Biomedical

Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders








  Peer Reviewed

Abstract

In this retrospective cohort study, we aimed to investigate the variables associated with progression to preeclampsia with severe features in parturients already diagnosed with mild hypertensive disorders of pregnancy. The study was conducted in a single university-affiliated medical center between 2018 and 2020. All women admitted due to hypertensive disorders were included. Data collected was compared between parturients who progressed and did not progress to preeclampsia with severe features. Among 359 women presenting without severe features, 18 (5%) developed severe features, delivered smaller babies at lower gestational age, and with higher rates of cesarean delivery (p < 0.001 for all). Chronic hypertension, maternal diabetes, any previous gestational hypertensive disorder, gestational diabetes, number of hospitalizations, earlier gestational age at initial presentation, and superimposed preeclampsia as the preliminary diagnosis were all associated with preeclampsia progression to severe features. Previous delivery within 2–5 years was a protective variable from preeclampsia progression. Following regression analysis and adjustment to confounders, only gestational age at initial presentation and superimposed preeclampsia remained significant variables associated with progression to severe features (aOR 0.74 (0.55–0.96) and 34.44 (1.07–1111.85), aOR (95% CI), respectively, p < 0.05 for both) with combined ROC-AUC prediction performance of 0.89, 95% CI 0.83–0.95, p < 0.001. In conclusion, according to our study results, early gestational age at presentation and superimposed preeclampsia as the preliminary diagnosis are the only independent factors that are associated with progression to severe features in women already diagnosed with mild hypertensive disorders during pregnancy.

Key Questions about Progression to Severe Preeclampsia in Mild Hypertensive Disorders

The article "Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders" by Sivan Barda et al. investigates variables linked to the development of severe preeclampsia in pregnant women initially diagnosed with mild hypertensive disorders. Conducted at a university-affiliated medical center between 2018 and 2020, the study analyzed data from women admitted due to hypertensive disorders. The findings highlight specific factors that may predict the progression to severe preeclampsia, providing valuable insights for clinical management.

What are mild hypertensive disorders in pregnancy, and how do they differ from severe preeclampsia?

Mild hypertensive disorders in pregnancy include conditions such as gestational hypertension, where elevated blood pressure occurs without significant proteinuria or other severe symptoms. In contrast, severe preeclampsia is characterized by high blood pressure accompanied by significant proteinuria and other complications, posing greater risks to both mother and fetus.

What factors are associated with the progression from mild hypertensive disorders to severe preeclampsia?

The study identifies specific variables that may predict the development of severe preeclampsia in women with mild hypertensive disorders. These factors are crucial for early identification and management to prevent adverse outcomes.

How can the findings of this study inform clinical practice?

By understanding the factors that contribute to the progression of mild hypertensive disorders to severe preeclampsia, healthcare providers can implement targeted monitoring and interventions. This proactive approach aims to improve maternal and fetal health outcomes.

By addressing these questions, the article contributes to a deeper understanding of the progression from mild hypertensive disorders to severe preeclampsia, offering insights that can enhance clinical management and patient care.