Superimposed versus de novo pre-eclampsia: Is there a difference?

Hilly R. Boneh, Gali Pariente, Yael Baumfeld, David Yohay, Reut Rotem, Adi Y. Weintraub

    Research output: Contribution to journalArticlepeer-review

    2 Scopus citations

    Abstract

    Objective: To investigate whether pre-eclampsia is a single clinical entity or whether de novo pre-eclampsia and superimposed pre-eclampsia are distinct entities, with respect to baseline maternal characteristics, obstetrical complications, and perinatal outcomes. Methods: A retrospective cohort study comparing singleton pregnancies complicated with de novo pre-eclampsia (n = 10 979, 93%) and superimposed pre-eclampsia (n = 804, 7%). Maternal baseline characteristics, pregnancy and labor complications, and neonatal outcomes were evaluated in the univariate analysis. Multivariable logistic regression models were performed for the prediction of different pregnancy outcomes while controlling for confounders. Results: In the multivariate regression models controlling for confounders, superimposed pre-eclampsia was found to be a significant risk factor for placental dysfunction, a composite outcome composed of severe pre-eclampsia (rather than mild), placental abruption, oligohydramnios, and small-for-gestational-age neonate (odds ratio [OR] 2.23, 95% confidence interval [CI] 1.90–2.62, P < 0.001), preterm delivery (OR 2.79, 95% CI 2.39–3.26, P < 0.001), and perinatal mortality (OR 1.79, 95% CI 1.11–2.88, P = 0.02). Conclusion: De novo and superimposed pre-eclampsia demonstrated significant differences in most studied variables, suggesting that these may be two distinct clinical syndromes. In our population, superimposed pre-eclampsia was found to be significantly associated with adverse pregnancy outcomes such as placental dysfunction, preterm delivery, and perinatal mortality compared with de novo pre-eclampsia.

    Original languageEnglish
    Pages (from-to)392-397
    Number of pages6
    JournalInternational Journal of Gynecology and Obstetrics
    Volume159
    Issue number2
    DOIs
    StatePublished - 1 Nov 2022

    Keywords

    • labor complications
    • maternal characteristics
    • obstetrical complications
    • perinatal mortality
    • placental dysfunction
    • preterm delivery
    • small for gestational age
    • superimposed pre-eclampsia

    ASJC Scopus subject areas

    • Obstetrics and Gynecology

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