Non-proteinuric pre-eclampsia: a novel risk indicator in women with gestational hypertension

被引:141
作者
Homer, Caroline S. E. [2 ]
Brown, Mark A. [1 ,3 ,4 ]
Mangos, George [1 ,3 ,4 ]
Davis, Gregory K. [3 ]
机构
[1] St Georges Hosp & Univ, Dept Renal Med, Kogarah, NSW 2217, Australia
[2] Univ Technol Sydney, Fac Nursing Midwifery & Hlth, Ctr Midwifery Child & Family Hlth, Sydney, NSW 2007, Australia
[3] St Georges Hosp & Univ, Dept Womens Hlth, Kogarah, NSW 2217, Australia
[4] St Georges Hosp & Univ, Dept Med, Kogarah, NSW 2217, Australia
关键词
gestational hypertension; hypertension in pregnancy; pre-eclampsia; proteinuria;
D O I
10.1097/HJH.0b013e3282f1a953
中图分类号
R6 [外科学];
学科分类号
1002 [临床医学]; 100210 [外科学];
摘要
Objective To determine whether outcomes differed for women with pre-eclampsia according to the presence of proteinuria and whether non-proteinuric pre-eclampsia is similar to gestational hypertension. Design From 1987 to 2005, at three hospitals in Sydney, Australia, women referred to the obstetric medicine team were recruited. Outcomes for three groups were compared: proteinuric pre-eclampsia, non-proteinuric pre-eclampsia and gestational hypertension. Results Women with proteinuric pre-eclampsia were more likely to have severe hypertension ( 39 versus 30%, P = 0.003), deliver preterm infants ( 39 versus 30%, P = 0.007) and had a higher perinatal mortality rate (25.2 versus 5.7 per 1000, P= 0.02) than those with non-proteinuric pre-eclampsia, who were more likely to have thrombocytopenia and liver disease. Women with non-proteinuric pre-eclampsia were more likely to have multiple pregnancies (3.9 versus 9.9%, P < 0.001), experience severe hypertension (8.9 versus 29.7%, P < 0.001), and deliver preterm infants (11.3 versus 30.2%, P < 0.001) who were small for gestational age (12.7 versus 20.9%, P < 0.001) than those with gestational hypertension. Conclusion This study highlights differences between non-proteinuric pre-eclampsia and gestational hypertension. The subclassification of `non-proteinuric pre-eclampsia' should be added to existing classification systems to alert clinicians to potential risks.
引用
收藏
页码:295 / 302
页数:8
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