnancies. The rate of rHDP and rHDP with SF was higher among those with a prior history of HDP with SF compared to those without SF (61 %vs31% p < 0.01, and 43 %vs5%, p < 0.01, respectively). The incidence of subsequent adverse pregnancy outcomes was higher among individuals with HDP with SF in their first pregnancy compared to those without SF (70 %vs37% p < 0.01). Multivariable regression analysis identified a history of preterm birth (22.3 %vs11.5 %, OR2.24, 95 %CI 1.49, 3.36) and HDP with SF (6.2 %vs4.7 %, OR2.85, 95 %CI 1.6, 5.1) in the first pregnancy as independent risk factors for rHDP.
CONCLUSION: Four out of ten individuals with a history of HDP experience rHDP in their subsequent pregnancy. A history of severe disease and preterm birth in the first pregnancy is associated with a higher rate of rHDP.
CONDENSATION: A history of severe disease and preterm birth in the first pregnancy is associated with a higher rate of recurrent hypertensive disorders in pregnancy.
OBJECTIVE: This study evaluated the outcomes of subsequent pregnancies following an initial pregnancy complicated by HDP and assessed the influence of disease severity on the recurrence of HDP (rHDP). This was a retrospective study. Data were analyzed for individuals with singleton first pregnancy complicated by HDP and a documented subsequent singleton pregnancy. The primary outcome was rHDP.
RESULTS: 1035 individuals met inclusion criteria, of whom 981 (95 %) without severe features (SF) while 54 (5 %) had HDP with SF in the first pregnancy. HDP recurred in 32.6 % of subsequent pregnancies. The rate of rHDP and rHDP with SF was higher among those with a prior history of HDP with SF compared to those without SF (61 %vs31% p < 0.01, and 43 %vs5%, p < 0.01, respectively). The incidence of subsequent adverse pregnancy outcomes was higher among individuals with HDP with SF in their first pregnancy compared to those without SF (70 %vs37% p < 0.01). Multivariable regression analysis identified a history of preterm birth (22.3 %vs11.5 %, OR2.24, 95 %CI 1.49, 3.36) and HDP with SF (6.2 %vs4.7 %, OR2.85, 95 %CI 1.6, 5.1) in the first pregnancy as independent risk factors for rHDP.
CONCLUSION: Four out of ten individuals with a history of HDP experience rHDP in their subsequent pregnancy. A history of severe disease and preterm birth in the first pregnancy is associated with a higher rate of rHDP.
CONDENSATION: A history of severe disease and preterm birth in the first pregnancy is associated with a higher rate of recurrent hypertensive disorders in pregnancy.