Article

Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy.

Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
Best practice & research. Clinical obstetrics & gynaecology (Impact Factor: 1.87). 02/2011; 25(4):391-403. DOI: 10.1016/j.bpobgyn.2011.01.006
Source: PubMed

ABSTRACT Hypertensive disorders of pregnancy include chronic hypertension, gestational hypertension, pre-eclampsia and chronic hypertension with superimposed pre-eclampsia. Pre-eclampsia complicates about 3% of pregnancies, and all hypertensive disorders affect about five to 10% of pregnancies. Secular increases in chronic hypertension, gestational hypertension and pre-eclampsia have occurred as a result of changes in maternal characteristics (such as maternal age and pre-pregnancy weight), whereas declines in eclampsia have followed widespread antenatal care and use of prophylactic treatments (such as magnesium sulphate). Determinants of pre-eclampsia rates include a bewildering array of risk and protective factors, including familial factors, sperm exposure, maternal smoking, pre-existing medical conditions (such as hypertension, diabetes mellitus and anti-phospholipid syndrome), and miscellaneous ones such as plurality, older maternal age and obesity. Hypertensive disorders are associated with higher rates of maternal, fetal and infant mortality, and severe morbidity, especially in cases of severe pre-eclampsia, eclampsia and haemolysis, elevated liver enzymes and low platelets syndrome.

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    ABSTRACT: To compare the risk factors as well as maternal and perinatal outcomes between women with eclampsia to those with mild and severe preeclampsia.MethodsA retrospective study comparing pregnancy outcomes of women with preeclampsia (mild and severe) with those who were complicated with eclampsia was conducted. Statistical analysis included chi-square test for trend (the linear-by-linear association test).ResultsThe study population consisted of 10,018 women, 0.5% (n = 52) suffered from eclampsia, 24% (n = 2,409) had severe preeclampsia and 75.4% (n = 7,557) had mild preeclampsia. A significant linear association was noted between the three groups (eclampsia, severe preeclampsia and mild preeclampsia) and risk factors such as nulliparity, young maternal age and oligohydramnios. A significant linear association was also documented between the three groups and adverse obstetric and perinatal outcomes such as post-partum hemorrhage, the need for blood transfusion, non reassuring fetal heart rate (NRFHR) patterns, low Apgar score at 5 min and perinatal mortality.Conclusions An unfavorable slope was noted in the rate of certain risk factors and adverse perinatal outcomes between women with eclampsia through patients with severe preeclampsia to those with mild preeclampsia.
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