The clinical characteristics and maternal and neonatal outcomes of early and late onset preeclampsia

doi:10.3877/cma.j.issn.2095-3259.2021.02.007

Abstract

Abstract:

Objective

To analyze the clinical characteristics and maternal and perinatal outcomes of early and late onset preeclampsia.

Methods

2693 pregnant women with preeclampsia who delivered in the Third Affiliated Hospital of Guangzhou Medical University from 2015 to 2020 were recruited. The clinical characteristics and maternal and neonatal outcomes of early onset (873 cases) and late onset preeclampsia (1820 cases) were analyzed.

Results

The gravidity(2.68±1.58 vs 2.27±1.38, Z=-6.80, P<0.05), patients referred to hospital(42% vs 6.3%, χ²=519.02, P<0.05), and patients with chronic hypertension(2.4% vs 0.8%, χ²=12.31, P<0.05) were higher in the early onset preeclampsia group than the late onset preeclampsia group (P<0.05). The rate of cesarean section(77.8% vs 60.1%, χ²=82.35, P<0.05), placental abruption(0.9% vs 0.3%, χ²=3.93, P<0.05), admission to ICU(9.7% vs 2.4%, χ²=69.3, P<0.05) and hospitalization days [(9.44±4.76) vs (6.30±5.15), Z=-20.52, P<0.05] were significantly higher in the early onset preeclampsia group. The incidence of stillbirth(22.3% vs 0.8%, χ²=381.1, P<0.05) and neonatal death was higher in the early onset preeclampsia than the late onset preeclampsia group.

Conclusions

The clinical characteristics, maternal and perinatal outcomes of patients complicated with early onset preeclampsia and late onset preeclampsia are different. From the perspective of clinical characteristics, maternal and perinatal outcomes, the two types of preeclampsia should be treated differently.

Key words: Pre-eclampsia, Pregnant women, Pregnancy outcome

Shilei Bi, Lizi Zhang, Lili Du, Dunjin Chen. The clinical characteristics and maternal and neonatal outcomes of early and late onset preeclampsia[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(02): 96-100.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhckjjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3259.2021.02.007

https://zhckjjdzzz.cma-cmc.com.cn/EN/Y2021/V10/I02/96

Figures/Tables 3

References 18

[1]	American College of Obestetricians and Gynecologist. Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin, No. 222 [J]．Obstet Gynecol, 2020, 135(6): e237-e260.
[2]	Mol BWJ, Roberts CT, Thangaratinam S, et al. Pre-eclampsia [J]. Lancet, 2016, 387(10022)：999-1011.
[3]	Phipps EA, Thadhant R, Benzing T, et al. Pre-eclampsia: pathogenesis, novel diagnostics and therapies [J]. Nat Rev Nephrol, 2019, 15(5): 275-289.
[4]	Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease [J]. Am J Obstet Gynecol, 2013, 209(6)：544.e1-e12.
[5]	谢幸，孔北华，段涛．妇产科学 [M].9版，北京：人民卫生出版社，2018：83.
[6]	韩菊香．早发型子痫前期重度妊娠结局的临床分析[J]．实用妇科内分泌杂志，2016，3(3)：131-133.
[7]	成志，王子莲，罗小华，等．不同产前检查情况与重度子痫前期及子痫的临床分析 [J/CD]．中华产科急救电子杂志，2015，4(4)：230-233.
[8]	Seeho SK, Algert CS, Roberts CL, et al. Early-onset preeclampsia appears to discourage subsequent pregnancy but the risks may be overestimated [J]. Am J Obstet Gynecol, 2016, 215(6)：785.e1-e8.
[9]	Jhee JH, Lee S, Park Y, et al. Prediction model development of late-onset preeclampsia using machine learning-based methods [J]. PLoS One, 2019, 14(8)：e0221202.
[10]	Abalos E, Cuesta C, Carroli G, et al. Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health [J]. BJOG, 2014, 121 (Suppl 1)：14-24.
[11]	Abalos E, Cuesta C, Grosso AL, et al. Global and regional estimates of preeclampsia and eclampsia: a systematic review [J]. Eur J Obstet Gynecol Reprod Biol, 2013, 170(1)：1-7.
[12]	Burton GJ, Redman CW, Roberts JM, et al. Pre-eclampsia: pathophysiology and clinical implications [J]. BMJ, 2019, 366：l2381.
[13]	Iacobelli S, Bonsante F, Robillard PY. Comparison of risk factors and perinatal outcomes in early onset and late onset preeclampsia: A cohort based study in Reunion Island [J]. J Reprod Immunol, 2017, 123：12-16.
[14]	Sites CK, Wilson D, Barsky M, et al. Embryo cryopreservation and preeclampsia risk [J]. Fertil Steril, 2017, 108(5): 784-790.
[15]	Gui J, Ling Z, Hou X, et al. In vitro fertilization is associated with the onset and progression of preeclampsia [J]. Placenta, 2020, 89：50-57.
[16]	Ananth CV. Ischemic placental disease: aunifying concept for preeclampsia, intrauterinegrowth restriction, and placental abruption [J]. Semin Perinatol, 2014，38(3)：131-132.
[17]	Lisonkova S, Sabr Y, Mayer C, et al. Maternal morbidity associated with early-onset and late-onset preeclampsia [J]. Obstet Gynecol, 2014, 124(4): 771-781.
[18]	Lisonkova S, Joseph KS. incidence of preeclampsia: risk factors and outcomes associated with early-versus late-onset disease [J]. Am J Obstet Gynecol, 2013，209(6): 544.e1-544.e12.

