Has Redefining Preeclampsia Influenced Rates of Indicated Preterm Birth and Associated Adverse Pregnancy Outcomes? - DOH-Net
The Diabetes, Obesity and Hypertension in Pregnancy Research Network (DOH-Net) is a multi-disciplinary research team of obstetrical, midwifery and maternal-fetal medicine specialists.
DOH-Net, research, diabetes, hypertension, obesity, pregnancy, gestational diabetes, diabetes, obesity and hypertension in pregnancy research network, Sunnybrook Health Sciences Centre, St. Michael's Hospital, McMaster University, obstetrics, midwife, maternal-fetal medicine, specialists, researchers, Toronto, Ontario, Canada, Hamilton, Greater Toronto Area, GTA
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Has Redefining Preeclampsia Influenced Rates of Indicated Preterm Birth and Associated Adverse Pregnancy Outcomes?

Recent substantial advances in the understanding of preeclampsia led the American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy in 2013 to redefine preeclampsia and its management and publish evidence based recommendations. In view of recent studies that indicate a poor correlation  between the quantity of urinary protein and pregnancy outcome in preeclampsia, massive proteinuria of greater than 5 g no longer defines the severity of preeclampsia. Moreover, the diagnostic criteria for preeclampsia no longer requires the presence of urinary protein, if additional signs or symptoms exist (thrombocytopenia, impaired liver or renal function, cerebral or visual symptoms or pulmonary edema). In May 2014 these recommendations were, in part, adopted by the Society of Obstetricians and Gynecologists Canada (SOGC). Thus, proteinuria is no longer considered obligatory and massive proteinuria no longer defines preeclampsia with severe features. While fetal growth restriction (FGR) was excluded from the new classification of The American Task Force for preeclampsia with severe features, it remains incorporated by SOGC.                               

This was a retrospective cohort study of all women who gave birth in Ontario, Canada between April, 2012 and November, 2016. Data were obtained from the Better Outcomes Registry & Network (BORN) Ontario. Our aim was to compare the rate of preeclampsia and pregnancy outcomes among women diagnosed with preeclampsia before and after the SOGC adopted ACOG’s Task Force recommendations on hypertension in Pregnancy. Our hypothesis is that the rate of preeclampsia would rise with the implementation of the new definition of preeclampsia. Additionally, the rate of indicated preterm birth prior to 370/7 weeks of gestation would decrease, improving immediate neonatal outcomes. By prolonging pregnancy, we also hypothesize that maternal morbidity would increase.

Contact for this study:
Negar Bagheri, negar.bagheri@unityhealth.to