Work

Is postpartum preeclampsia a continuation of intrapartum preeclampsia? Maternal risk factors in intrapartum vs. postpartum preeclampsia: a retrospective cohort study

Year: 2025

Type: article

Abstract: OBJECTIVE: To compare maternal characteristics and risk factors associated with intrapartum and postpartum preeclampsia in relation to pregnancies without preeclampsia. STUDY DESIGN: This retrospective cohort study used data from 265,068 pregnancies (2013–2024) categorized into three groups: no preeclampsia (96.9%), intrapartum preeclampsia (2.8%), and postpartum preeclampsia (0.2%). Multivariate logistic regression models identified risk factors associated with intrapartum preeclampsia and postpartum preeclampsia, with no preeclampsia as the reference group. RESULTS: Postpartum preeclampsia shared remarkably similar risk factors with intrapartum preeclampsia after adjusting for confounders. Key associations included maternal age (adjusted odds ratio (aOR) = 1.03, 95% confidence interval (CI): 1.02–1.03 for intrapartum pre-eclampsia and aOR = 1.03, 95% CI: 1.03–1.04 for postpartum preeclampsia); obesity (aOR = 1.50, 95% CI: 1.41–1.59 for intrapartum preeclampsia and aOR = 1.51, 95% CI: 1.43–1.61 for postpartum preeclampsia), and nulliparity (aOR = 2.20, 95% CI: 2.05–2.35 for intrapartum preeclampsia and aOR = 2.12, 95% CI: 1.99–2.27 for postpartum preeclampsia). Additional associations included diabetes (aOR = 1.55, 95% CI: 1.36–1.76 for intrapartum preeclampsia; aOR = 1.51 and 95% CI: 1.33–1.71 for postpartum preeclampsia); hypertension (aOR = 4.02, 95% CI: 3.50–4.59 for intrapartum preeclampsia and OR = 4.01, 95% CI: 3.51–4.56 for postpartum preeclampsia), and gestational hypertension (aOR = 2.46, 95% CI: 2.21–2.74 for intrapartum pre-eclampsia and aOR = 2.46, 95% CI: 2.22–2.73 for postpartum preeclampsia. CONCLUSION: Postpartum and intrapartum preeclampsia share similar clinical and demographic risk factors, suggesting postpartum preeclampsia may be a continuation of preeclampsia rather than a distinct clinical entity. Identifying shared risk factors can facilitate early diagnosis and intervention, critical for reducing maternal morbidity and mortality.

Source: BMC Pregnancy and Childbirth

DOI: 10.1186/s12884-025-08227-2

Authors: Hila Shalev-Ram, Talish Razi, Dorit Ravid, Hezzy Shmueli, Ronen Arbel, Tal Biron-Shental