{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T09:30:42Z","timestamp":1783071042146,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T00:00:00Z","timestamp":1614211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MCT 87522"],"award-info":[{"award-number":["MCT 87522"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the association between pre\u2010eclampsia definition and pregnancy outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of Control of Hypertension in Pregnancy Study (CHIPS) trial data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>International multicentre randomised controlled trial (RCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>In all, 987 women with non\u2010severe non\u2010proteinuric pregnancy hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated the association between pre\u2010eclampsia definitions and adverse pregnancy outcomes, stratified by hypertension type and blood pressure control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Main CHIPS trial outcomes: primary (perinatal loss or high\u2010level neonatal care for &gt;48\u00a0hours), secondary (serious maternal complications), birthweight &lt;10th centile, severe maternal hypertension, delivery at &lt;34 or &lt;37\u00a0weeks, and maternal hospitalisation before birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 979\/987 women with informative data, 280 (28.6%) progressed to pre\u2010eclampsia defined restrictively by new proteinuria, and 471 (48.1%) to pre\u2010eclampsia defined broadly as proteinuria or one\/more maternal symptoms, signs or abnormal laboratory tests. The broad (versus restrictive) definition had significantly higher sensitivities (range 62\u201379% versus 36\u201350%), lower specificities (range 53\u201365% versus 72\u201382%), and similar or higher diagnostic odds ratios and \u2018true\u2010positive\u2019 to \u2018false\u2010positive\u2019 ratios. Stratified analyses showed similar results. Addition of available fetoplacental manifestations (stillbirth or birthweight &lt;10th centile) to the broad pre\u2010eclampsia definition improved sensitivity (74\u201387%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A broad (versus restrictive) pre\u2010eclampsia definition better identifies women who develop adverse pregnancy outcomes. These findings should be replicated in a prospective study within routine healthcare to ensure that the anticipated increase in surveillance and intervention in a larger number of women with pre\u2010eclampsia is associated with improved outcomes, reasonable costs and congruence with women's values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>A broad (versus restrictive) pre\u2010eclampsia definition better identifies the risk of adverse pregnancy outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.16602","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T08:25:10Z","timestamp":1606206310000},"page":"1373-1382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The impact of pre\u2010eclampsia definitions on the identification of adverse outcome risk in hypertensive pregnancy \u2013 analyses from the CHIPS trial (Control of Hypertension in Pregnancy Study)"],"prefix":"10.1111","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1355-610X","authenticated-orcid":false,"given":"LA","family":"Magee","sequence":"first","affiliation":[{"name":"Department of Women and Children's Health King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Singer","sequence":"additional","affiliation":[{"name":"School of Population and Public Health Centre for Health Evaluation and Outcome Science Providence Health Care Research Institute University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Lee","sequence":"additional","affiliation":[{"name":"Centre for Health Evaluation and Outcome Science Providence Health Care Research Institute University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Rey","sequence":"additional","affiliation":[{"name":"Department of Medicine Universit\u00e9 de Montreal Montreal QC Canada"},{"name":"Department of Obstetrics and Gynaecology Universit\u00e9 de Montreal Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9468-2860","authenticated-orcid":false,"given":"E","family":"Asztalos","sequence":"additional","affiliation":[{"name":"Pediatrics University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Hutton","sequence":"additional","affiliation":[{"name":"Midwifery McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Helewa","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology University of Manitoba Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AG","family":"Logan","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W","family":"Ganzevoort","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Amsterdam University Medical Centers University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7890-3504","authenticated-orcid":false,"given":"R","family":"Welch","sequence":"additional","affiliation":[{"name":"University of Plymouth Plymouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-6876","authenticated-orcid":false,"given":"JG","family":"Thornton","sequence":"additional","affiliation":[{"name":"Division of Child Health, Obstetrics &amp; 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