Wadhwani Pooja, Saha Pradip Kumar, Kalra Jaswinder Kaur, Gainder Shalini, Sundaram Venkataseshan
Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Neonatology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Obstet Gynecol Sci. 2020 May;63(3):270-277. doi: 10.5468/ogs.2020.63.3.270. Epub 2020 Apr 3.
The risk factors, clinical trends, and maternal and fetal health of early- and late-onset preeclampsia have not been adequately studied. We examined the effects of early- and late-onset preeclampsia on maternal and perinatal outcomes as well as the known risk factors of preeclampsia.
One hundred and fifty women with preeclampsia were consecutively enrolled in each group. Those who developed preeclampsia before 34 weeks of gestation were identified as having early-onset preeclampsia, while those who developed at 34 weeks or later were identified as having late-onset preeclampsia. Maternal and perinatal outcomes were compared between groups.
Compared with the late-onset group, the early-onset group had higher rates of abruptio placentae (16% vs. 7.3%; =0.019), but there was no intergroup difference in the composite maternal outcomes. A significantly higher number of women with early-onset preeclampsia developed severe features during the disease course, and most required treatment with antihypertensive drugs. Late-onset preeclampsia was more prevalent among primigravid mothers. Babies born to mothers with early-onset preeclampsia had a significantly higher rate of adverse outcomes.
These study findings indicate that women with early-onset preeclampsia had more adverse outcome than those with late-onset preeclampsia, but the difference was not statistically significant. There were more babies with adverse perinatal outcomes in the early-than late-onset group.
早发型和晚发型子痫前期的危险因素、临床趋势以及母婴健康尚未得到充分研究。我们研究了早发型和晚发型子痫前期对母婴结局的影响以及子痫前期的已知危险因素。
每组连续纳入150例子痫前期患者。妊娠34周前发生子痫前期的患者被确定为早发型子痫前期,而在34周及以后发生的患者被确定为晚发型子痫前期。比较两组的母婴结局。
与晚发型组相比,早发型组胎盘早剥发生率更高(16%对7.3%;P=0.019),但母婴综合结局的组间差异无统计学意义。早发型子痫前期患者在病程中出现严重症状的人数明显更多,且大多数需要使用降压药物治疗。晚发型子痫前期在初产妇中更为常见。早发型子痫前期母亲所生婴儿的不良结局发生率明显更高。
这些研究结果表明,早发型子痫前期患者的不良结局比晚发型子痫前期患者更多,但差异无统计学意义。早发型组围产期不良结局的婴儿比晚发型组更多。