Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders
In this retrospective cohort study, we aimed to investigate the variables associated with progression to preeclampsia with severe features in parturients already diagnosed with mild hypertensive disorders of pregnancy. The study was conducted in a single university-affiliated medical center between...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-11-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/22/7022 |
| _version_ | 1797458848075743232 |
|---|---|
| author | Sivan Barda Yochai Yoeli Nitzan Stav Amir Naeh Esther Maor-Sagie Mordechai Hallak Rinat Gabbay-Benziv |
| author_facet | Sivan Barda Yochai Yoeli Nitzan Stav Amir Naeh Esther Maor-Sagie Mordechai Hallak Rinat Gabbay-Benziv |
| author_sort | Sivan Barda |
| collection | DOAJ |
| description | In this retrospective cohort study, we aimed to investigate the variables associated with progression to preeclampsia with severe features in parturients already diagnosed with mild hypertensive disorders of pregnancy. The study was conducted in a single university-affiliated medical center between 2018 and 2020. All women admitted due to hypertensive disorders were included. Data collected was compared between parturients who progressed and did not progress to preeclampsia with severe features. Among 359 women presenting without severe features, 18 (5%) developed severe features, delivered smaller babies at lower gestational age, and with higher rates of cesarean delivery (<i>p</i> < 0.001 for all). Chronic hypertension, maternal diabetes, any previous gestational hypertensive disorder, gestational diabetes, number of hospitalizations, earlier gestational age at initial presentation, and superimposed preeclampsia as the preliminary diagnosis were all associated with preeclampsia progression to severe features. Previous delivery within 2–5 years was a protective variable from preeclampsia progression. Following regression analysis and adjustment to confounders, only gestational age at initial presentation and superimposed preeclampsia remained significant variables associated with progression to severe features (aOR 0.74 (0.55–0.96) and 34.44 (1.07–1111.85), aOR (95% CI), respectively, <i>p</i> < 0.05 for both) with combined ROC-AUC prediction performance of 0.89, 95% CI 0.83–0.95, <i>p</i> < 0.001. In conclusion, according to our study results, early gestational age at presentation and superimposed preeclampsia as the preliminary diagnosis are the only independent factors that are associated with progression to severe features in women already diagnosed with mild hypertensive disorders during pregnancy. |
| first_indexed | 2024-03-09T16:44:02Z |
| format | Article |
| id | doaj.art-7051375ab8ad4b07ad257c3d4c68d691 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:44:02Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7051375ab8ad4b07ad257c3d4c68d6912023-11-24T14:49:11ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011222702210.3390/jcm12227022Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive DisordersSivan Barda0Yochai Yoeli1Nitzan Stav2Amir Naeh3Esther Maor-Sagie4Mordechai Hallak5Rinat Gabbay-Benziv6Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelDepartment of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelDepartment of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelDepartment of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelDepartment of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelDepartment of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelDepartment of Obstetrics and Gynecology, Hillel Yaffe Medical Center, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa 3200003, IsraelIn this retrospective cohort study, we aimed to investigate the variables associated with progression to preeclampsia with severe features in parturients already diagnosed with mild hypertensive disorders of pregnancy. The study was conducted in a single university-affiliated medical center between 2018 and 2020. All women admitted due to hypertensive disorders were included. Data collected was compared between parturients who progressed and did not progress to preeclampsia with severe features. Among 359 women presenting without severe features, 18 (5%) developed severe features, delivered smaller babies at lower gestational age, and with higher rates of cesarean delivery (<i>p</i> < 0.001 for all). Chronic hypertension, maternal diabetes, any previous gestational hypertensive disorder, gestational diabetes, number of hospitalizations, earlier gestational age at initial presentation, and superimposed preeclampsia as the preliminary diagnosis were all associated with preeclampsia progression to severe features. Previous delivery within 2–5 years was a protective variable from preeclampsia progression. Following regression analysis and adjustment to confounders, only gestational age at initial presentation and superimposed preeclampsia remained significant variables associated with progression to severe features (aOR 0.74 (0.55–0.96) and 34.44 (1.07–1111.85), aOR (95% CI), respectively, <i>p</i> < 0.05 for both) with combined ROC-AUC prediction performance of 0.89, 95% CI 0.83–0.95, <i>p</i> < 0.001. In conclusion, according to our study results, early gestational age at presentation and superimposed preeclampsia as the preliminary diagnosis are the only independent factors that are associated with progression to severe features in women already diagnosed with mild hypertensive disorders during pregnancy.https://www.mdpi.com/2077-0383/12/22/7022preeclampsiasevere featuresgestational hypertensionsuperimposed preeclampsiamild featuresprogression |
| spellingShingle | Sivan Barda Yochai Yoeli Nitzan Stav Amir Naeh Esther Maor-Sagie Mordechai Hallak Rinat Gabbay-Benziv Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders Journal of Clinical Medicine preeclampsia severe features gestational hypertension superimposed preeclampsia mild features progression |
| title | Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders |
| title_full | Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders |
| title_fullStr | Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders |
| title_full_unstemmed | Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders |
| title_short | Factors Associated with Progression to Preeclampsia with Severe Features in Pregnancies Complicated by Mild Hypertensive Disorders |
| title_sort | factors associated with progression to preeclampsia with severe features in pregnancies complicated by mild hypertensive disorders |
| topic | preeclampsia severe features gestational hypertension superimposed preeclampsia mild features progression |
| url | https://www.mdpi.com/2077-0383/12/22/7022 |
| work_keys_str_mv | AT sivanbarda factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders AT yochaiyoeli factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders AT nitzanstav factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders AT amirnaeh factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders AT esthermaorsagie factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders AT mordechaihallak factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders AT rinatgabbaybenziv factorsassociatedwithprogressiontopreeclampsiawithseverefeaturesinpregnanciescomplicatedbymildhypertensivedisorders |