UC Researcher Published Study on Preeclampsia in Hypertensive Women in "New England Journal of Medicine"
Cincinnati--A research study demonstrates that women who have high
blood pressure for at least four years before getting pregnant have an
increased risk of developing the dangerous condition known as
The research was conducted at the University of Cincinnati (UC) and 12
other US Maternal-Fetal Medicine Units, which are part of the National
Institute of Child Health and Human Development's (NICHD) Network of
Maternal-Fetal Medicine Units. Study results were published in the
September 3 issue of The New England Journal of Medicine.
Menachem Miodovnik, MD, professor of Obstetrics and Gynecology at the
College of Medicine and principal investigator of UC's Maternal-Fetal
Medicine Unit, co-authored the study, which sought to determine the
factors that predispose women with chronic hypertension, a major risk
factor for preeclampsia, to develop the condition. In all, researchers
recruited 763 women with chronic hypertension who were 13 to 26 weeks
along in the pregnancies.
Preeclampsia can strike without warning. The condition results in high
blood pressure and protein in the urine. In turn, preeclampsia may
progress to eclampsia, which can be fatal. About five percent of
first-time mothers and one to two percent of mothers having subsequent
pregnancies develop preeclampsia.
Although the study showed that protein in the urine early in pregnancy
did not increase a woman's risk of developing preeclampsia, these women
were more likely to have infants who were small for gestational age,
born prematurely, require admission to a neonatal intensive care unit,
and suffer brain hemorrhages.
These researchers found that women were more likely to develop
preeclampsia if they had a history of hypertension for at least four
years before becoming pregnant, preeclampsia during a previous
pregnancy, and a diastolic blood pressure reading from 100 to 110 mmHg
early in pregnancy.
Women who developed preeclampsia were also more likely to develop
abruptio placentae, which is a potentially serious complication of
pregnancy when the placenta separates prematurely from the uterine wall
and causes significant bleeding for the women. In addition, the
newborns of women with preeclampsia were more likely to be born
prematurely, require admission to a neonatal intensive care unit,
suffer a hemorrhage in the womb, and die shortly before, during, or
In cases where preeclampsia did not progress to eclampsia, these
mothers delivered infants who were small for gestational age or born
prematurely, both factors which may place infants at risk for a variety
of other complications. Although the high blood pressure accompanying
preeclampsia can be treated with blood pressure medication, the only
curative treatment is immediate delivery.
The researchers originally collected the information as part of a study
to determine if low-dose aspirin would reduce the incidence of
hypertension in women at risk for preeclampsia. The aspirin treatment
did not appear to affect whether women developed the condition with 26
percent of the women taking aspirin developing preeclampsia and 24.6
percent of the women taking the placebo developing it.
"These findings underscore the importance of preconception counseling
regarding the adverse effects of proteinuria in hypertensive women,"