Is a history of preeclampsia associated with an increased risk of a small for gestational age infant in a future pregnancy? Am J Obstet Gynecol 2016 Sep;215(3):355.e1-6
Date
03/21/2016Pubmed ID
26994655DOI
10.1016/j.ajog.2016.03.011Scopus ID
2-s2.0-84963877872 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
BACKGROUND: A history of preeclampsia is associated with an increased risk of subsequent preeclampsia, but it is unclear whether women with prior preeclampsia are at increased risk of having a small-for-gestational-age infant in their subsequent pregnancy, even if they do not develop preeclampsia.
OBJECTIVE: The objective of this study was to evaluate whether women with preeclampsia in a prior pregnancy are at increased risk of having a pregnancy complicated by a small-for-gestational-age infant, even in the absence of recurrent preeclampsia.
STUDY DESIGN: This was a secondary analysis of data from 2 multicenter, randomized controlled trials evaluating the role of aspirin in preeclampsia prevention in healthy nulliparas and women at high risk of preeclampsia (ie, with chronic hypertension or a history of preeclampsia). Women who developed preeclampsia in a subsequent pregnancy and women with pregestational diabetes or with a multiple gestation were excluded. The association between a history of preeclampsia and the subsequent birth of a small-for-gestational-age infant was determined in both a univariable and multivariable analysis.
RESULTS: A total of 4052 women were included in the analysis: 2972 healthy nulliparas, 499 women with a history of preeclampsia, and 581 women with chronic hypertension. The frequency of delivery of a small-for-gestational-age infant significantly differed by clinical history (5.1% vs 9.2% vs 12.1% in healthy nulliparas, women with a history of preeclampsia, and women with chronic hypertension, respectively, P < .001). Compared with healthy nulliparas, a history of preeclampsia was associated with a significantly increased odds for a small-for-gestational-age infant, even if recurrent preeclampsia did not occur (adjusted odds ratio, 1.48, 95% confidence interval, 1.02-2.17).
CONCLUSION: Even in the absence of recurrent preeclampsia, women with a history of preeclampsia are at a higher risk of delivering a small-for-gestational-age infant in a subsequent pregnancy.
Author List
Palatnik A, Grobman WA, Miller ESAuthor
Anna Palatnik MD Associate Professor in the Obstetrics and Gynecology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultFemale
Humans
Infant, Newborn
Infant, Small for Gestational Age
Multivariate Analysis
Parity
Pre-Eclampsia
Pregnancy
Randomized Controlled Trials as Topic
Risk Factors
Young Adult