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BJOG. 2015 Sep;122(10):1403-9. doi: 10.1111/1471-0528.13285. Epub 2015 Mar 9.

Formerly eclamptic women have lower nonpregnant blood pressure compared with formerly pre-eclamptic women: a retrospective cohort study.

Author information

1
Department of Obstetrics and Gynaecology, University of Maastricht, Maastricht, the Netherlands.
2
Department of Obstetrics, Gynaecology and Reproductive Sciences, University of Vermont, Burlington, VT, USA.
3
Department of Neurological Sciences, University of Vermont, Burlington, VT, USA.

Abstract

OBJECTIVE:

To compare nonpregnant blood pressure and circulating metabolic factors between formerly pre-eclamptic women who did and did not deteriorate to eclampsia.

DESIGN:

Retrospective observational cohort study.

SETTING:

Tertiary referral centre.

POPULATION:

Formerly pre-eclamptic women with (n = 88) and without (n = 698) superimposed eclampsia.

METHODS:

Women who experienced pre-eclampsia with or without superimposed eclampsia during their pregnancy or puerperium were tested for possible underlying cardiovascular risk factors at least 6 months postpartum. We measured blood pressure and determined cardiovascular and metabolic risk markers in a fasting blood sample. Groups were compared using Mann-Whitney U test, Spearman's Rho test or Fisher's Exact test (odds ratios).

MAIN OUTCOME MEASURES:

Differences in postpartum blood pressures and features of the metabolic syndrome between formerly pre-eclamptic and formerly eclamptic women.

RESULTS:

Formerly pre-eclamptic women who developed eclampsia differed from their counterparts without eclampsia by a lower blood pressure (P < 0.01) with blood pressure correlating inversely with the likelihood of having experienced eclampsia (P < 0.001). In addition, formerly eclamptic women had higher circulating C-reactive protein levels than formerly pre-eclamptic women (P < 0.05). All other circulating metabolic factors were comparable. Finally, 40% of all eclamptic cases occurred in the puerperium.

CONCLUSIONS:

Formerly pre-eclamptic women with superimposed eclampsia have lower nonpregnant blood pressure compared with their counterparts without neurological sequelae with blood pressure negatively correlated to the occurrence of eclampsia. As about 40% of all eclamptic cases occur postpartum, routine blood pressure monitoring postpartum should be intensified.

KEYWORDS:

Blood pressure; eclampsia; pre-eclampsia

PMID:
25753846
PMCID:
PMC4551599
DOI:
10.1111/1471-0528.13285
[Indexed for MEDLINE]
Free PMC Article

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