Article Data

  • Views 1707
  • Dowloads 131

Original Research

Open Access

What affects the outcome of severe preeclampsia?


1Department of OB/GYN, School of Medicine, University of Zagreb, Zagreb, Croatia

2University of Applied Health Sciences, Zagreb, Croatia

DOI: 10.22514/SV101.062015.1 Vol.10,Issue S1,June 2015 pp.6-12

Published: 22 June 2015

*Corresponding Author(s): PETRANA BELJAN E-mail:


Preeclampsia is a severe multi-system pregnancy related disorder associated with multiple maternal and fetal adverse out-comes, including fetal and maternal mor-tality. The aim of this study is to investigate the clinical difference between early- and late-onset preeclampsia and their impact to perinatal outcome, and to detect pos-sible antenatal parameters that can predict adverse fetal and maternal outcomes. The research team conducted a retrospective cohort study of 308 singleton pregnan-cies complicated with severe preeclamp-sia over an 8-year period in our tertiary level centre. Clinical differences and perinatal outcomes between early- (<34 weeks, n=147) and late-onset (≥34 weeks, n=161) preeclampsia were analyzed. Pos-sible antenatal risk factors that can influ-ence adverse perinatal outcomes in severe preeclampsia were also evaluated. Clinical symptoms and perinatal outcomes were significantly unfavourable in early-onset preeclampsia. Adverse perinatal outcomes in the early-onset group were complicated with 10 (6.08%) intrauterine fetal deaths and 4 (2.37%) neonatal deaths. Primipa-rity seems to be the significant antenatal risk factor for appearance of early-onset of the disease (p<0.001, OR 2.39, 95% CI 1.48-3.86) and for the first minute Apgar score <7 (p=0.036, OR 1.68, 95% CI 1.04-2.74). Patients with severe preeclampsia are high- risk obstetric patients because of the unpredictability, varying clinical pres-entation and potential adverse outcomes of the disease. Pregnant women with an early appearance of the disease had severe clinical presentation and more often an unfavourable perinatal outcome.


early-onset preeclampsia, peri-natal outcome, HELLP

Cite and Share



1. Lindheimer MD, Roberts JM and Cunningham FG. Chesley’s hypertensive disorders in pregnancy. 3rd ed.Amsterdam :ElsevierInc; 2009.

2. Surapaneni T, PatilBada V, and Kumar Nirmalan CP. Risk of recurrence of pre-eclampsia in the subsequent pregnancy. JCDR 2013;7:2889–2891.

3. World Health Organization. Make Every Mother and Child Count. World Health Report; 2005; World Health Organization, Geneva. Switzerland.

4. Brown MA, Lindheimer MD, De Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the international society for the study of hypertension in pregnancy (ISSHP). Hypertension in Pregnancy 2001;20(1):9–14.

5. Davison JM, Homuth V, Jeyabalan A. New aspects in the pathophysiology of Preeclampsia. J Am SocNephrol2004;15:2440–2448.

6. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet 2005;365:785–799.

7. Roberts JM, Escudero C. The placenta in preeclampsia.Pregnancy Hypertension. 2012;2(2):72–83.

8. Redman CW, Sargent IL. Latest advances in understanding preeclampsia. Science 2005;308(5728):1592–1594.

9. Davison JM, Homuth V, Jeyabalan A, et al. New aspects in the pathophysiology of preeclampsia. Journal of the American Society of Nephrology 2004;15(9):2440–2448.

10. Powe CE, Levine RJ, Karumanchi SA. Preeclampsia, a disease of the maternal endothelium: the role of antiangiogenic factors and implications for later cardiovascular disease. Circulation 2011;123:2856–2869.

11. Report of the National High Blood Pressure Education Program. Working group on High Blood Pressure in Pregnancy. Am J ObstetGynecol 2000;183:S1-22.

12. Publications Comitee, Society for Maternal-Fetal Medicine. Evaluation and management of severe preeclampsia before 34 weeks’ gestation. Am J ObstetGynecol 2011;205:191.

13. Moon M, Odibo A. First-trimester screening for preeclampsia:impact of maternal parity on modeling and screening effectiveness. J Matern Fetal Neonatal Med 2014;11:1-6.

14. Duckitt K, Harrington D. Risk factors for preeclampsia at antenatal booking: systematic review of controlled studies. BMJ 2005;330:565-573.

15. Reis ZS, Lage EM, Teixeira PG, Guedes LR, Oliviera EC, Cabral AC. Early onsep preeclampsia: is it a better classification for maternal and perinatal outcome?. Rev Bras GinecolObstet2010;32:584-590.

16. Buchbinder A, Sibai BM, Caritis S. Adverse perinatal outcome are significantly higher in severe gestational hypertension than in mild preeclampsia. National Institute Of Child Health And Human Development Network Of Maternal-Fetal Medicine Units. Am J ObstetGynecol 2002;186:66-67.

17. Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease. Am J ObstetGy-necol2013;209:544.e1-12.doi:10.1016/j.ajog.2013.08.019.

18. Sibai BM, Spinnato JA, Watson DL, Anderson GD. Pregnancy outcome in 303 cases with severe preeclampsia. Am J ObstetGynecol 1984;64(3):319-322.

19. Geyl C, Clouquer E, Lambert J, Subtil D, Debarge V, Deruelle P. Links between preeclampsia and intrauterine growth restriction. GynecolObstet-Fertil2014;42:229-233.

20. Srinivas SK, Edlow AG, Neff PM, Sammel MD, Andrela CM, Elovitz MA. Rethinking IUGR in preeclampsia: dependent or independent of mater-nal hypertension? J Perinatol2009;29(10):680-684. doi: 10.1038/jp.2009.83.

21. Stubert Ullman S, Dieterich M, Diedrich D, Reimer T. Clinical differences between early- and- late onset severe preeclampsia and analysis of predic-tors for perinatal outcome. J PerinatMed 2014;42:617-627.

22. Boghossian NS, Yeung E, Mendola P, Hinkle SN, Laughon SK, Zhang C, Albert PS. Risk factors differ between recurrent and incident preeclampsia: a hospital- based cohort study. Ann Epidemiol 2012;24:871-877.

23. Schummers L, Hutcheon JA, Bodnar LM, Lieberman E, Himes KP: Risk of adverse pregnancy outcomes by prepregnancu body mass index: a population –based study to inform prepregnancy weight loss counseling. ObstetGynecol 2015;125:133-143.

24. Nischintha P, PallaveeP, Seetesh G. Correlation between 24-urine protein, spot urine protein/creatinine ratio, and serum uric acid and their associa-tion with fetomaternal outcomes in preeclamptic women. J Nat SciBiolMed 2014;5:255-260.

25. Gray PH, O’Callaghan MJ, Mohay HA, Burns JR, King FK. Maternal hypertension and neurodevelopmental outcome in very preterm infants, Archives of Disease in Childhood: Fetal and Neonatal Edition1998;2(79): 88–93.

26. Silveira RC, Procianoy RS, Koch MS, Benjamin ACV, Schlindwein CF. Growth and neurodevelopment outcome of very low birth weight infants delivered by preeclamptic mothers. ActaPaediatrica, International Journal of Paediatrics 2007;12(96):1738–1742.

27. Saleem S, McClure EM, Goudar SS et al. Newborn Health Registry Study Investigators. A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries. Bull World Health Organ 2014;1;92(8):605-612. doi: 10.2471/BLT.13.127464.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time