scholarly journals Maternofetal outcomes in early versus late onset pre-eclampsia: a comparative study

Author(s):  
Poornima Shankar ◽  
Kavitha Karthikeyan ◽  
Amrita Priscilla Nalini ◽  
Sindhura M. ◽  
Gowtham Kim

Background: Preeclampsia is being increasingly recognized as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset disease occurring at 34 or more weeks of gestation. Early-onset and late-onset pre-eclampsia are found to have different implications for the mother and neonate. The aim of this study is to compare the risk factors, maternal and fetal outcomes in early (<34 weeks) versus late (≥34weeks) onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Chettinad Academy of Research and Education over a period of three years (From January 2014 to December 2016) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on risk factors, maternal and fetal outcomes were collected and analyzed using Chi Square and Fisher’s test and compared.Results: The overall preeclampsia rate was 6.3%. Early onset and late onset were 34.6% and 65.3% respectively and the rate increased with increasing gestational age.35.3% of patients with late onset preeclampsia and 55.6% patients of early onset type required more than one drug which is a statistically significant difference. Proteinuria more than 3gm/l/day was significantly more in late onset preeclampsia than in early onset preeclampsia. 55.5% of patients with early onset pre-eclampsia required MgSO4 when compared to 17.4%. There was no statistically significant difference in the rate of caesarean section (61.1% vs 73.5%). Altered coagulation profile was significantly more in early onset preeclampsia (11.1%). The incidence of oligohydramnios, SGA and low APGAR at 5 minutes of birth were significantly high in early onset pre-eclampsia when compared to late onset type.Conclusions: Patients with early onset pre-eclampsia are found to have significantly higher rates of specific maternal and fetal morbidity when compared to the late onset type.

2021 ◽  
Vol 8 (5) ◽  
pp. 900
Author(s):  
Vikram R.

Background: Pre-eclampsia is typed as two different entities: early-onset preeclampsia occurring at less than 34 weeks of gestation, and late-onset occurring at 34 or more weeks of gestation. The aim of this study is to compare the fetal and neonatal outcomes in early versus late onset preeclampsia.Methods: 208 patients diagnosed with pre-eclampsia in Shri Sathya Sai medical college and research institute over a period of three years (From January 2016 to January 2019) were retrospectively studied. Patients were classified as early onset and late onset pre-eclampsia based on the gestational age of onset. Data on fetal and neonatal outcomes were collected and analysed using Chi square and Fisher’s test and compared.Results:  Early onset and late onset pre-eclampsia were 34.6% and 65.3%. The incidence of oligohydramnios, SGA, low APGAR at 5 minutes of birth were high in early onset type. 64.9% of early onset type required NICU admission whereas only 38.23% new born of mothers with late onset type required NICU admissions.10.8% of babies of patients with early onset type were still born. The incidence of NICU admissions, requirement of respiratory support, duration of NICU stay were significantly high in early onset type.Conclusions: Patients with early onset pre-eclampsia are found to have higher rates of specific fetal and neonatal morbidity when compared to the late onset type. Prudent and close scrutinizing and follow up and delaying delivery in stable and appropriately selected patients with pre-eclampsia would be advantageous for neonates.


2018 ◽  
Vol 3 (2) ◽  
pp. 11
Author(s):  
Lita Nafratilova ◽  
Yusrawati Yusrawati ◽  
Irza Wahi

