Risk factors associated with preeclampsia in healthy nulliparous women☆,☆☆,★,★★
Section snippets
Material and methods
The trial was designed and implemented by the members of the Calcium for Preeclampsia Prevention (CPEP) study group under the direction of the National Institute of Child Health and Human Development. Study procedures were conducted according to a common protocol and with identical data collection forms at all five participating clinical centers, located in Albuquerque, Birmingham, Cleveland, Memphis, and Portland.16 The trial included 4589 healthy nulliparous women who were followed up
Results
A total of 326 women who were delivered at ≥20 weeks' gestation (7.6%) had preeclampsia; 217 (5.0%) had mild preeclampsia and 109 (2.5%) had severe preeclampsia. Because the results of the trial revealed no differences in the incidence of preeclampsia between those assigned to calcium and those assigned to placebo,12 models were fit to data pooled over both treatment arms. The rate of preeclampsia ranged from 4.8% among women recruited in Portland to 12% among women recruited in Memphis. The
Comment
Several case-control studies and few longitudinal studies have evaluated the association between maternal clinical characteristics and the risk of subsequent preeclampsia.4, 5, 6, 7, 8, 9, 10, 11 Most of these studies lacked information about techniques of blood pressure measurements, as well as the methods used to assess the presence of proteinuria. Therefore there were differences regarding preeclampsia among these studies. Our study is unique in that it used standardized techniques to
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From the Department of Obstetrics and Gynecology, University of Tennessee College of Medicine,a the Department of Obstetrics and Gynecology, University of Alabama,b the Department of Obstetrics and Gynecology, MetroHealth Medical Center,c The Emmes Corporation,d the Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health,e and the Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center.f A complete list of members of the CPEP Study Group is shown at the end of the article.
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Supported by the National Institute of Child Health and Human Development with cofunding from the National Heart, Lung, and Blood Institute under contract numbers N01-HD-1-3121 through 3126, N01-HD-2-3154, and N01-HD-5-3246.
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Reprints not available from the authors.
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