University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Am J Obstet Gynecol. 2011 Apr;204(4):345.e1-6. doi: 10.1016/j.ajog.2010.11.027. Epub 2011 Feb 26.
We sought to compare the rates of superimposed preeclampsia and adverse outcomes in women with chronic hypertension with or without prior preeclampsia.
We conducted secondary analysis of 369 women with chronic hypertension (104 with prior preeclampsia) enrolled at 12-19 weeks as part of a multisite trial of antioxidants to prevent preeclampsia (no reduction was found). Outcome measures were rates of superimposed preeclampsia and other adverse perinatal outcomes.
Prepregnancy body mass index, blood pressure, and smoking status at enrollment were similar between groups. The rates of superimposed preeclampsia (17.3% vs 17.7%), abruptio placentae (1.0% vs 3.1%), perinatal death (6.7% vs 8.7%), and small for gestational age (18.4% vs 14.3%) were similar between groups, but preterm delivery <37 weeks was higher in the prior preeclampsia group (36.9% vs 27.1%; adjusted risk ratio, 1.46; 95% confidence interval, 1.05-2.03; P = .032).
In women with chronic hypertension, a history of preeclampsia does not increase the rate of superimposed preeclampsia, but is associated with an increased rate of delivery at <37 weeks.
我们旨在比较慢性高血压伴或不伴既往子痫前期的女性中重叠子痫前期和不良结局的发生率。
我们对 369 名慢性高血压女性（104 名有既往子痫前期）进行了二次分析，这些女性在 12-19 周时作为抗氧化剂预防子痫前期的多中心试验的一部分被纳入（未发现降低）。结局指标为重叠子痫前期和其他不良围产结局的发生率。
两组孕妇的孕前体重指数、血压和入组时的吸烟状况相似。重叠子痫前期的发生率（17.3%与 17.7%）、胎盘早剥（1.0%与 3.1%）、围产儿死亡（6.7%与 8.7%）和胎儿生长受限（18.4%与 14.3%）相似，但既往子痫前期组的早产<37 周发生率较高（36.9%与 27.1%；调整风险比，1.46；95%置信区间，1.05-2.03；P=0.032）。
在慢性高血压女性中，既往子痫前期史不会增加重叠子痫前期的发生率，但与<37 周分娩的发生率增加相关。
