Key result
In pregnant women with chronic arterial hypertension, stage 2 hypertension in the 1st trimester was a significant risk factor for developing moderate (OR 2.1) and severe (OR 3.1) preeclampsia.
Why the study?
Data were lacking on risk factors for the development of preeclampsia of varying severity in women with chronic arterial hypertension.
What are the medical and biological risk factors for the development of preeclampsia of varying severity in pregnant women with chronic arterial hypertension?
Observational (n=254)
What are the medical and biological risk factors for the development of preeclampsia of varying severity in pregnant women with chronic arterial hypertension?
Identifying risk factors such as stage 2 hypertension, elevated mean BP, and history of urinary tract infections in the first trimester can help predict and potentially prevent the development of preeclampsia in pregnant women with chronic arterial hypertension.
May inform early preeclampsia risk stratification in chronic hypertension; hypothesis-generating and requires prospective validation before guiding care.
Introduction. Preeclampsia (PE) develops in 20% of women with chronic arterial hypertension (CAH). This is associated with increased maternal and perinatal morbidity compared to de novo PE. There are no data on risk factors for the addition of PE of varying severity to CAH, which confirms the relevance of this study. The aim of the study was to clarify the medical and biological risk factors for the development of preeclampsia of varying severity in patients with CAH. Methods. Clinical and statistical. Data were copied from medical records. The study was conducted with the participation of 254 patients (147 pregnant women with CAH, 62 with moderate preeclampsia on the background of CAH, 45 with severe preeclampsia on the background of CAH). The quantitative description of the values with a normal distribution was carried out using an arithmetic value and an arithmetic mean error (M±m). Results. Risk factors for the addition of moderate and severe PE to CAH, determined in the 1st trimester of pregnancy, are: stage 2 hypertension (OR=2.1; 95% CI 1.7—6.2; OR=3.1; 95% CI 2.8—7.4) with target organ damage, retinal angiopathy I b degree (OR=4.0; 95% CI 3.6—16.9; OR=1.8; 95% CI 1.2—5.3), urinary tract infections in history (OR=2.32; 95% CI 1.7—6.4; OR=3.2; 95% CI 2.4—10.4), mean BP above 95 mmHg. upon registration (OR=3.2; 95% CI 1.5—14.9; OR=4.9; 95% CI 1.7—41.2). Additional risk factors for moderate PE are unregistered marriage (OR=1.6; 95% CI 1.05—4.1), smoking (OR=2.3; 95% CI 1.2—18.2), irregular use antihypertensive drugs before pregnancy (OR=1.7; 95% CI 1.2—4.1); severe PE — no antihypertensive therapy in the 1st trimester of pregnancy (OR=2.3; 95% CI 1.5—6.4), duration of hypertension for more than 5 years (OR=3.3; 95% CI 1.2—4, 1), preeclampsia in the anamnesis (OR=2.0; 95% CI 1.3—5.5). Conclusion. Timely correction of modifiable risk factors and prevention of PE will improve maternal and perinatal outcomes in women with CAH.
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Panova et al. (2024) conducted an observational in Chronic arterial hypertension in pregnancy (n=254). Stage 2 hypertension with target organ damage vs. Absence of stage 2 hypertension was evaluated on Development of moderate preeclampsia (OR 2.1, 95% CI 1.7-6.2). In pregnant women with chronic arterial hypertension, stage 2 hypertension in the 1st trimester was a significant risk factor for developing moderate (OR 2.1) and severe (OR 3.1) preeclampsia.
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