Common pathogenesis of early and late preeclampsia: evidence from recurrences and review of the literature

TL;DR

This study examines whether preeclampsia occurring early or late in pregnancy shares a common cause by analyzing data from multiple pregnancies.

Contribution

The study provides evidence for a single underlying cause of preeclampsia regardless of gestational age at onset.

Findings

No significant correlation was found between gestational age at preeclampsia onset in recurrent cases and previous pregnancies.

The findings suggest a single pathogenesis for preeclampsia, regardless of when it occurs during pregnancy.

Variations in preeclampsia progression may depend on compensatory mechanisms.

Abstract

To investigate whether there is an association between the gestational age at the onset of preeclampsia in recurrent cases and the gestational age at the onset of preeclampsia in previous pregnancies.

This retrospective nested case–control study was designed to investigate whether gestational age at diagnosis and at delivery in recurrent cases of preeclampsia correlates with gestational age at diagnosis and delivery in the previous cases of preeclampsia in the same individuals. The database of a Ukrainian research network was used to find patients with the diagnosis of preeclampsia between 2019 and 2021. The database was further queried to identify those with a history of preeclampsia in a previous pregnancy. The comparison was made using the Pearson correlation coefficient.

One hundred and three patients who were diagnosed with preeclampsia were identified. Of those, 15 had recurrent preeclampsia, 2 of whom had preeclampsia in 2 previous pregnancies. There was no statistically significant correlation: based on gestational age at delivery R = − 0.28 (P = 0.30; 95% confidence interval (− 0.69 to 0.28) and based on gestational age at the time of diagnosis R = − 0.14 (P = 0.62; − 0.60 to 0.41).

Our data do not find an association between the gestational age of recurrent preeclampsia and preeclampsia diagnosed in a previous pregnancy. This supports the idea that there is single pathogenesis for preeclampsia regardless of the gestational age. It suggests that there are variations in the course of preeclampsia that may be determined by the capacity of the compensatory mechanisms.

Figures