Takeaway
- In healthy nulliparous pregnant women, ≥0.75 kg weight gain each week, obesity and diastolic blood pressure (DBP) ≥75 mmHg at 20 weeks of gestation were associated with an increased risk for preeclampsia.
- Pre-eclampsia also led to a higher number of caesarean delivery, prolonged hospitalisation and poor neonatal outcomes.
Why this matters
- Findings add support to other studies, showing an increased frequency of Caesarean sections, preterm births, neonatal near misses, 5-minute Apgar scores less than 7 and low birth weight in pregnancies complicated by preeclampsia.
Study design
- This case-control study of 1165 preterm nulliparous pregnant women (19-21 weeks of gestation) derived from a secondary analysis of Preterm SAMBA study included 87 cases of pre-eclampsia matched with 1078 controls.
- Funding: Preterm SAMBA was supported by the Bill and Melinda Gates Foundation and the Brazilian CNPq.
Key results
- The incidence of preeclampsia was 7.5% in a nulliparous group of healthy pregnant women.
- Factors associated with an increased risk of development of pre-eclampsia included:
- weight gain rate ≥0.75 kg/week (risk ratio [RR], 2.04; 95% CI, 1.12-3.69),
- obesity (BMI>30.9 kg/m2) (RR, 2.28; 95% CI, 1.39-3.74), and
- DBP ≥75 mmHg at 20 weeks of gestation (RR, 2.21; 95% CI, 1.30-3.74).
- Pre-eclampsia led to a higher risk for adverse maternal outcomes:
- Caesarean delivery (RR, 5.30; 95% CI, 1.25-22.38),
- Hospitalisation, ≥5 days (RR, 5.80; 95% CI, 2.12-15.91), and
- Preterm birth <34 weeks of gestation (RR, 3.97; 95% CI, 1.55-10.20).
- In addition, it led to poor perinatal outcomes which included:
- lower birth weight (mean 379 g lower),
- small for gestational age (RR, 2.45; 95% CI, 1.52-3.95),
- 5-minute Apgar score less than 7 (RR, 2.11; 95% CI, 1.03-4.29),
- neonatal intensive care unit admission (RR, 3.34; 95% CI, 1.61-6.9), and
- neonatal near miss (RR, 3.65; 95% CI, 1.78-7.49).
Limitations
- Risk of potential bias.
References
References
