Expectant management of mild preeclampsia versus superimposed preeclampsia up to 37 weeks

Amy M. Valent, Emily A. Defranco, Allessa Allison, Ahmed Salem, Lori Klarquist, Kyle Gonzales, Mounira Habli, C. David Adair, Casey Armistead, Yuping Wang, David Lewis, Baha Sibai

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Objective We sought to compare maternal and neonatal outcomes of expectantly managed pregnancies complicated by chronic hypertension with superimposed preeclampsia vs mild preeclampsia up to 37 weeks of gestation. Study Design This was a multicenter retrospective cohort study of all pregnancies complicated by chronic hypertension with superimposed preeclampsia or mild preeclampsia expectantly managed in the hospital from January 2008 through December 2011. The primary outcomes, adverse maternal and neonatal composite morbidities, were compared between these 2 groups. Frequency differences of maternal adverse outcomes were stratified by gestational age at delivery of <34 and 34-366/7 weeks of gestation. Results We found no significant differences in rates of neonatal composite morbidity or latency periods between women with superimposed preeclampsia and mild preeclampsia. Adverse neonatal outcomes were significantly higher at <34 compared to 34-366/7 weeks of gestation (97-98% vs 48-50%) in both cohorts. Maternal adverse composite outcome occurred more frequently in women with superimposed preeclampsia compared to mild preeclampsia (15% vs 5%; P =.003; relative risk, 3.0; 95% confidence interval, 1.45-6.29). Conclusion Women with superimposed preeclampsia have similar neonatal outcomes but more maternal complications than women with preeclampsia without severe features who are expectantly managed <37 weeks.

Original languageEnglish (US)
Pages (from-to)515.e1-515.e8
JournalAmerican journal of obstetrics and gynecology
Volume212
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Keywords

  • expectant management
  • hypertension
  • preeclampsia

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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