second pregnancy: does previous outcome matter?

[caryn]

...Inter-pregnancy intervals of 6 years or more were associated with increased incidence of pre-eclampsia (19.4% vs. 14.7%). A change of partner had a protective effect while an increase in BMI increased the risk of pre-eclampsia. A history of pre-eclampsia was associated with 5 times higher risk {adjusted O.R. 5.12 (95% C.I. 4.42-6.48)} of pre-eclampsia in the second pregnancy. Compared to a term delivery, a previous second trimester pregnancy loss was associated with a 4 times higher risk {adjusted O.R. 4.22 (95% C.I. 2.54-7.03)} of pre-eclampsia in the next pregnancy. Previous very preterm and preterm births were associated with adjusted odds ratios of 2.32 (95% C.I. 1.62-3.32) and 1.62 (95% C.I. 1.46-1.72) respectively. The risk of pre-eclampsia was no higher in women with a previous history of fetal death after 20 weeks than those with a previous live birth, after adjusting for pre-eclampsia in the first pregnancy...

http://www.ncbi.nlm.nih.gov/pubmed/19394128

Boo hiss.

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[beth11]

I am sooooo slow today :) So, a history of pre-e has a 5 times higher rish of pre-e in a second pregnancy - but a second trimester loss only as a 4 times higher risk of pre-e in the second pregnancy? Oh wait, do they mean second term loss regardless of the reason?

[caryn]

Yes, that's it. Cases were women with PE in their second pregnancy, and some of them didn't have it in their first pregnancy. :-)

[wwyy88]

Hi Caryn,

I had a severe pre-eclampsia loss in my first pregnancy in the 26.5 weeks (2nd trimester). Does this mean I will have a higher chance of getting PE in the second? I am a bit confused.........

According t your quote, it should be either 4 times higher or not higher?

thanks,

Jennifer

[caryn]

Jennifer, it's worded in a confusing way.

Our Experts say that preeclampsia before week 28 means a [url="http://www.preeclampsia.org/forum/viewtopic.php?t=331"]60% chance[/url] of developing preeclampsia in another pregnancy. Usually it happens later in pregnancy and is more mild, but not always.

My best advice is always to find a doctor who specializes in these pregnancies and who can work with your other doctors. Many OBs go to extra school to become maternal-fetal medicine specialists, or MFMs, which is another term for peri (perinatologist.) If your peri isn't a specialist in these pregnancies, you might want another peri.

Welcome to the forums. I'm so sorry you had to find us because your daughter died. This disease is just brutal.

[wwyy88]

Thanks, Caryn.

I didn't know perinatologist has Specialty too!!! I just found out recently the mine wasn't specialized in lupus/autoimmune disease, which I had. Mine wasn't active though and my rheum. dr. gave me the okay to get pregnant. The result is I got hit by severe PE in the 2nd trimester and our baby boy died of placenta insufficiency. My peri thinks I had Thrombophilia, even though I wasn't tested positive before. It is so complicated. Anyway, back to your topic, my peri said I would have a 30-40% chance to get PE again in my next pregnancy --- that's much lower a chance than the study you are showing here........ Who is right?

[caryn]

Your peri has seen *your* records, so I would trust your peri. The Experts are giving guesses for the whole population, and don't have information from your records that might make them change their answer!