Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsia

Catherine A. Bigelow, Guilherme A. Pereira, Amber Warmsley, Jennifer Cohen, Chloe Getrajdman, Erin Moshier, Julia Paris, Angela Bianco, Stephanie H. Factor, Joanne Stone

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Objective Risk factors for the development of new-onset late postpartum preeclampsia (LPP) in women without any history of preeclampsia are not known. Because identification of women who are at risk may lead to an earlier diagnosis of disease and improved maternal outcomes, this study identified risk factors (associated patient characteristics) for new-onset LPP. Study Design A case-control study of 34 women with new-onset LPP and 68 women without new-onset LPP after normal delivery, who were matched on date of delivery, was conducted at Mount Sinai Hospital, New York, NY. Data were collected by chart review. Exact conditional logistic regression identified patient characteristics that were associated with new-onset LPP. Results New-onset LPP was associated with age <40 years (adjusted odds ratio, 24.83; 95% confidence interval [CI], 1.43-infinity; P =.03), black race (adjusted odds ratio, 78.35; 95% CI, 7.25-infinity; P <.001), Latino ethnicity (adjusted odds ratio, 19.08; 95% CI, 2.73-infinity; P =.001), final pregnancy body mass index of <30 kg/m 2 (adjusted odds ratio, 13.38; 95% CI, 1.87-infinity; P =.01), and gestational diabetes mellitus (adjusted odds ratio, 72.91; 95% CI, 5.52-infinity; P <.001). As predictive tests for new-onset LPP, the sensitivity and specificity of having <1 of these characteristics was 100% and 59%, respectively, and the sensitivity and specificity of having <2 was 56% and 93%, respectively. Conclusion Older age, black race, Latino ethnicity, obesity, and a pregnancy complicated by gestational diabetes mellitus all are associated positively with the development of new-onset LPP. Closer observation may be warranted in these populations.

Original languageEnglish
Pages (from-to)338.e1-338.e8
JournalAmerican Journal of Obstetrics and Gynecology
Volume210
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • anticipatory guidance
  • new-onset late postpartum preeclampsia
  • postpartum eclampsia
  • preeclampsia
  • risk factor

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