Assistant Professor



Department of Obstetrics and Gynecology

Department of Health Research Methods, Evidence and Impact

McMaster University
1280 Main St. West,
HSC3V - 43B
Hamilton, Ontario ​L8S 4K1
Canada



842Prevention of severe preeclampsia at term gestation among women with chronic hypertension


Journal article


S. Lisonkova, J. Bone, G. Muraca, N. Razaz, A. Boutin, Y. Sabr, K. Joseph
International Journal of Epidemiology, 2021

Semantic Scholar DOI
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APA   Click to copy
Lisonkova, S., Bone, J., Muraca, G., Razaz, N., Boutin, A., Sabr, Y., & Joseph, K. (2021). 842Prevention of severe preeclampsia at term gestation among women with chronic hypertension. International Journal of Epidemiology.


Chicago/Turabian   Click to copy
Lisonkova, S., J. Bone, G. Muraca, N. Razaz, A. Boutin, Y. Sabr, and K. Joseph. “842Prevention Of Severe Preeclampsia at Term Gestation among Women with Chronic Hypertension.” International Journal of Epidemiology (2021).


MLA   Click to copy
Lisonkova, S., et al. “842Prevention Of Severe Preeclampsia at Term Gestation among Women with Chronic Hypertension.” International Journal of Epidemiology, 2021.


BibTeX   Click to copy

@article{s2021a,
  title = {842Prevention of severe preeclampsia at term gestation among women with chronic hypertension},
  year = {2021},
  journal = {International Journal of Epidemiology},
  author = {Lisonkova, S. and Bone, J. and Muraca, G. and Razaz, N. and Boutin, A. and Sabr, Y. and Joseph, K.}
}

Abstract

Chronic hypertension is a strong risk factor for severe preeclampsia/eclampsia (SPE), and timely obstetric intervention can prevent SPE and reduce perinatal complications. We quantified gestational age-specific rates of SPE and estimated the benefits of preventive interventions among women with chronic hypertension at term gestation (≥37 weeks).

Women with chronic hypertension and a term, singleton, hospital delivery in Washington State, 2003-2013, were included in the study (N = 9697) with data obtained from birth certificates and hospital records. Adverse outcomes included SPE and composite severe neonatal morbidity (e.g., seizures, intracranial hemorrhage) and perinatal death (SNMM). Preventive interventions included labour induction and pre-labour cesarean delivery.

There were 1026 cases of SPE (10.6 per 100 women with chronic hypertension). Gestational age-specific SPE rates ranged between 2.8 and 4.1 per 100 ongoing pregnancies; the frequency of preventive intervention at each gestational week ranged between 58% and 66%. Gestational age-specific SPE and SNMM rates were lower following preventive intervention: such intervention reduced the frequency of SPE/SNMM by 28 per 100 additional interventions at 37 weeks, 22 per 100 at 38 weeks, 17 per 100 at 39 weeks, 13 at 40 weeks and 6 per 100 additional interventions at 41 weeks’ gestation.

Labour induction and pre-labour cesarean delivery at term gestation can prevent a substantial proportion of severe preeclampsia/eclampsia and perinatal death/severe neonatal morbidity among women with chronic hypertension.

SPE occurs in approximately 11% of women with chronic hypertension at term gestation. Obstetric interventions can prevent SPE and improve adverse pregnancy outcomes.


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