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BMJ. 2005 Mar 12;330(7491):565. Epub 2005 Mar 2.

Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies.

Author information

  • 1Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford OX3 9DU. Kduckitt@doctors.org.uk

Abstract

OBJECTIVE:

To determine the risk of pre-eclampsia associated with factors that may be present at antenatal booking.

DESIGN:

Systematic review of controlled studies published 1966-2002.

DATA SYNTHESIS:

Unadjusted relative risks were calculated from published data.

RESULTS:

Controlled cohort studies showed that the risk of pre-eclampsia is increased in women with a previous history of pre-eclampsia (relative risk 7.19, 95% confidence interval 5.85 to 8.83) and in those with antiphospholipids antibodies (9.72, 4.34 to 21.75), pre-existing diabetes (3.56, 2.54 to 4.99), multiple (twin) pregnancy (2.93, 2.04 to 4.21), nulliparity (2.91, 1.28 to 6.61), family history (2.90, 1.70 to 4.93), raised blood pressure (diastolic > or = 80 mm Hg) at booking (1.38, 1.01 to 1.87), raised body mass index before pregnancy (2.47, 1.66 to 3.67) or at booking (1.55, 1.28 to 1.88), or maternal age > or = 40 (1.96, 1.34 to 2.87, for multiparous women). Individual studies show that risk is also increased with an interval of 10 years or more since a previous pregnancy, autoimmune disease, renal disease, and chronic hypertension.

CONCLUSIONS:

These factors and the underlying evidence base can be used to assess risk at booking so that a suitable surveillance routine to detect pre-eclampsia can be planned for the rest of the pregnancy.

Comment in

PMID:
15743856
[PubMed - indexed for MEDLINE]
PMCID:
PMC554027
Free PMC Article
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