Medical and biological risk factors for the development of pre-eclampsia of variable severity in pregnant women with chronic arterial hypertension

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INTRODUCTION

Preeclampsia (PE) develops in 20% of women with chronic arterial hypertension (CAH). This is associated with increased maternal and perinatal morbidity compared to de novo PE. There are no data on risk factors for the addition of PE of varying severity to CAH, which confirms the relevance of this study.

THE AIM OF THE STUDY

Was to clarify the medical and biological risk factors for the development of preeclampsia of varying severity in patients with CAH.

METHODS

Clinical and statistical. Data were copied from medical records. The study was conducted with the participation of 254 patients (147 pregnant women with CAH, 62 with moderate preeclampsia on the background of CAH, 45 with severe preeclampsia on the background of CAH). The quantitative description of the values with a normal distribution was carried out using an arithmetic value and an arithmetic mean error (M±m).

RESULTS

Risk factors for the addition of moderate and severe PE to CAH, determined in the 1st trimester of pregnancy, are: stage 2 hypertension (OR=2.1; 95% CI 1.7—6.2; OR=3.1; 95% CI 2.8—7.4) with target organ damage, retinal angiopathy I b degree (OR=4.0; 95% CI 3.6—16.9; OR=1.8; 95% CI 1.2—5.3), urinary tract infections in history (OR=2.32; 95% CI 1.7—6.4; OR=3.2; 95% CI 2.4—10.4), mean BP above 95 mmHg. upon registration (OR=3.2; 95% CI 1.5—14.9; OR=4.9; 95% CI 1.7—41.2). Additional risk factors for moderate PE are unregistered marriage (OR=1.6; 95% CI 1.05—4.1), smoking (OR=2.3; 95% CI 1.2—18.2), irregular use antihypertensive drugs before pregnancy (OR=1.7; 95% CI 1.2—4.1); severe PE — no antihypertensive therapy in the 1st trimester of pregnancy (OR=2.3; 95% CI 1.5—6.4), duration of hypertension for more than 5 years (OR=3.3; 95% CI 1.2—4, 1), preeclampsia in the anamnesis (OR=2.0; 95% CI 1.3—5.5).

CONCLUSION

Timely correction of modifiable risk factors and prevention of PE will improve maternal and perinatal outcomes in women with CAH.

Keywords:

chronic arterial hypertension

preeclampsia of varying severity

risk factors

Authors:

Panova I.A.

Ivanovo Scientific Research Institute of Motherhood and Childhood named after V.N. Gorodkov

ORCID: 0000-0002-1145-0563

Rokotyanskaya E.A.

Ivanovo Research Institute of Motherhood and Childhood named after V.N. Gorodkov

ORCID: 0000-0003-4660-7249

Khizrieva Z.S.

Ivanovo Scientific Research Institute of Motherhood and Childhood named after V.N. Gorodkov

ORCID: 0009-0006-0192-7678

Received:

22.05.2023

Accepted:

26.10.2023

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