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Original article

Vol. 145 No. 3132 (2015)

Incidence of preeclampsia in pregnant Swiss women

  • Mette-Triin Purde
  • Marc Baumann
  • Ute Wiedemann
  • Urs Nydegger
  • Lorenz Risch
  • Daniel Surbek
  • Martin Risch
DOI
https://doi.org/10.4414/smw.2015.14175
Cite this as:
Swiss Med Wkly. 2015;145:w14175
Published
26.07.2015

Summary

QUESTION UNDER STUDY: The epidemiology of preeclampsia in Switzerland is known only from a retrospective registry study. This analysis aimed to prospectively determine the incidence of preeclampsia in a cohort of pregnant women in Switzerland.

METHODS: Pregnant women presenting at gestational week 11–14 at their obstetrician’s office were consecutively included and prospectively followed-up until the end of pregnancy. Ultrasound characteristics, blood pressure measurements, body mass index, and personal history were recorded. Duration of pregnancy, occurrence of preeclampsia, birth weight and Apgar scores were recorded as outcomes.

RESULTS: There were 1,300 pregnancies with follow-up available for analysis. Median age was 30 years (interquartile range [IQR] 27–33), median body mass index (BMI) 23.3 kg/m2 (IQR 21.2–26.1), median systolic blood pressure 117 mm Hg (IQR 109–126) and median diastolic blood pressure 70 mm Hg (IQR 64–77). A total of 30 women developed preeclampsia, corresponding to an incidence of 2.31% (95% confidence interval [CI] 1.62%–3.28%). Of the women with preeclampsia, 6.66% (95% CI 2.04%–21.42%) had early-onset preeclampsia, 13.33% (95% CI 5.45%–29.83%) progressed to eclampsia, whereas 10% (95% CI 3.63%–28.75%) developed HELLP syndrome (haemolysis, elevated liver enzymes, low platelet count). Nulliparity and prior history of preeclampsia were more frequently seen in pregnancies with preeclampsia than in pregnancies without preeclampsia. BMI, as well as systolic and diastolic blood pressure were higher in pregnancies subsequently developing preeclampsia.

CONCLUSION: The incidence of preeclampsia in Switzerland is in line with frequencies observed elsewhere in the world. Extrapolation to a national level indicates that about 1,911 (range 1,340–2,713) preeclampsia cases per year can be expected to occur in Switzerland.

