Risk factors associated with early and late onset preeclampsia:IJOGR
Preeclampsia is a multi-organ disorder that occurs during pregnancy and the postpartum period which is characterized by blood pressure ≥ 140/90 mmHg that appears after 20 weeks of gestation in patients who previously had no history of hypertension.
Preeclampsia is classified as either early onset preeclampsia or late onset preeclampsia, depending on the gestational age at which the condition was initially identified. When identified at less than 34 weeks of gestation, the condition is referred to as Early onset preeclampsia (EOP). It is referred to as Late onset preeclampsia (LOP) if the gestational age is 34 weeks or more. While late-onset preeclampsia may show less severe clinical signs, early-onset preeclampsia is regarded to be quite dangerous for both the mother and the fetus.
Preeclampsia can cause abortion, prematurity, intrauterine growth retardation and even stillbirth. Therefore, early detection (antenatal care) is needed to prevent this disease. Examination of risk factors, early diagnosis and intervention in every pregnant woman can be taken as one of the steps to reduce mortality due to preeclampsia.
Pregestational diabetes, thrombophilia, nulliparity, multifetal gestations, chronic hypertension, pregestational diabetes, gestational diabetes, systemic lupus erythematosus, prepregnancy Body Mass Index (BMI) > 30, maternal age ≥ 35 years, kidney disease, assisted reproductive technology, and obstructive sleep apnea are among the risk factors that have been linked to the incidence of preeclampsia. Preeclampsia is associated with risk factors in Indonesia, including obesity, history of hypertension, history of preeclampsia in prior pregnancies, maternal age ≥ 35 years, BMI, nullipara, and active or passive smoker.
This study aimed to determine the characteristics and whether there are differences in risk factors in the occurrence of early onset and late onset preeclampsia. These risk factors can help clinician to predict and identify cases that may develop into early onset and late onset preeclampsia. This study included maternal age, active or passive smoking, BMI, multifetal pregnancy, gestational diabetes, diabetes mellitus, chronic hypertension, history of preeclampsia, family history of hypertension, preeclampsia, and diabetes mellitus.
This was a retrospective analysis with a cross sectional design. The data was collected using medical records, which include maternal data, medical history, and obstetric history. Risk factors associated with preeclampsia were studied between early onset preeclampsia and late onset preeclampsia. Risk factors were analyzed by logistic regression analysis.
The data obtained showed that all samples in the early onset preeclampsia group had a previous history of hypertension, gestational diabetes and diabetes mellitus. Risk factors associated with early onset preeclampsia were maternal age (Odd ratio [OR] 1.61, 95% Confident Interval [CI] 1.24-5.12), chronic hypertension (OR 5.97, 95% CI 3.10-8.37), history of preeclampsia with incident (OR 2.53, 95% CI 1.46-6.36). Risk factors associated with late onset preeclampsia were maternal age (OR 1.25, 95% CI 2.12-6.31), chronic hypertension (OR 2.06, 95% CI 1.41-3.92), BMI (OR 3.27, 95% CI 1.95-7.11).
The risk factors that differ between early and late onset of preeclampsia were history of preeclampsia and BMI ≥ 25 kg/m2. Maternal age and chronic hypertension were risk factors for both early and late onset preeclampsia. Although they share some etiological features, they also differ with respect to other risk factors. The two preeclampsia types should be treated as distinct entities from an etiological standpoint.
Source: Johnny et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(3):432–436
