Abstract:
Objective
To analyze the clinical symptoms of patients with recurrent preeclampsia(PE)and explore the influencing factors of its onset,thereby providing a basis for the prevention and treatment of recurrent PE.
Methods
Complete data of 574 patients with PE admitted to the Third Affiliated Hospital of Guangzhou Medical University and Guangzhou Panyu District Maternal and Child Health Hospital from June 2010 to December 2021 were collected.Patients were divided into a recurrence group(132 cases)and a nonrecurrence group(442 cases)based on whether PE occurred during a second pregnancy.The clinical data and pregnancy characteristics of the two groups were compared using the chisquare test,t-test,or rank sum test.Logistic regression model was used to analyze the risk factors for PE recurrence.
Results
(1)The recurrence rate of PE was 23.0%;(2)The age of pregnancy in the recurrent group was higher than that in the non recurrent group[(32.92±4.14)years vs(30.81±4.29)years,t= -4.982],while the gestational weeks at admission[(36.36±3.12)weeks vs(37.96±2.25)weeks,t=6.493]and delivery[(36.73±2.87)weeks vs(38.19±2.10)weeks,t=6.377]were lower than those in the non-recurrent group,with statistical significance(P<0.05);The vaginal delivery rates were 31.8% vs.43.1%,and cesarean delivery rates were 68.2% vs.56.9% in the two groups,respectively(χ2=5.355),demonstrating statistically significant differences(P<0.05).(3)The recurrence group demonstrated significantly higher incidences of both ascites(4.5% vs 0.2%,χ2=15.706)and epigastric discomfort(2.3% vs 0.2%,χ2=6.143),with all differences being statistically significant(P<0.05).(4)The white blood cell count in the recurrent group was higher than that in the non-recurrent group[(9.85±2.14)×109/L vs(9.2±2.2)×109/L,t= -2.122],and the difference was statistically significant(P<0.05).(5)The birth weight[(2 760.0±830.0)g vs(3 120.0±540.0)g,t=5.867]and Apgar score of newborns[1 min:(9.51±1.56)vs(9.79±1.11),t=2.299;5 min:(9.70±1.35)vs(9.88±0.97),t=1.697]in the recurrent group were significantly lower than those in the non-recurrent group,and the incidence of fetal growth restriction was higher(6.9%vs2.0%,χ2=7.738),with statistical significance(P<0.05).The neonatal mortality rate was significantly higher than that of the non-recurrence group(9.1% vs 3.8%).(6)The recurrence group had an increase in blood pressure in the previous pregnancy[(33.85±5.35)weeks vs(36.64±3.83)weeks,t=36.531]and the gestational age at admission[(35.56±4.46)weeks vs(37.44±3.04)weeks,t=42.792)]was earlier than the non-recurrence group,while the highest systolic blood pressure[(165.1±13.8)mmHg vs(156.1±13.4)mmHg,t= -5.508]and maximum diastolic blood pressure[(106.2±11.9)mmHg vs(100.4±10.4)mmHg,t= -4.463]was higher than that of the nonrecurrence group,and the proportion of non-first pregnancies(46.2% vs 36.7%,t=7.66)was significantly higher than that of the non-recurrence group(P<0.05).(7)Logistic regression analysis showed that age(OR=1.18,95%CI:1.03~1.35),highest systolic blood pressure during the previous pregnancy(OR=1.05,95%CI:1.01~1.08,P<0.05),age of the previous pregnancy(OR=1.23,95%CI:1.16~1.37,P<0.05),gestational age of the previous delivery(OR=1.32,95%CI:1.23~1.39,P<0.05),and urinary protein during the previous pregnancy(OR=2.59,95%CI:1.01~6.64,P<0.05)were risk factors for PE recurrence in pregnant women.The starting gestational age of the previous increase in blood pressure(OR=0.89,95%CI:0.82~0.97,P<0.05)was a protective factor for PE recurrence.
Conclusions
Recurrent PE has certain clinical characteristics.The maternal age,highest systolic blood pressure during the previous pregnancy,age of the previous pregnancy,gestational age of the previous pregnancy,and urinary protein during the previous pregnancy are risk factors for recurrent PE.The initial gestational age of the previous pregnancy with elevated blood pressure is a protective factor for recurrent PE.
Key words:
Preeclampsia,
Recurrence,
Features,
Influencing factors
Weiwei Wang, Xialin Li, Jingjin Gong, Wen Sun, Lizhi Zhang, Yong Wang. Analysis of clinical characteristics and influencing factors in recurrent preeclampsia[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2025, 14(02): 95-101.