Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies

• Autor: Duckitt, Kirsten ; Harrington, Deborah
• Assuntos: Age Factors ; Antiphospholipid Syndrome - complications ; Autoimmune Diseases - complications ; Birth Intervals ; Blood Pressure ; Body Mass Index ; Cohort studies ; Diabetes ; Disease risk ; Eclampsia ; Epidemiologic Methods ; Family history ; Female ; Humans ; Hypertension, Pregnancy-Induced - etiology ; International economic parity ; Kidney Diseases - complications ; Parity ; Pedigree ; Pre-Eclampsia - etiology ; Pre-Eclampsia - physiopathology ; Predisposing factors ; Preeclampsia ; Pregnancy ; Pregnancy in Diabetics - complications ; Pregnancy, Multiple ; Prenatal Care
• É parte de: BMJ, 2005-03, Vol.330 (7491), p.565-567
• Notas: istex:42A55C830B741BA8C639EE248230ADF473DF5DC6
  href:bmj-330-565.pdf
  ArticleID:bmj.38380.674340.E0
  PMID:15743856
  Correspondence to: K Duckitt
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  Contributors: The original idea for the article came from a meeting of the PRECOG (pre-eclampsia community guideline) development group. The study was designed by KD. Data were extracted independently by KD and DH. The paper was written by KD and reviewed by DH. KD is guarantor.
  Funding: The photocopying of some of the articles was paid for by the charity APEC (Action on Pre-eclampsia).
  Competing interests: None declared.
  Funnel plots for the main outcomes can be found on bmj.com
  We thank Jill Mollison from the Centre for Statistics in Medicine, Oxford who provided statistical advice.
  Correspondence to: K Duckitt Kduckitt@doctors.org.uk
  Ethical approval: Not needed.
  
• Descrição: Abstract Objective To determine the risk of pre-eclampsia associated with factors that may be present at antenatal booking. Design Systematic review of controlled studies published 1966-2002. Data synthesis Unadjusted relative risks were calculated from published data. Results Controlled cohort studies showed that the risk of pre-eclampsia is increased in women with a previous history of pre-eclampsia (relative risk 7.19, 95% confidence interval 5.85 to 8.83) and in those with antiphospholipids antibodies (9.72, 4.34 to 21.75), pre-existing diabetes (3.56, 2.54 to 4.99), multiple (twin) pregnancy (2.93, 2.04 to 4.21), nulliparity (2.91, 1.28 to 6.61), family history (2.90, 1.70 to 4.93), raised blood pressure (diastolic ≥ 80 mm Hg) at booking (1.38, 1.01 to 1.87), raised body mass index before pregnancy (2.47, 1.66 to 3.67) or at booking (1.55, 1.28 to 1.88), or maternal age ≥ 40 (1.96, 1.34 to 2.87, for multiparous women). Individual studies show that risk is also increased with an interval of 10 years or more since a previous pregnancy, autoimmune disease, renal disease, and chronic hypertension. Conclusions These factors and the underlying evidence base can be used to assess risk at booking so that a suitable surveillance routine to detect pre-eclampsia can be planned for the rest of the pregnancy.
  
• Editor: England: British Medical Journal Publishing Group
  
• Idioma: Inglês