Abstract
BackgroundData on the prevalence of persistent symptoms in the first year after preeclampsia are limited. Furthermore, possible risk factors for these sequelae are poorly defined. We investigated kidney function, blood pressure, proteinuria and urine sediment in women with preeclampsia 6 months after delivery with secondary analysis for possible associated clinical characteristics.MethodsFrom January 2007 to July 2014 all women with preeclampsia and 6-months follow up at the University Hospital Basel were analyzed. Preeclampsia was defined as new onset of hypertension (≥140/90 mmHg) and either proteinuria or signs of end-organ dysfunction. Hypertension was defined as a blood pressure ≥ 140/90 mmHg or the use of antihypertensive medication. Proteinuria was defined as a protein-to-creatinine ratio in a spot urine > 11 mg/mmol. Urine sediment was evaluated by a nephrologist. Secondary analyses were performed to investigate for possible parameters associated with persistent symptoms after preeclampsia.ResultsTwo hundred two women were included into the analysis. At a mean time of follow up of 172 days (+/− 39.6) after delivery, mean blood pressure was 124/76 mmHg (+/− 14/11, range 116–182/63–110) and the mean serum-creatinine was 61.8 μmol/l (33–105 μmol/l) (normal < 110 μmol/l). Mean estimated glomerular filtration rate using CKD-EPI was 110.7 mml/min/1.73m2 (range 59.7–142.4 mml/min/1.73m2) (normal > 60 mml/min/1.73m2). 20.3% (41/202) had a blood pressure of 140/90 mmHg or higher (mean 143/89 mmHg) or were receiving antihypertensive medication (5.5%, 11/202). Proteinuria was present in 33.1% (66/199) (mean 27.5 mg/mmol). Proteinuria and hypertension was present in 8% (16/199). No active urine sediment (e.g. signs of glomerulonephritis) was observed. Age and gestational diabetes were associated with persistent proteinuria and severe preeclampsia with eGFR decline of ≥ 10 ml/min/1.73m2.ConclusionHypertension and proteinuria are common after 6 months underlining the importance of close follow up to identify those women who need further care.
Highlights
Data on the prevalence of persistent symptoms in the first year after preeclampsia are limited
The aim of the study was to determine the frequency of hypertension, proteinuria and estimated glomerular filtration rate (eGFR) decline 6 months after preeclampsia and to search for possible parameters associated with these endpoints
Severe preeclampsia was observed in 67% (132/197) and eclampsia as the most severe form was seen in 2% (4/198). 90.1% (181/201) had no pre-existing diseases before pregnancy
Summary
Data on the prevalence of persistent symptoms in the first year after preeclampsia are limited. Apart from the high morbidity with sometimes even lifethreatening implications for mother and child during the acute phase of the disease, there are concerns about. To identify those with chronic hypertension or proteinuria after delivery, it is important to know the usual time of resolution of these symptoms. There is data indicating that hypertension persists in almost 40% of patients after 3 months and still is Girsberger et al BMC Pregnancy and Childbirth (2018) 18:177 present in 18% after 2 years [11]. In regard to the few existing studies, we hypothesized that a significant part of patients still show sequelae of preeclampsia 6 months after pregnancy. The aim of the study was to determine the frequency of hypertension, proteinuria and eGFR (estimated glomerular filtration rate) decline 6 months after preeclampsia and to search for possible parameters associated with these endpoints
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