Early Onset Preeclampsia (EO-PE) is preeclampsia that develops before 34 weeks 'gestation, caused by intrinsic factors, while Late Onset Preeclampsia (LO-PE) is preeclampsia that develops after 34 weeks' gestation due to extrinsic and maternal factors. There is an increased production of antiangiogenic factors (sFlt-1, s-Eng and PIGF) contribute to pathophysiology of preeclampsia.This study aims to measure the difference of sFlt-1, sEng, PIGF levels between EO-PE and LO-PE. This was an observational study with cross sectional design conducted at Dr. M. Djamil, TK Hospital. III dr. Reksodiwiryo and Biomedical Laboratory FK Unand Padang from August 2017 to August 2018. The sample of this study were 26 severe preeclampsia women : 13 (EO-PE)  and 13 (LO-PE), selected using consecutive sampling. Levels of sFlt-1, sEng, PIGF were examined using the enzyme-linked immunosorbent assay (ELISA) method. Statistical analysis was performed using unpaired t test and Mann-Whitney Test. Results shown that serum levels of sFlt-1 and sEng in (EO-PE)  were 9.51 ± 0.71 ng / L, 1.44 ± 0.06 ng / mL, 5.79 ± 0.42 ng / mL while in PEAL it was 8, 89 ± 0.78 ng / mL, 1.35 ± 0.14 ng / mL, 6.72 ± 0.76. There were a significant difference with a value of p <0.05. The conclusion of this study is that the levels of sFlt-1 and sEng are higher in (EO-PE)  than(LO-PE)and PIGF levels was lower in (EO-PE) compared to (LO-PE)


2021 ◽  
Vol 17 (2) ◽  
pp. 70-76
Author(s):  
V.V. Kachkovska ◽  
L.N. Prystupa

Relevance. The relevance of the study of Arg16Gly polymorphism of the β2-adrenoceptor (β2-AR) gene is due to the fact that a number of studies have proven its role in the development of bronchial asthma (BA), bronchial hyperactivity, the effectiveness of basic treatment. However, these associations show low reproducibility in various studies, so the question of the possibility of clinical application of the results of genetic testing for Arg16Gly polymorphic variant of the β2-AR gene remains unanswered. The main reasons why the clinical significance of this polymorphism is not confirmed in various studies are - population heterogeneity, insufficient sample size, improper characterization of comparison groups. Objective: to study the association of Arg16Gly polymorphism in the β2-adrenoceptor gene with BA clinical course taking into account the age of onset. Materials and methods. We examined 553 BA patients (group I included 282 patients with late-onset asthma and group II included 271 patients with early-onset asthma) and 95 apparently healthy individuals. The study has been approved by the Bioethics Committee of Medical Institute of Sumy State University. Arg16Gly polymorphism in the β2-АR gene (rs1042713) was determined using polymerase chain reaction-restriction fragment length polymorphism analysis. Statistical analysis of obtained results was performed using SPSS–17 program. Results. There was no significant difference in the distribution of genotypes for Arg16Gly polymorphism in the β2-AR gene depending on asthma severity with no regard for the age of onset (χ2 = 5.14; p = 0.27). With regard for the age of onset, we found out that early-onset BA was linked to a difference in genotype distribution for this polymorphic variant in patients with severe and non-severe course (χ2 = 14.76; р = 0.001). The frequency of Gly/Gly genotype was higher in patients with severe course (41.4%) as compared to patients with mild course (16.4%), while the frequency of Arg/Arg (32.9%) and Arg/Gly (50.7%) genotypes was higher in patients with mild asthma as compared to patients with severe course (24.3% and 34.3%). There was no significant difference in the distribution of genotypes in patients with late-onset asthma with regard to course severity (χ2 = 4.94; p = 0.084). The relative risk of severe course for early-onset asthma was 3.84 times higher (95% CI 2.11–7.36; p = 0.001) in the recessive model, 2.58 times higher (95% CI 1.53–4,37, p = 0.001) in the dominant model, and 2.16 times (95% CI 1.56–3.04) higher in the additive model. In patients with late-onset asthma, no association was found in all models. Conclusions. There was no significant difference in the distribution of genotypes for Arg16Gly polymorphism in the β2-AR gene depending on asthma severity with no regard for the age of onset. When adjusted for the age of onset, the analysis revealed a difference in genotype distribution for this polymorphic variant in patients with severe and non-severe course having early-onset BA (р = 0.001). The frequency of Gly/Gly genotype was higher in patients with severe course as compared to patients with mild course. For patients with late-onset asthma, no differences were found (p = 0.084). Heterozygous and homozygous Gly allele carriers have a higher risk of early-onset asthma only.


