(551) Risk of recurrent preeclampsia (PRE) in a consecutive pregnancy cohort

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: Previous preeclampsia (PRE) is a risk factor for recurrence of PRE in future pregnancies. However, the magnitude of the recurrence risk in contemporaneous population-based cohorts is not well quantified. We evaluated the risk of recurrent PRE following PRE in prior pregnancy in a large database of consented and enrolled participants with two consecutive pregnancies during the study period.

Study Design: This was a retrospective cohort study of an IRB-approved, subject consented prospectively collected perinatal database from a large academic center from 2011-2022. All participants with two consecutive singleton pregnancies were included. Maternal demographics, comorbidities and obstetrical outcomes were compared between subsequent pregnancies in participants with and without PRE in the index pregnancy. The primary outcome was PPRE in the next subsequent pregnancy. Logistic regression was used to evaluate the association of PRE in the index pregnancy with PRE in the subsequent pregnancy, and identify subpopulations with a significant disproportionate and elevated risk.

Results: 5,559 participants were included. The rate of PRE was 24.9% in participants with PRE in the index pregnancy versus 4.8% in those without prior PRE(p < 0.001, Table 1). Participants with recurrent PRE were of lower overall parity, higher BMI, and more likely to have chronic hypertension, diabetes mellitus, and identify as Black. The aOR of recurrent PRE was 3.91 (95% CI (2.82– 5.42), after adjusting for potential confounders. Among participants on aspirin therapy, the aOR of recurrent PRE was aOR 2.54 (1.59-4.10) (Table 2).

Conclusion: In a cohort of participants with two included pregnancies in the study period, participants with prior PRE had a nearly 4-fold risk of recurrence after adjustment for known risk factors. The design of incorporating consecutive pregnancies in the same database provided a rigorous opportunity to evaluate recurrence, as the participants’ first pregnancy serves as their own reference and thereby reducing inherent study bias.

Primary & Presenting Author(s)

Matthew A. Shanahan, MD (he/him/his)
Fellow Physician
Baylor College of Medicine
Houston, Texas, United States

Coauthor(s)

Brian Burnett, MD
Baylor College of Medicine
Houston, Texas, United States
Kelly Albrecht, BSc,MD,FRCSC
MFM fellow
Baylor College of Medicine
Houston, Texas, United States
Alison N. Goulding, MD, MSCR (she/her/hers)
Maternal-Fetal Medicine Fellow
Baylor College of Medicine
Houston, Texas, United States
GJ
Grace J. Johnson, MD
Maternal-Fetal Medicine Fellow
Baylor College of Medicine
Houston, Texas, United States
Kjersti M. Aagaard, MD,PhD
Professor and Vice Chair of Research Department of Obstetrics and Gynecology, Division of MFM
Texas Children's and Baylor College of Medicine
Houston, Texas, United States