{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:31:38Z","timestamp":1790875898078,"version":"4.1.0"},"reference-count":29,"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\u2003Risk factors of early- and late-onset preeclampsia among pregnant individuals with chronic hypertension are not well described in the literature. We hypothesized that early- and late-onset superimposed preeclampsia (SIPE) have different risk factors. Therefore, we aimed to examine the risk factors of early- and late-onset SIPE among individuals with chronic hypertension.<\/jats:p><jats:p>\n            Study Design\u2003This was a retrospective case-control study of pregnant individuals with chronic hypertension who delivered at 22 weeks' gestation or greater at an academic institution. Early-onset SIPE was defined as SIPE diagnosed before 34 weeks' gestation. To identify risk factors, we compared individuals' characteristics between individuals who developed early- and late-onset SIPE and those who did not. We then compared characteristics between individuals who developed early-onset SIPE and late-onset SIPE. Characteristics with p-values of less than 0.05 by bivariable variables were analyzed by simple and multivariable logistic regression models to calculate crude and adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Missing values were imputed with multiple imputation.<\/jats:p><jats:p>\n            Results\u2003Of 839 individuals, 156 (18.6%) had early-onset, 154 (18.4%) had late-onset SIPE and 529 (63.1%) did not have SIPE. The multivariate logistic regression model showed that serum creatinine \u2265 0.7\u2009mg\/dL compared to less than 0.7\u2009mg\/dL (aOR: 2.89 [95% CI: 1.63\u20135.13]), increase of creatinine (1.33 [1.16\u20131.53]), nulliparity compared to multiparity (1.77 [1.21\u20132.60]), and pregestational diabetes (1.70 [1.11\u20132.62]) were risk factors for early-onset SIPE. The multivariate logistic regression model showed that nulliparity compared to multiparity (1.53 [1.05\u20132.22]) and pregestational diabetes (1.74 [1.14\u20132.64]) was a risk factor for late-onset SIPE. Serum creatinine \u2265 0.7\u2009mg\/dL (2.90 [1.36\u20136.15]) and increase of creatinine (1.33 [1.10\u20131.60]) were significantly associated with early-onset SIPE compared to late-onset SIPE.<\/jats:p><jats:p>\n            Conclusion\u2003Kidney dysfunction seemed to be associated with the pathophysiology of early-onset SIPE. Nulliparity and pregestational diabetes were common risk factors for both early- and late-onset SIPE.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-2096-5052","type":"journal-article","created":{"date-parts":[[2023,5,21]],"date-time":"2023-05-21T22:31:25Z","timestamp":1684708285000},"page":"e2073-e2080","source":"Crossref","is-referenced-by-count":6,"special_numbering":"S","title":["Risk Factors for 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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Seagraves","sequence":"additional","affiliation":[{"name":"Department of Maternal Fetal Medicine, Beaumont Maternal-Fetal Medicine, Beverly Hills, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Baraki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Donaldson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Temple University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Barake","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Abuhamad","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim C.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"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 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