Recurrence rates of preeclampsia over the past 20 years in women assessed for non-pregnant cardiovascular risk factors

Abstract

Objective: Several efforts to reduce recurrent preeclampsia have been implemented in clinical practice in the past decades. We assessed whether recurrence rates of preeclampsia and related offspring complications decreased in the past 20 years in women who received tailored preventive advices.

Study design: In this observational cohort study, we included 752 women who had their first pregnancy complicated by preeclampsia between 1996 and 2012, and who participated in a non-pregnant risk factor assessment. A questionnaire was sent to women to follow-up on their next pregnancy outcome.

Main outcome measures: Prevalence of preeclampsia and related offspring complications in the subsequent pregnancy.

Results: 467 (62%) women responded to the questionnaire of which two-thirds had a subsequent ongoing pregnancy. Recurrent preeclampsia occurred in 29% of women who delivered between 1997 and 2004, in 20% of women who delivered between 2005 and 2009, and in 24% of women who delivered between 2010 and 2016 (overall p-value = 0.319). Combined maternal complications did not change over time (OR 0.98 per year, 95% CI 0.93-1.04, p-value = 0.503). Offspring complications in the subsequent pregnancy decreased over time with an OR of 0.92 (95% CI 0.86-0.98, p = 0.009) per year.

Conclusion: Recurrence rates of preeclampsia did not decrease over the past 20 years in women who have been extensively assessed on cardiovascular risk factors. In the same period, foetal and neonatal outcomes improved substantially. Efforts to extend and improve strategies to reduce recurrence risk of preeclampsia still seem to be necessary.

Keywords: Cardiovascular assessment; Metabolic syndrome; Preeclampsia; Recurrent disease.