The role of placental histopathological lesions in predicting recurrence of preeclampsia.

Abstract:

OBJECTIVE:We aimed to study the role of placental pathology in the prediction of preeclampsia (PE) recurrence. METHODS:The medical records and pathological placental reports of all women diagnosed with PE, during 2008-2015, were reviewed. The study population was divided according to the outcome of their subsequent pregnancy: those who did (recurrence group) or did not (no-recurrence group) develop recurrent PE. Data regarding maternal characteristics and placental maternal/fetal vascular malperfusion lesions, of the initial pregnancies, were compared. Two prediction models were generated for PE recurrence. RESULTS:Compared to the no-recurrence group (n = 130), the recurrence group (n = 96) was characterized by lower gestational age (p < 0.001), longer inter-pregnancy interval (p = 0.012), and higher rate of severe features (p < 0.001). By logistic regression analysis composite maternal (aOR = 3.05, 95%CI 1.39-6.71, p = 0.005), fetal (aOR = 9.31, 95%CI 3.9-22.1, p < 0.001), and concurrent maternal + fetal (aOR = 13.94, 95%CI 5.08-38.21, p < 0.001), vascular malperfusion lesions were found to be independently associated with recurrence. A clinical prediction model accounted for 20.8% of PE recurrence (R2  = 0.208, AUC = 0.732), while a clinical-pathological model accounted for 34.2% of recurrence (R2  = 0.342, AUC = 0.80). CONCLUSION:Placental maternal and fetal vascular malperfusion lesions are independently associated with increased risk for PE recurrence. A clinical-pathological prediction model for recurrence of PE is superior to a prediction model based merely on clinical factors. © 2016 John Wiley & Sons, Ltd.

journal_name

Prenat Diagn

journal_title

Prenatal diagnosis

authors

Weiner E,Mizrachi Y,Grinstein E,Feldstein O,Rymer-Haskel N,Juravel E,Schreiber L,Bar J,Kovo M

doi

10.1002/pd.4918

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

953-960

issue

10

eissn

0197-3851

issn

1097-0223

journal_volume

36

pub_type

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