Effect of Pregnancy Interval on Second Pregnancy Blood Pressure Following Prior Preeclampsia. 2018

Lindsay Howe, and Erica Hammer, and Gary Badger, and Ira M Bernstein
1 Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont, Burlington, VT, USA.

Preeclampsia generally occurs in first pregnancies and tends not to recur when the interpregnancy interval (IPI) is short. We hypothesized that, in women experiencing preeclampsia in their first pregnancy, the difference in mean arterial pressure (MAP) across pregnancy between their index and subsequent pregnancy would be inversely associated with the length of time between pregnancies and that the interval between pregnancies will be directly associated with the likelihood of preeclampsia recurrence. This was a retrospective chart review evaluating 171 women diagnosed with preeclampsia during their first pregnancy who had a subsequent pregnancy at our institution. Blood pressures were collected from each pregnancy, marking the recurrence of hypertensive disorders, including preeclampsia. Antepartum MAP was compared between pregnancies, examining differences as a function of IPI. There was a significant association of IPI with the reduction in MAP between pregnancies across trimesters ( P = .04), but this reduction became smaller over time. The MAP during the third trimester decreased significantly between pregnancies across all patient groups (IPI <24 months: -5.7 mm Hg, P < .0001; IPI 24-48 months: -4.5 mm Hg, P < .0001; IPI >48 months -3.4 mm Hg, P = .03). The recurrence rate of preeclampsia did not vary significantly with IPI ( P = .21). The IPI influences the MAP of the second pregnancy in women with prior preeclampsia. Shorter IPI is associated with a greater reduction in MAP when compared to the longer IPI. Although there was a trend toward higher preeclampsia recurrence with longer IPI, this trend did not reach statistical significance.

UI MeSH Term Description Entries
D011225 Pre-Eclampsia A complication of PREGNANCY, characterized by a complex of symptoms including maternal HYPERTENSION and PROTEINURIA with or without pathological EDEMA. Symptoms may range between mild and severe. Pre-eclampsia usually occurs after the 20th week of gestation, but may develop before this time in the presence of trophoblastic disease. Toxemias, Pregnancy,EPH Complex,EPH Gestosis,EPH Toxemias,Edema-Proteinuria-Hypertension Gestosis,Gestosis, EPH,Hypertension-Edema-Proteinuria Gestosis,Preeclampsia,Preeclampsia Eclampsia 1,Pregnancy Toxemias,Proteinuria-Edema-Hypertension Gestosis,Toxemia Of Pregnancy,1, Preeclampsia Eclampsia,1s, Preeclampsia Eclampsia,EPH Toxemia,Eclampsia 1, Preeclampsia,Eclampsia 1s, Preeclampsia,Edema Proteinuria Hypertension Gestosis,Gestosis, Edema-Proteinuria-Hypertension,Gestosis, Hypertension-Edema-Proteinuria,Gestosis, Proteinuria-Edema-Hypertension,Hypertension Edema Proteinuria Gestosis,Of Pregnancies, Toxemia,Of Pregnancy, Toxemia,Pre Eclampsia,Preeclampsia Eclampsia 1s,Pregnancies, Toxemia Of,Pregnancy Toxemia,Pregnancy, Toxemia Of,Proteinuria Edema Hypertension Gestosis,Toxemia Of Pregnancies,Toxemia, EPH,Toxemia, Pregnancy,Toxemias, EPH
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D001721 Birth Intervals The lengths of intervals between births to women in the population. Birth Spacing,First Birth Intervals,Pregnancy Intervals,Birth Interval,Birth Spacings,First Birth Interval,Pregnancy Interval
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D062186 Arterial Pressure The blood pressure in the ARTERIES. It is commonly measured with a SPHYGMOMANOMETER on the upper arm which represents the arterial pressure in the BRACHIAL ARTERY. Aortic Blood Pressure,Aortic Pressure,Aortic Pulse Pressure,Aortic Tension,Arterial Blood Pressure,Arterial Tension,Blood Pressure, Aortic,Blood Pressure, Arterial,Mean Aortic Pressure,Mean Arterial Pressure,Aortic Blood Pressures,Aortic Pressure, Mean,Aortic Pressures,Aortic Pressures, Mean,Aortic Pulse Pressures,Aortic Tensions,Arterial Blood Pressures,Arterial Pressure, Mean,Arterial Pressures,Arterial Pressures, Mean,Arterial Tensions,Blood Pressures, Aortic,Blood Pressures, Arterial,Mean Aortic Pressures,Mean Arterial Pressures,Pressure, Aortic,Pressure, Aortic Blood,Pressure, Aortic Pulse,Pressure, Arterial,Pressure, Arterial Blood,Pressure, Mean Aortic,Pressure, Mean Arterial,Pressures, Aortic,Pressures, Aortic Blood,Pressures, Aortic Pulse,Pressures, Arterial,Pressures, Arterial Blood,Pressures, Mean Aortic,Pressures, Mean Arterial,Pulse Pressure, Aortic,Pulse Pressures, Aortic,Tension, Aortic,Tension, Arterial,Tensions, Aortic,Tensions, Arterial

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