References

  1. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785–99.
  2. Harlow FH, Brown MA. The diversity of diagnoses of preeclampsia. Hypertension in pregnancy 2001; 20:57-67.
  3. Chappell S, Morgan L. Searching for genetic clues to the causes of pre-eclampsia. Clinical science. 2006;110:443–58.
  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). Hypertens Pregnancy. 2001;20:IX–XIV.
  5. The hypertensive disorders of pregnancy. Report of a WHO study group. World Health Organ Tech Rep Ser. 1987;758:1–114.
  6. Baumann MU, Bersinger NA, Surbek DV. Serum markers for predicting pre-eclampsia. Mol Aspects Med. 2007;28:227–44.
  7. Carty DM, Delles C, Dominiczak AF. Novel biomarkers for predicting preeclampsia. Trends Cardiovasc Med. 2008;18:186–94.
  8. Moslemi Zadeh N, Naghshvar F, Peyvandi S, Gheshlaghi P, Ehetshami S. PP13 and PAPP-A in the First and Second Trimesters: Predictive Factors for Preeclampsia? ISRN Obstet Gynecol. 2012;2012:263871.
  9. Baumann MU, Bersinger NA, Mohaupt MG, Raio L, Gerber S, Surbek DV. First-trimester serum levels of soluble endoglin and soluble fms-like tyrosine kinase-1 as first-trimester markers for late-onset preeclampsia. Am J Obstet Gynecol. 2008;199:266e261–6.
  10. Cnossen JS, Morris RK, ter Riet G, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. Can Med Assoc J. 2008;178:701–11.
  11. Espinoza J, Romero R, Nien JK, et al. Identification of patients at risk for early onset and/or severe preeclampsia with the use of uterine artery Doppler velocimetry and placental growth factor. Am J Obstet Gynecol. 2007;196:326 e321–13.
  12. Baumann M, Korner M, Huang X, Wenger F, Surbek D, Albrecht C. Placental ABCA1 and ABCG1 expression in gestational disease: Pre-eclampsia affects ABCA1 levels in syncytiotrophoblasts. Placenta. 2013;34:1079–86.
  13. Gong YH, Jia J, Lu DH, Dai L, Bai Y, Zhou R. Outcome and risk factors of early onset severe preeclampsia. Chin Med J (Engl). 2012;125:2623–7.
  14. Madazli R, Yuksel MA, Imamoglu M, et al. Comparison of clinical and perinatal outcomes in early- and late-onset preeclampsia. Arch Gynecol Ostet. 2014;290:53–7.
  15. Vatten LJ, Skjaerven R. Is pre-eclampsia more than one disease? BJOG. 2004;111:298–302.
  16. Eiland E, Nzerue C, Faulkner M. Preeclampsia 2012. JPregnancy 2012;2012:586578.
  17. Al-Jameil N, Aziz Khan F, Fareed Khan M, Tabassum H. A brief overview of preeclampsia. J Clin Med Res. 2014;6:1–7.
  18. Conde-Agudelo A, Belizan JM. Risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women. BJOG. 2000;107:75–83.
  19. Dekker G, Sibai B. Primary, secondary, and tertiary prevention of pre-eclampsia. Lancet. 2001;357:209–15.
  20. Cnattingius S, Mills JL, Yuen J, Eriksson O, Salonen H. The paradoxical effect of smoking in preeclamptic pregnancies: smoking reduces the incidence but increases the rates of perinatal mortality, abruptio placentae, and intrauterine growth restriction. Am J Obstet Gynecol. 1997;177:156–61.
  21. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330:565.
  22. Assis TR, Viana FP, Rassi S. Study on the major maternal risk factors in hypertensive syndromes. Arq Bras Cardiol. 2008;91:11–7.
  23. Savitz DA, Danilack VA, Engel SM, Elston B, Lipkind HS. Descriptive epidemiology of chronic hypertension, gestational hypertension, and preeclampsia in New York State, 1995-2004. Matern Child Health J. 2014;18:829–38.
  24. Khalil A, Rezende J, Akolekar R, Syngelaki A, Nicolaides KH. Maternal racial origin and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2013;41:278–85.
  25. Altman D, Carroli G, Duley L, et al. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet. 2002;359:1877–90.
  26. Abalos E, Cuesta C, Carroli G, et al. Pre-eclampsia, eclampsia and adverse maternal and perinatal outcomes: a secondary analysis of the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG. 2014;121Suppl1:14–24.
  27. von Schmidt auf Altenstadt JF, Hukkelhoven CW, van Roosmalen J, Bloemenkamp KW. Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands. PloS one. 2013;8:e81959.
  28. Dahlstrom BL, Engh ME, Bukholm G, Oian P. Changes in the prevalence of pre-eclampsia in Akershus County and the rest of Norway during the past 35 years. Acta Obstet Gynecol Scand. 2006;85:916–21.
  29. Lamminpaa R, Vehvilainen-Julkunen K, Gissler M, Heinonen S. Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997–2008. BMC Pregnacy Childbrith. 2012;12:47.
  30. Statistik; Bf, Bevölkerungsbewegung – Detaillierte Daten; Geburt und Fruchtbarkeit. http://www.bfs.admin.ch/bfs/portal/de/index/themen/01/06/blank/data/01.html: Bundesamt für Statistik, 2015.