子痫前期分组	例数	产次[例(%)]		流产次数[例(%)]			孕次(次，±s)	阴道分娩次数[例(%)]
子痫前期分组	例数	0次	≥1次	0次	1次	≥2次	孕次(次，±s)	0次	≥1次
晚发型	1820	1050(57.7)	770(42.3)	1305(71.7)	345(19.0)	170(9.3)	2.27±1.38	1430(78.6)	390(21.4)
早发型	873	412(47.2)	461(52.8)	567(64.9)	183(21.0)	123(14.1)	2.68±1.58	653(74.8)	220(25.2)
统计值		χ²＝38.54		χ²＝17.31			Z＝-6.8	χ²＝4.79
P值		<0.05		<0.05			<0.05	<0.05
子痫前期分组	例数	剖宫产次数[例(%)]		户籍[例(%)]		入院类型[例(%)]			分娩孕周(周，±s)
子痫前期分组	例数	0次	≥1次	广东省内	广东省外	门诊	急诊	转诊	分娩孕周(周，±s)
晚发型	1820	1430(78.6)	390(21.4)	1504(82.6)	316(17.4)	1088(59.8)	617(33.9)	115(6.3)	37.89±1.66
早发型	873	617(70.7)	256(29.3)	665(76.2)	208(23.8)	287(32.9)	219(25.1)	367(42.0)	29.83±3.04
统计值		χ²＝20.17		χ²＝15.73		χ²＝519.02			Z＝-42.12
P值		<0.05		<0.05		<0.05			<0.05
子痫前期分组	例数	产检情况[例(%)]				教育水平[例(%)]		慢性高血压[例(%)]	自然受孕[例(%)]
子痫前期分组	例数	规律	不规律	不产检	不详	大学及以上	大学以下	慢性高血压[例(%)]	自然受孕[例(%)]
晚发型	1820	868(47.8)	879(48.4)	38(2.1)	31(1.7)	1121(62.2)	680(37.8)	14(0.8)	1502(82.5)
早发型	873	287(33.0)	491(56.4)	57(6.6)	35(4.0)	325(37.7)	538(62.3)	21(2.4)	760(87.1)
统计值		χ²＝83.35				χ²＝142.09		χ²＝12.31	χ²＝9.14
P值		<0.05				<0.05		<0.05	<0.05

