Metabolic syndrome and the risk for recurrent pre-eclampsia: a retrospective cohort study

Objective To compare the prevalence of recurrent pre-eclampsia between women who have and do not have metabolic syndrome when non-pregnant. Design Retrospective cohort study. Setting Three tertiary referral hospitals in the Netherlands. Population Formerly pre-eclamptic women. Methods The presence or absence of metabolic syndrome was assessed in 480 women at least 6months after their first pre-eclamptic pregnancy using World Health Organization criteria. We compared the prevalence of recurrent pre-eclampsia in the subsequent pregnancy, calculating odds ratios (OR), adjusted for confounders. Main outcome measure Recurrence of pre-eclampsia in the subsequent pregnancy. Results Subsequent pregnancy outcome data were available for 197 women. Forty women had metabolic syndrome after previous pregnancy (20%). The prevalence of recurrent pre-eclampsia was 18/40 (45%) in women with metabolic syndrome versus 27/157 (17%) in women without metabolic syndrome; OR 3.94 (95% confidence interval [CI] 1.86-8.33, adjusted OR 3.77 (95% CI 1.61-8.81). The risk of recurrent pre-eclampsia increased with each extra component of the metabolic syndrome from 11.8% for absent components up to 43.9% for three or more (P for trend<0.001). Conclusions Interpregnancy metabolic syndrome predisposes to recurrent pre-eclampsia.