What affects the outcome of severe preeclampsia?

Abstract

Preeclampsia is a severe multi-system pregnancy related disorder associated with multiple maternal and fetal adverse out­comes, including fetal and maternal mortality. The aim of this study is to investigate the clinical difference between early-and late-onset preeclampsia and their impact to perinatal outcome, and to detect possible antenatal parameters that can predict adverse fetal and maternal outcomes. The research team conducted a retrospective cohort study of 308 singleton pregnancies complicated with severe preeclampsia over an 8-year period in our tertiary level centre. Clinical differences and perinatal outcomes between early-(≥34 weeks, n=147) and late-onset (≥34 weeks, n=161) preeclampsia were analyzed. Pos­sible antenatal risk factors that can influ­ence adverse perinatal outcomes in severe preeclampsia were also evaluated. Clinical symptoms and perinatal outcomes were significantly unfavourable in early-onset preeclampsia. Adverse perinatal outcomes in the early-onset group were complicated with 10 (6.08%) intrauterine fetal deaths and 4 (2.37%) neonatal deaths. Primiparity seems to be the significant antenatal risk factor for appearance of early-onset of the disease (p<0.001, OR 2.39, 95% CI 1.48-3.86) and for the first minute Apgar score <7 (p=0.036, OR 1.68, 95% CI 1.04-2.74). Patients with severe preeclampsia are high-risk obstetric patients because of the unpredictability, varying clinical presentation and potential adverse outcomes of the disease. Pregnant women with an early appearance of the disease had severe clinical presentation and more often an unfavourable perinatal outcome.