子痫前期分组	例数	产次[例(%)]		流产次数[例(%)]			孕次(次，±s)	阴道分娩次数[例(%)]
子痫前期分组	例数	0次	≥1次	0次	1次	≥2次	孕次(次，±s)	0次	≥1次
晚发型	1820	1050(57.7)	770(42.3)	1305(71.7)	345(19.0)	170(9.3)	2.27±1.38	1430(78.6)	390(21.4)
早发型	873	412(47.2)	461(52.8)	567(64.9)	183(21.0)	123(14.1)	2.68±1.58	653(74.8)	220(25.2)
统计值		χ²＝38.54		χ²＝17.31			Z＝-6.8	χ²＝4.79
P值		<0.05		<0.05			<0.05	<0.05
子痫前期分组	例数	剖宫产次数[例(%)]		户籍[例(%)]		入院类型[例(%)]			分娩孕周(周，±s)
子痫前期分组	例数	0次	≥1次	广东省内	广东省外	门诊	急诊	转诊	分娩孕周(周，±s)
晚发型	1820	1430(78.6)	390(21.4)	1504(82.6)	316(17.4)	1088(59.8)	617(33.9)	115(6.3)	37.89±1.66
早发型	873	617(70.7)	256(29.3)	665(76.2)	208(23.8)	287(32.9)	219(25.1)	367(42.0)	29.83±3.04
统计值		χ²＝20.17		χ²＝15.73		χ²＝519.02			Z＝-42.12
P值		<0.05		<0.05		<0.05			<0.05
子痫前期分组	例数	产检情况[例(%)]				教育水平[例(%)]		慢性高血压[例(%)]	自然受孕[例(%)]
子痫前期分组	例数	规律	不规律	不产检	不详	大学及以上	大学以下	慢性高血压[例(%)]	自然受孕[例(%)]
晚发型	1820	868(47.8)	879(48.4)	38(2.1)	31(1.7)	1121(62.2)	680(37.8)	14(0.8)	1502(82.5)
早发型	873	287(33.0)	491(56.4)	57(6.6)	35(4.0)	325(37.7)	538(62.3)	21(2.4)	760(87.1)
统计值		χ²＝83.35				χ²＝142.09		χ²＝12.31	χ²＝9.14
P值		<0.05				<0.05		<0.05	<0.05

子痫前期分组	例数	分娩方式[例(%)]		胎盘早剥[例(%)]	入住ICU[例(%)]	住院天数(d，±s)	孕产妇死亡
子痫前期分组	例数	阴道分娩	剖宫产	胎盘早剥[例(%)]	入住ICU[例(%)]	住院天数(d，±s)	孕产妇死亡
晚发型	1820	727 (39.9)	1093 (60.1)	6 (0.3)	44 (2.4)	6.30±5.15	0
早发型	873	194 (22.2)	679 (77.8)	8 (0.9)	85 (9.7)	9.44±4.76	0
统计值		χ²＝82.35		χ²＝3.93	χ²＝69.3	Z＝-20.52	-
P值		<0.05		<0.05	<0.05	<0.05	-

子痫前期分组	例数	分娩方式[例(%)]		胎盘早剥[例(%)]	入住ICU[例(%)]	住院天数(d，±s)	孕产妇死亡
子痫前期分组	例数	阴道分娩	剖宫产	胎盘早剥[例(%)]	入住ICU[例(%)]	住院天数(d，±s)	孕产妇死亡
晚发型	1820	727 (39.9)	1093 (60.1)	6 (0.3)	44 (2.4)	6.30±5.15	0
早发型	873	194 (22.2)	679 (77.8)	8 (0.9)	85 (9.7)	9.44±4.76	0
统计值		χ²＝82.35		χ²＝3.93	χ²＝69.3	Z＝-20.52	-
P值		<0.05		<0.05	<0.05	<0.05	-

子痫前期分组	例数	新生儿出生体重(g，±s)	新生儿身长(cm，±s)	新生儿头围(cm，±s)	Apgar评分(分，±s)			1 min Apgar评分≤7分[例(%)]
子痫前期分组	例数	新生儿出生体重(g，±s)	新生儿身长(cm，±s)	新生儿头围(cm，±s)	1 min	5 min	10 min	1 min Apgar评分≤7分[例(%)]
晚发型	1820	2964.10±594.56	48.62±2.84	32.70±1.79	9.61±1.05	9.91±0.47	9.96±0.32	92(5.2)
早发型	873	1215.12±506.31	37.37±5.52	27.45±2.71	8.21±1.98	9.36±1.27	9.63±1.04	186(27.9)
统计值		Z＝-39.97	Z＝-39.41	Z＝-35.92	Z＝-29.36	Z＝-25.93	Z＝-24.48	χ²＝246.94
P值		<0.05	<0.05	<0.05	<0.05	<0.05	<0.05	<0.05
子痫前期分组	例数	5 min Apgar评分≤7分[例(%)]	新生儿状态[例(%)]			新生儿结局[例(%)]
子痫前期分组	例数	5 min Apgar评分≤7分[例(%)]	活产	死产	死胎	出院	死亡	转院
晚发型	1820	13(0.7)	1771(99.2)	0	14(0.8)	1765(99.6)	0	7(0.4)
早发型	873	47(7.0)	667(77.5)	2(0.2)	192(22.3)	664(99.1)	6(0.9)	0(0)
统计值		χ²＝80.43	χ²＝381.1			χ²＝313.53
P值		<0.05	<0.05			<0.05

Please choose a citation manager

Content to export