2020 ◽  
Vol 24 (4) ◽  
pp. 360-366
Author(s):  
Dae-Lyong Ha ◽  
Geun-Hwi Park ◽  
Hoon-Soo Kim ◽  
Hyun-Chang Ko ◽  
Moon-Bum Kim ◽  
...  

Background Atopic dermatitis (AD) in adults is not uncommon, and its prevalence has been increasing in the recent decades. However, there is a paucity of data about the differences between early-onset and late-onset adult AD. Objective The objective of this study is to investigate the clinical and laboratory characteristics of adult AD, focusing on the differences between early-onset and late-onset adult AD. Methods We retrospectively reviewed the medical records and clinical photos of 214 adult AD patients (≥18 years of age) over a 3-year period. We classified the patients into 2 groups: early-onset (first onset of AD before 12 years of age) and late-onset (first onset of AD at 12 years of age or later). Results Among 214 patients, 151 patients (70.6%) belonged to the early-onset group (mean age 24.5 years), while 63 patients belonged to the late-onset group (mean age 29.5 years). An association with allergic asthma or rhinitis, a family history of atopic disease, elevated total serum IgE, and sensitivity to food allergens were more commonly seen in the early-onset group. The late-onset group had a significant likelihood of nonflexural involvement (38.1% vs 13.2%). There was no significant difference in the mean eczema area severity index score, eosinophil count, and sensitivity to aeroallergens between 2 groups. Conclusion Adult AD shows different clinical and laboratory characteristics depending on the age of onset. This study could help to create awareness about the heterogeneity of AD in adulthood and encourage further studies on clinical outcomes and different therapeutic methods depending on the age of onset.


2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Rizka Amelia ◽  
Ariadi Ariadi ◽  
Syaiful Azmi

AbstrakPreeklampsia dan eklampsia tidak hanya berdampak bagi ibu, tetapi juga terhadap janin yang dikandungnya, seperti hambatan pertumbuhan janin intrauterin yang dapat dilihat dari berat lahir bayi tersebut. Ibu dengan preeklampsia berat/ eklampsia early onset cenderung melahirkan bayi dengan berat lahir Kecil untuk Masa Kehamilan (KMK), sementara yang  late onset cenderung melahirkan bayi dengan berat lahir Sesuai untuk Masa Kehamilan (SMK) atau bahkan Besar untuk Masa Kehamilan (BMK). Tujuannya penelitian ini adalah menentukan perbedaan berat lahir bayi pasien preeklampsia berat/ eklampsia early dan late onset. Penelitian ini dilaksanakan dari Oktober 2012 sampai Juli 2013 di bagian Rekam Medik RSUP Dr. M. Djamil Padang. Jenis penelitian yang digunakan adalah observasional analitik dengan desain cross sectional. Hasil penelitian menunjukkan bahwa angka kejadian preeklampsia berat/ eklampsia early onset adalah 26,1% dan yang late onset sebanyak 73,9%. Bayi KMK lebih banyak dilahirkan oleh ibu preeklampsia berat/ eklampsia early onset (16,67%) dibandingkan dengan yang  late onset (7,35%). Setelah dilakukan analisis melalui uji chi-square, disimpulkan bahwa tidak ada perbedaan berat lahir bayi antara pasien preeklampsia berat/eklampsia early dan late onset secara signifikan (p>0,05).Kata kunci: preeklampsia berat/eklampsia early onset, preeklampsia berat/eklampsia late onset, berat lahir bayi AbstractPreeclampsia and eclampsia are not only effect to mother, but also influent to the fetus, such as intrauterine fetal growth retardation  which can be seen as baby's birth weight. Mothers with early onset severe preeclampsia / eclampsia tend to give birth small for gestational age  babies, while the late onset tend to give birth normal birth weight or large for gestational age babies. The objective of this study was to determine the differentiation between baby's birth weight of early and late onset severe preeclampsia/ eclampsia. The research was conducted from October 2012 to July 2013 at the medical records department of general hospital center Dr. M. Djamil Padang. The type of this research was observational analytic with cross sectional design. The results showed that the incidence of early onset severe preeclampsia/ eclampsia was 26.1% and late onset was 73.9%. Small for gestational age babies born from mothers with early onset severe preeclampsia/ eclampsia (16.67%) is more than the late onset (7.35%). After analyzed by chi square test, it was concluded that there was no differentiation between baby's birth weight of early and late onset severe preeclampsia/ eclampsia significantly (p> 0,05).Keywords: early onset severe preeclampsia/eclampsia, late onset severe preeclampsia/eclampsia, baby’s birth weight


