Maternal and Perinatal Outcomes of Early- and Late-onset Preeclampsia

Jeong, Eun Jeong; Kim, Young Nam; Kim, Jong Hyuk; Jo, Yu Kyung; Byun, Jung Mi; Jeong, Dae Hoon; Lee, Kyung Bok; Sung, Moon Su; Kim, Ki Tae

Abstract

PURPOSE
Early-onset preeclampsia is thought to be associated with fetal mortality and maternal complications. We compared maternal clinical characteristics, complications, and perinatal outcome between early- and late-onset preeclampsia.
METHODS
We analysed retrospectively 212 pregnant women with preeclampsia between 2004 and 2008 at a tertiary university hospital. We divided preeclamptic women as early-onset (n=58), with an onset before 32 weeks gestation, and late-onset (n=154), with an onset after 32 weeks gestation. We compared maternal characteristics, maternal complications, and neonatal outcomes between the two groups.
RESULTS
There were no significant differences in maternal age, parity, BMI, previous history of preeclampsia, hypertension, and DM between early- and late-onset preeclampsia. Among the maternal complications, maternal blood pressure was higher in early-onset preeclampsia without any statistical significance, but the amount of 24 hours urine protein was significantly higher in early-onset preeclampsia than late-onset (P=0.003). There were significantly higher rate of visual disturbance, elevated liver enzyme, pulmonary edema and severe disease in early-onset preeclampsia (all P<0.05). Comparing neonatal outcome, there were higher rate of fetal death in uterus (FDIU) (P=0.0001), low Apgar score (P<0.0001), and perinatal death (P<0.0001) in early-onset preeclampsia. Fetal birth weight and onset of preeclampsia were significant covariate factors for perinatal mortality.
CONCLUSION
Early-onset preeclampsia was related to poor perinatal and materanl outcomes, but there was no difference in maternal characteristics. Further studies are necessary for prediction, pathogenesis, and therapy of early-onset preeclampsia.