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University of Cincinnati Academic Health Center
Publish Date: 09/08/98
Media Contact: AHC Public Relations, (513) 558-4553
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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 preeclampsia.

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 after birth.

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," says Miodovnik.

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