Exponential increase of the gestational-age-specific incidence of preeclampsia onset (COPE study): a multicenter retrospective cohort study in women with maternal check-ups at <20 weeks of gestation in Japan

Akihide Ohkuchi, Hirotada Suzuki, Keiichi Matsubara, Kazushi Watanabe, Takuya Saitou, Hideyuki Oda, Soichiro Obata, Shinya Kondo, Kiyoshi Noda, Junya Miyoshi, Satoru Ikenoue, Makoto Nomiyama, Hiroyuki Seki, Sachi Sukegawa, Satoshi Ichigo, Hirofumi Ando, Chiho Fuseya, Takuya Shimomura, Rika Suzuki, Kazuya MimuraIchiro Yasuhi, Masashi Fukuda, Sumiko Hara, Ryuhei Kurashina, Arihiro Shiozaki, Shigeki Matsubara, Shigeru Saito

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

According to the 2004 Japanese definition, early-onset (EO) preeclampsia (PE) is defined as PE occurring at <32 weeks of gestation. This was based on the presence of “dual peaks” (30–31 and 34–35 weeks) in the prevalence of severe forms of hypertension. In contrast, the international definition adopted a cutoff of 34 weeks based on the consensus. Our aim was to investigate whether there were “dual peaks” in the gestational-age-specific incidence or prevalence of PE onset in pregnant women who underwent maternal check-ups at <20 weeks of gestation in a multicenter retrospective cohort study. Diagnoses of PE and superimposed preeclampsia (SPE) were based on the new Japanese definition. A total of 26,567 pregnant women with singleton pregnancy were investigated. The best fitting equations for the distribution of the onset of gestational-age-specific incidence (hazard) rates of PE/SPE, PE, and PE with severe hypertension (a systolic blood pressure ≥160 and/or a diastolic blood pressure ≥110 mmHg) were investigated using the curve estimation function in SPSS. PE/SPE occurred in 1.83% of the patients. EO-PE/SPE with onset at <32 and <34 weeks of gestation and preterm PE/SPE occurred in 0.38, 0.56, and 1.07% of the patients, respectively. Gestational-age-specific incidence rates of PE/SPE, PE, and PE with severe hypertension showed exponential increases, with very high R2 values (0.975, 0.976, and 0.964, respectively). There were no “dual peaks” in the prevalence rates of women with SPE/PE, PE, and PE with severe hypertension. In conclusion, the absence of “dual peaks” refutes the previous rationale of EO-PE being defined as PE at <32 weeks of gestation. Further studies to determine an appropriate definition of EO-PE/SPE are needed.

Original languageEnglish
Pages (from-to)1679-1689
Number of pages11
JournalHypertension Research
Volume45
Issue number11
DOIs
Publication statusPublished - 2022 Nov

Keywords

  • Early onset
  • Gestational hypertension
  • Incidence;
  • Preeclampsia
  • Superimposed preeclampsia

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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