Severe, Very Early Onset Preeclampsia: Subsequent Pregnancies and Future Parental Cardiovascular Health

Objective: To study subsequent pregnancy outcome in women with severe, very early onset preeclampsia (onset before 24 weeks' gestation) and to analyze cardiovascular risk profiles of these women and their partners.

Study Design: Twenty women with preeclampsia with an onset before 24 weeks' gestation, admitted between 1 January 1993 and 31 December 2002 at a tertiary university referral center, were enrolled in the study. Data on subsequent pregnancies were obtained from medical records. Their cardiovascular risk profiles and those of their partners (n=15) were compared with those of 20 control women after uncomplicated pregnancies only, matched for age and parity, and those of their partners (n=13). Body weight, height, waist and hip circumference, blood pressure and intima media thickness (IMT) of the common carotid artery were measured. Fasted blood samples were drawn for detection of metabolic cardiovascular risk factors.

Results: Of the 20 case women 17 women had 24 subsequent pregnancies, of which 12 (50%) were complicated by preeclampsia. Severe preeclampsia developed in five (21%) pregnancies. No perinatal deaths occurred. Case women had significantly more often chronic hypertension as compared to controls (55% vs. 10%, P=0.002). IMT of the common carotid artery was increased in a subset of case women using antihypertensive medication (P=0.03). Case women showed increased microalbuminuria (P<0.05). No differences were found in cardiovascular risk profiles between partners of cases and controls.

Conclusions: Women with severe, very early onset preeclampsia have an increased risk of preeclampsia in future pregnancies, yet neonatal outcome is, in general, favourable. Regarding cardiovascular health, women after severe, very early onset preeclampsia exhibit more risk factors compared to controls whereas men who fathered these pregnancies do not.