Clinical factors associated with preeclampsia recurrence

Objective: Preeclampsia is associated with immediate and long term offspring and maternal morbidities and mortality. Incidence of preeclampsia has increased and recurrent preeclampsia has not decreased in recent decades. The aim of the current study was to identify risk factors for recurrent preeclampsia among women with a history of preeclampsia. Methods: A population-based nested case- control study was performed at the Soroka University Medical Center. Included were all women with at least two pregnancies, with preeclampsia diagnosis in their first pregnancy. Cases were defined as women with recurrent preeclampsia and the controls as women with preeclampsia in their first but not in their second pregnancy. First pregnancy characteristics were compared among women with and without recurrent preeclampsia in subsequent pregnancy. A sub-analysis was conducted among women with first pregnancy preeclampsia with early onset. A multivariable logistic model was used to identify independent risk factors for recurrent preeclampsia, and to study whether the risk increased with each additional complication. The models adjusted for maternal age and ethnicity. Results: A total of 2899 women who had preeclampsia in their first pregnancy were included in the study, 496 of them had recurrent preeclampsia (17.1%) in subsequent pregnancy. Maternal age, cesarean and preterm deliveries were significant independent risk factors for recurrent preeclampsia. These factors were not associated with early onset recurrent preeclampsia. Conclusions: Cesarean and preterm deliveries are significant risk factors for recurrent preeclampsia. Different etiologies and risk factors are possibly involved in preeclampsia recurrence following early versus late first preeclampsia onset.