Evaluation of a definition of pre-eclampsia

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dc.contributor.author North, RA en
dc.contributor.author Taylor, Rennae en
dc.contributor.author Schellenberg, JC en
dc.date.accessioned 2011-12-14T01:38:29Z en
dc.date.issued 1999-08 en
dc.identifier.citation British Journal of Obstetrics and Gynaecology 106(8):767-773 Aug 1999 en
dc.identifier.issn 1470-0328 en
dc.identifier.uri http://hdl.handle.net/2292/10025 en
dc.description.abstract Objectives To determine: 1. whether an alternative definition of gestational hypertension and preeclampsia stratifies women according to their risk of maternal and fetal complications; 2. whether pregnancy outcome in women with gestational hypertension differs in the presence or absence of '+' proteinuria; and 3. whether a blood pressure rise of greater than or equal to 30/15 mmHg during pregnancy is associated with adverse outcome in women who remain normotensive.Design Prospective, nested case-control study.Setting Community based.Population Healthy, nulliparous women (n = 1496).Methods Women recruited into a study investigating serum markers predictive of pre-eclampsia were classified as having gestational hypertension (systolic blood pressure greater than or equal to 140 mmHg with a rise of greater than or equal to 30 mmHg and/or diastolic blood pressure greater than or equal to 90 mmHg with a rise of greater than or equal to 15 mmHg) or pre-eclampsia (gestational hypertension plus proteinuria greater than or equal to 2+on dipstick or > 0.3 g/24 h). Maternal and fetal complications in gestational hypertension or pre-eclampsia were compared with a control group of 223 randomly selected normotensive women. The main outcome measures were severe maternal disease, preterm birth and small for gestational age infant.Results A stepwise increase in adverse maternal and fetal outcomes occurred in gestational hypertension (n = 117, 7.8%) and pre-eclampsia (n = 71, 4.8%). Severe maternal disease developed in 26.5% (21.4% severe hypertension alone, 5.1% multisystem disease) of women with gestational hypertension and 63.4% (21.1% severe hypertension alone, 42.3% multisystem disease) of women with preeclampsia (OR 4.8; 95% CI 2.4-9.5). Preterm birth and small for gestational age infants were more frequent in gestational hypertension (OR 1.7; 95% CI 0.5-5.4, and OR 2.0; 95% CI 1.0-3.7, respectively) and pre-eclampsia (OR 14.6; 95% CI 5.8-37.8, and OR 2.6; 95% CI 1.2-5.3) than in the normotensive group. Among women with gestational hypertension severe maternal disease was more common in women with '+' proteinuria (41.7%) than in those with no proteinuria (15.9%): OR 3.8; 95% CI 1.5-9.8. Pregnancies were uncomplicated in the 27% of normotensive women who had a rise of 2 30 mmHg systolic blood pressure and/or 2 15 mmHg rise in diastolic blood pressure.Conclusions In the nulliparous population studied our definition of gestational hypertension and preeclampsia identified women at increasing risk of maternal and fetal complications. In gestational hypertension, the presence of proteinuria '+' was associated with a 3.8-fold increase in severe maternal disease. Normotensive women who have a rise in blood pressure greater than or equal to 30/15 mmHg had uncomplicated pregnancies. en
dc.language EN en
dc.publisher BLACKWELL SCIENCE LTD en
dc.relation.ispartofseries BJOG: An International Journal of Obstetrics and Gynaecology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject HYPERTENSIVE PREGNANCY en
dc.subject BLOOD-PRESSURE en
dc.subject PROTEINURIA en
dc.subject CLASSIFICATION en
dc.subject POPULATION en
dc.subject DISORDERS en
dc.title Evaluation of a definition of pre-eclampsia en
dc.type Journal Article en
dc.identifier.doi 10.1111/j.1471-0528.1999.tb08396.x en
pubs.issue 8 en
pubs.begin-page 767 en
pubs.volume 106 en
dc.rights.holder Copyright: RCOG 1999 British Journal of Obstetrics and Gynaecology en
pubs.author-url http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.1999.tb08396.x/abstract en
pubs.end-page 773 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 1762 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Obstetrics and Gynaecology en
dc.identifier.eissn 1471-0528 en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 10453825 en


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