  31. Schwab P, Zwimpfer A. Statistik der Schweiz. Gebären in Schweizer Spitälern. Spitalaufenthalte während Schwangerschaft und Entbindung. Neuchatel: Bundesamt für Statistk. 2007.
  32. Statistik; Bf, Fortpflanzung, Gesundheit der Neugeborenen – Daten, Indikatoren. http://www.bfs.admin.ch/bfs/portal/de/index/themen/14/02/03/key/04.html: Bundesamt für Statistik. 2015.
  33. Roberts CL, Ford JB, Algert CS, et al. Population-based trends in pregnancy hypertension and pre-eclampsia: an international comparative study. BMJ open. 2011;1:e000101.
  34. Schneuer FJ, Nassar N, Khambalia AZ, et al. First trimester screening of maternal placental protein 13 for predicting preeclampsia and small for gestational age: in-house study and systematic review. Placenta. 2012;33:735–40.
  35. Caradeux J, Serra R, Nien JK, et al. First trimester prediction of early onset preeclampsia using demographic, clinical, and sonographic data: a cohort study. Prenat Diagn. 2013;33:732–6.
  36. Mihu D, Costin N, Mihu CM, Seicean A, Ciortea R. HELLP syndrome – a multisystemic disorder. J Gastrointestin Liver Dis. 2007;16:419–24.
  37. Abraham KA, Connolly G, Farrell J, Walshe JJ. The HELLP syndrome, a prospective study. Renal failure. 2001;23:705–13.
  38. Magann EF, Perry KG, Jr., Chauhan SP, Graves GR, Blake PG, Martin JN, Jr. Neonatal salvage by week's gestation in pregnancies complicated by HELLP syndrome. J Soc Gynecol Investlg. 1994;1:206–9.
  39. Oliveira N, Doyle LE, Atlas RO, Jenkins CB, Blitzer MG, Baschat AA. External validity of first-trimester algorithms in the prediction of pre-eclampsia disease severity. Ultrasound Obstet Gynecol. 2014;44:286–92.
  40. Abu-Heija AT, Chalabi HE. Great grand multiparity: is it a risk? J Obstet Gynecol. 1998;18:136–8.
  41. Zhang J, Meikle S, Trumble A. Severe maternal morbidity associated with hypertensive disorders in pregnancy in the United States. Hypertens Pregnancy. 2003; 22:203-212.
  42. Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335:974.
  43. Catov JM, Ness RB, Kip KE, Olsen J. Risk of early or severe pre-eclampsia related to pre-existing conditions. Int J Epidemiol. 2007;36:412–9.
  44. Klungsoyr K, Morken NH, Irgens L, Vollset SE, Skjaerven R. Secular trends in the epidemiology of pre-eclampsia throughout 40 years in Norway: prevalence, risk factors and perinatal survival. Paediatr Perinat Epidemiol. 2012;26:190–8.
  45. Hernandez-Diaz S, Toh S, Cnattingius S. Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. BMJ. 2009;338:b2255.
  46. Eskild A, Vatten LJ. Abnormal bleeding associated with preeclampsia: a population study of 315,085 pregnancies. Acta Obstet Gynecol Scand. 2009;88:154–8.
  47. Ros HS, Cnattingius S, Lipworth L. Comparison of risk factors for preeclampsia and gestational hypertension in a population-based cohort study. Am J Epidemiol. 1998;147:1062–70.
  48. Lawler J, Osman M, Shelton JA, Yeh J. Population-based analysis of hypertensive disorders in pregnancy. HypertensPregnancy. 2007;26:67–76.
  49. Xiong X, Demianczuk NN, Saunders LD, Wang FL, Fraser WD. Impact of preeclampsia and gestational hypertension on birth weight by gestational age. Am J Epidemiol. 2002;155:203–9.
  50. Ananth CV, Keyes KM, Wapner RJ. Pre-eclampsia rates in the United States, 1980–2010: age-period-cohort analysis. BMJ. 2013;347:f6564.
  51. Dawson LM, Parfrey PS, Hefferton D, et al. Familial risk of preeclampsia in Newfoundland: a population-based study. J Am Soc Nephrol. 2002;13:1901–6.
  52. Roberts CL, Algert CS, Morris JM, Ford JB, Henderson-Smart DJ. Hypertensive disorders in pregnancy: a population-based study. Med J Aust. 2005;182:332–5.
  53. Lee CJ, Hsieh TT, Chiu TH, Chen KC, Lo LM, Hung TH. Risk factors for pre-eclampsia in an Asian population. Int J Gynaecol Obstet. 2000;70:327–33.
  54. Shiozaki A, Matsuda Y, Satoh S, Saito S. Comparison of risk factors for gestational hypertension and preeclampsia in Japanese singleton pregnancies. J Obstet Gynaecol Res. 2013;39:492–9.
  55. Ye C, Ruan Y, Zou L, et al. The 2011 survey on hypertensive disorders of pregnancy (HDP) in China: prevalence, risk factors, complications, pregnancy and perinatal outcomes. PloS one. 2014;9:e100180.
  56. Shental O, Friger M, Sheiner E. Ethnic differences in the monthly variation of preeclampsia among Bedouin and Jewish parturients in the Negev. HypertensPregnancy. 2010;29:342–9.
  57. Subramaniam V. Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions. BMC Womens Health. 2007;7:18.

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