It is unclear which women will progress from preeclampsia without severe features to more severe disease by delivery. The objective of this study was to evaluate potential predictors of progression from preterm gestational hypertension (GHTN) or preeclampsia (PE) without severe features to severe disease.METHODS:
At a university hospital between January 2008 and July 2015, women with singleton pregnancies and GHTN or PE without severe features diagnosed prior to 34 0/7 weeks had demographic and obstetric factors retrospectively collected to determine if those factors influence progression to preeclampsia with severe features.RESULTS:
63 women developed GHTN or PE without severe features less than 34 weeks. 38 women remained without severe features (60.3%), and 25 progressed to PE with severe features (39.7%). There was no difference in age, race, or gestational age at diagnosis or delivery. Smoking (OR 4.7, 95% CI 1.08 to 20.22) and a history of preeclampsia (OR 5.7, 95% CI 1.04 to 30.93) were associated with higher odds of developing severe features. IUGR was associated with a lower risk of progressing to severe features (OR 0.1, 95% CI 0.01 to 0.85). All IUGR patients were delivered for abnormal antenatal testing. Women who developed severe features had lower parity (P=.03) than those without severe features.CONCLUSION:
Smoking and history of preeclampsia may be predictors of progression to PE with severe features in women who develop preterm GHTN or PE without severe features. IUGR is associated with lower odds of progression to severe features, likely secondary to earlier delivery for fetal indications.