{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:34:10Z","timestamp":1740126850109,"version":"3.37.3"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"S 01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n            Objective\u2003Superimposed preeclampsia (SIPE), defined as preeclampsia in individuals with chronic hypertension, is one of the most common complications, accounting for 13 to 40% of pregnancies with chronic hypertension. However, there are limited data regarding maternal outcomes of early- and late-onset SIPE in individuals with chronic hypertension. We hypothesized that early-onset SIPE was associated with increased odds of adverse maternal outcomes compared with late-onset SIPE. Therefore, we aimed to compare adverse maternal outcomes between individuals with early-onset SIPE and those with late-onset SIPE.<\/jats:p><jats:p>\n            Study Design\u2003This was a retrospective cohort study of pregnant individuals with SIPE who delivered at 22 weeks' gestation or greater at an academic institution. Early-onset SIPE was defined as the onset of SIPE before 34 weeks' gestation. Late-onset SIPE was defined as the onset of SIPE at or after 34 weeks' gestation. Our primary outcome was a composite of eclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, maternal death, placental abruption, pulmonary edema, SIPE with severe features, and thromboembolic disease. Maternal outcomes were compared between early- and late-onset SIPE. We used simple and multivariate logistic regression models to calculate crude and adjusted odds ratios (aOR) with 95% confidence intervals (95% CI).<\/jats:p><jats:p>\n            Results\u2003Of 311 individuals, 157 (50.5%) had early-onset SIPE, 154 (49.5%) had late-onset SIPE. There were significant differences in the proportions of obstetric complications, including the primary outcome, HELLP syndrome, SIPE with severe features, fetal growth restriction (FGR), and cesarean delivery between early- and late-onset SIPE. Compared with individuals with late-onset SIPE, those with early-onset SIPE had increased odds of the primary outcome (aOR: 3.28; 95% CI: 1.42\u20137.59), SIPE with severe features (aOR: 2.72; 95% CI: 1.25\u20135.90), FGR (aOR: 6.07; 95% CI: 3.25\u201311.36), and cesarean delivery (aOR 3.42; 95% CI: 2.03\u20135.75).<\/jats:p><jats:p>\n            Conclusion\u2003Individuals with early-onset SIPE had higher odds of adverse maternal outcomes compared with those with late-onset SIPE.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2096-3403","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T22:50:05Z","timestamp":1684536605000},"page":"e2010-e2016","source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Comparison of Adverse Maternal Outcomes between Early- and Late-Onset Superimposed Preeclampsia"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-4684","authenticated-orcid":false,"given":"Kazuma","family":"Onishi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Seagraves","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine, Beaumont Maternal-Fetal Medicine, Beverly Hills, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Baraki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carole","family":"Barake","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim C.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"134.e1","DOI":"10.1016\/j.ajog.2011.10.878","article-title":"Prevalence, trends, and outcomes of chronic hypertension: a nationwide sample of delivery admissions","volume":"206","author":"B T Bateman","year":"2012","journal-title":"Am J Obstet Gynecol"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1056\/NEJM199809033391004","article-title":"Risk factors for preeclampsia, abruptio placentae, and adverse neonatal outcomes among women with chronic hypertension","volume":"339","author":"B M Sibai","year":"1998","journal-title":"N Engl J Med"},{"key":"ref3","first-page":"849","article-title":"Management of mild chronic hypertension during pregnancy: a review","volume":"96","author":"R L Ferrer","year":"2000","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"e26","DOI":"10.1097\/AOG.0000000000003020","article-title":"ACOG Practice Bulletin No. 203: chronic hypertension in pregnancy","volume":"133","author":"American College of Obstetricians and Gynecologists' Committee on Practice Bulletins\u2014Obstetrics","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1161\/HYPERTENSIONAHA.107.107565","article-title":"Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study","volume":"51","author":"L C Chappell","year":"2008","journal-title":"Hypertension"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"270","DOI":"10.5468\/ogs.2020.63.3.270","article-title":"A study to compare maternal and perinatal outcome in early vs. late onset preeclampsia","volume":"63","author":"P Wadhwani","year":"2020","journal-title":"Obstet Gynecol Sci"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.preghy.2022.02.006","article-title":"Hypertensive disorders in pregnancy - 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