Startseite Clinical differences between early- and late-onset severe preeclampsia and analysis of predictors for perinatal outcome
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Clinical differences between early- and late-onset severe preeclampsia and analysis of predictors for perinatal outcome

  • Johannes Stubert EMAIL logo , Stefanie Ullmann , Max Dieterich , Doreen Diedrich und Toralf Reimer
Veröffentlicht/Copyright: 26. April 2014

Abstract

Aims: To analyze the clinical differences between early- and late-onset cases of severe preeclampsia and to evaluate parameters that could help to predict perinatal outcome.

Methods: Over a period of 6 years, all cases of severe preeclampsia (n=68) at our institution were included in a retrospective cohort analysis. Differences between early (<34 weeks, n=44) and late (≥34 weeks, n=24) onset of the disease were evaluated. Risk factors for low 5-min Apgar score (≤7), small-for-gestational-age (SGA) infants and neonatal acidosis (umbilical arterial pH <7.20) were identified and considered in a multiple logistic regression model.

Results: Early- and late-onset severe preeclampsia differed from each other remarkably. Perinatal outcome was unfavorable in early-onset disease and seemed to be mainly a result of premature delivery and development of fetal growth restriction. Abnormal uterine Doppler velocimetry increased the risk of low 5-min Apgar values [odds ratio (OR) 8.0, P=0.012] and preterm birth <34+0 weeks (OR 17.9, P<0.001). An increased resistance of the umbilical artery was associated with a higher risk for SGA birth weight (OR 4.9, P=0.010).

Conclusion: Preeclampsia is a heterogeneous syndrome even if only severe cases were analyzed. Abnormal Doppler flow characteristics facilitated the identification of patients who were at increased risk for worse perinatal outcome.


Corresponding author: Johannes Stubert, MD, Department of Obstetrics and Gynecology, University of Rostock, Suedring 81, 18059 Rostock, Germany, Tel.: +49 38144018475, Fax: +49 38144014599, E-mail:

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-10-21
Accepted: 2014-1-6
Published Online: 2014-4-26
Published in Print: 2014-9-1

©2014 by De Gruyter

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