TY - JOUR
T1 - Risk factors for new-onset late postpartum preeclampsia in women without a history of preeclampsia
AU - Bigelow, Catherine A.
AU - Pereira, Guilherme A.
AU - Warmsley, Amber
AU - Cohen, Jennifer
AU - Getrajdman, Chloe
AU - Moshier, Erin
AU - Paris, Julia
AU - Bianco, Angela
AU - Factor, Stephanie H.
AU - Stone, Joanne
PY - 2014/4
Y1 - 2014/4
N2 - 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.
AB - 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.
KW - anticipatory guidance
KW - new-onset late postpartum preeclampsia
KW - postpartum eclampsia
KW - preeclampsia
KW - risk factor
UR - http://www.scopus.com/inward/record.url?scp=84897461398&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2013.11.004
DO - 10.1016/j.ajog.2013.11.004
M3 - Article
C2 - 24211478
AN - SCOPUS:84897461398
SN - 0002-9378
VL - 210
SP - 338.e1-338.e8
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 4
ER -