Can you explain the "two year window"?

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caryn
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Re: Can you explain the "two year window"?

Postby caryn » Fri Jul 08, 2011 11:44 pm

Ah, if it were data from a study not meant to answer that question that would explain why I can't find it!

Re: "later and more mild" - that's usually true, yes. It depends on what contribution to the severity came from inadequately remodeled vessels and what contribution came from an inability to tolerate any more inflammation because of underlying disorders.

Re: definitions - yes, they'll usually say in the full-text of the paper that preeclamptics were defined as a population with two readings of 140/90 and a 24-hour proteinuria above 300 mg. Women who develop eclampsia before anyone gets around to running a 24-hour get included in studies into eclampsia, but are usually excluded from preeclampsia studies simply because they don't meet the research definition. Some of the studies I post will broaden that population to include anyone with X set of criteria. (I am SO READY for a diagnostic test I cannot tell you.)
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
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Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

rebecca2
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Re: Can you explain the "two year window"?

Postby rebecca2 » Fri Jul 08, 2011 05:52 pm

I don't have time to look for the actual study at the moment because my son is in the NICU, but there was a study that mentioned risk of reoccurance being less during the 2 yr window. IIRC, The main focus of the study wasn't really to look at what interval lessens the risk...it was just an observation the authors noted in the study.

I'm almost certain it was the study that Dr E discussed in his presentation at the PE Foundation's patient symposium that was held in Chicago in 2009. I don't have the name of the article, but it looked at reoccurance rates for subsequent pregnancies and included something like 750,000 pregnancies (or women? Sorry details are fuzzy in my sleep deprived state. ;)) & had a really nice flow chart that looked at 1st thru 6th pregnancies and how many of the subsequent pregnancies developed PE. In the txt of the study is where they mention the 2 week window observation. Anyway, if anyone still has the handouts from that symposium, it should reference this study.
Becky
Mom to...
baby girl Addison 3/11/09-3/11/09 (severe preeclampsia 26w5d)
baby boy Aden 5/25/10 (35w6d low amniotic fluid)
baby boy #2 due 7/4/11

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aajatwins
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Re: Can you explain the "two year window"?

Postby aajatwins » Fri Jul 08, 2011 02:01 pm

Hey Caryn - just a question about those type articles and studies that you post (that I try really hard to not read because I won't understand more than whatever you've already said): When they say preeclampsia, do they actually mean preeclampsia and only that? I know sometimes all hypertensive disorders will be lumped together and called PE, but I was just wondering what those usually mean (because I only had PIH and eclampsia, technically).
Anna (28) - endometriosis
Hubby (27)
Aidan & Jordan - 7.2.09 at 36 weeks. Induction turned emergency c-section due to eclampsia. big healthy toddlers today!
Asa - 10.23.11 at 39 weeks. NO hypertensive issues!! successful VBAC :)

flori
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Re: Can you explain the "two year window"?

Postby flori » Fri Jul 08, 2011 12:50 am

There was no mention of severity, only recurrence. Does this mean that the adage of "later and less severe" still applies?
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

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caryn
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Re: Can you explain the "two year window"?

Postby caryn » Fri Jul 08, 2011 11:03 am

Yeah, that partner thing is sort of an early understanding of what was going on too. They used to worry more about primapaternity - first exposure to the partner - until the data came out showing that the problem was more likely exposure to a partner carrying HLA-C, which is to say a lot of people. The problem is really that we're making babies with other humans. :D On top of that, a lot of women develop preeclampsia because of underlying predispositions to overreact to pregnancy inflammation, and partner specifics won't matter so much for them - and the rest of us would benefit from spiral artery remodeling regardless.

Here's a link to the most recent abstract I can find on these topics. It says The risk of recurrent preeclampsia is inversely related to gestational age at the first delivery: 38.6% for 28 weeks' gestation or earlier, 29.1% for 29-32 weeks, 21.9% for 33-36 weeks, and 12.9% for 37 weeks or more. The recurrent preeclampsia risk was fairly constant if both births occurred within 7 years. Obese and overweight women had higher risks of recurrent preeclampsia (19.3% and 14.2%), compared with women with normal BMI (11.2%). The recurrence risk did not differ according to paternity status.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

flori
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Re: Can you explain the "two year window"?

Postby flori » Thu Jul 07, 2011 09:44 pm

Also, thanks Caryn. The link works now.
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

flori
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Re: Can you explain the "two year window"?

Postby flori » Thu Jul 07, 2011 09:43 pm

I've read about that. Something about father's DNA being introduced to mommy via baby and it being good for subsequent pregnancies because the "foreign" DNA has already been there. Clearly I am no scientist. ;)
Flori, 30
Mommy to Gracie- born at 25 weeks 03/15/11, 11 inches, 1.1lbs, and absolutely beautiful. Became my sweet angel the next day.

steffthomas
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Re: Can you explain the "two year window"?

Postby steffthomas » Thu Jul 07, 2011 05:20 pm

Has anyone heard of the same father theory? That if the baby has the same father as baby with the p/e pregnancy, that your chances are lowered? Just another thing I've read/heard!

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caryn
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Re: Can you explain the "two year window"?

Postby caryn » Thu Jul 07, 2011 03:36 pm

Yeah, I think people like putting a number on how long those spiral arteries will stay remodeled. But a) I'm sure it's a bell curve with a ton of individual variation because the trophoblastic cells that are doing this remodeling are highly variable in humans and b) I seriously doubt anyone has randomized populations to this, because there is no way for you to be randomly assigned to get pregnant within two years or else within more than two years and not, um, notice that you weren't in the placebo group.
Science! The articles you don't want to miss:
The Preeclampsia Puzzle (New Yorker) and Silent Struggle: A New Theory of Pregnancy (New York Times)
Looking for recent articles and studies?
A chance to participate in research? For us on Facebook or Twitter?

Caryn, @carynjrogers, who is not a doctor and who talks about science stuff *way* too much
DS Oscar born by emergent C-section at 34 weeks for fetal indicators, due to severe PE
DD Bridget born by C-section after water broke at 39 weeks after a healthy pregnancy

steffthomas
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Joined: Wed Jun 29, 2011 6:47 am

Re: Can you explain the "two year window"?

Postby steffthomas » Thu Jul 07, 2011 03:28 pm

Not that this will help much-but I have heard of a 5 year window--That if you have a baby within 5 years of having P/E, your chances are lower of having it again


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