2015 ◽  
Vol 24 (3) ◽  
pp. 183-9 ◽  
Author(s):  
Sulaeman A. Susilo ◽  
Karina N. Pratiwi ◽  
Adly N.A. Fattah ◽  
Rima Irwinda ◽  
Noroyono Wibowo

Background: Preeclampsia has great implication on adverse neonatal outcome. Appearance, pulse, grimace, activity, respiration (APGAR) score at 1 or 5 minutes is one of the indicators of physiologic maturity of the infant. Therefore, the aim of this study was to know the correlation of APGAR score in preeclamptic deliveries with its risk factors. Methods: This study was a retrospective cohort. Data were collected from January to December 2013 including all preeclamptic women with singleton live pregnancies who delivered their babies in Cipto Mangunkusumo Hospital, Jakarta. The primary outcome was APGAR score. There were some determinants conducted in this study. Binary logistic was used as multivariate analysis to analyze the correlation between APGAR score and risk factors of preeclampsia, data were analyzed using chi square test. Results: Out of 450 preeclamptic women, 446 of them met the inclusion criteria. Low APGAR scores at 1 and 5 minutes were found in 19% (86/446) and 5.4% (24/446) of neonates respectively. Early onset of preeclampsia (adjusted OR = 4.577; 95% CI = 2.147 - 9.757), white blood cell ≥ 15,000/μL (adjusted OR = 3.315; 95% CI = 1.738 – 6.324), HELLP syndrome (adjusted OR = 2.00; 95% CI = 1.38 – 2.91) were independent risk factors for having infant with low APGAR score at 1 minute. Meanwhile, there was no significant risk factors at 5 minutes APGAR score after adjustment.Conclusion: Leukocytosis, early onset preeclampsia, preterm birth, and thrombocytopenia, severity of preeclampsia, and HELLP syndrome are independent risks of having infant born with low APGAR score at 1 minute in preeclamptic deliveries.


Author(s):  
Hapsari Kinanti ◽  
Muhammad Ilham Aldika Akbar ◽  
Pudji Lestari

Introduction: Preeclampsia is still one of the major causes of maternal morbidity and mortality worldwide. Preeclampsia nowadays has another classification, early-onset preeclampsia and late-onset preeclampsia. This study aimed to evaluate the differences between early-onset and late-onset preeclampsia in Dr. Soetomo General Hospital, Surabaya in 2016.Methods: This was an analytic observational study, evaluating the difference between early- and late-onset preeclampsia in terms of maternal data, medical history, and obstetric history. The samples were taken from the medical record of Dr. Soetomo General Hospital, Surabaya from January until December 2016.Results: In maternal data, early- and late-onset preeclampsia mostly happened in productive age, consisted of 34 patients of early-onset preeclampsia (77.3%) and 31 patients of late-onset preeclampsia (73.8%). Early-onset preeclampsia tended to happen in nullipara (42.2%) and primigravida (35.6%) women, and late-onset preeclampsia usually happened in multipara (43.9%) and multigravida (85.4%) women. In medical and obstetric history, early-onset preeclampsia mostly had a history of hypertension (61.7%), rather than late-onset preeclampsia (32.7%). Moreover, there were no significant differences in other variables.Conclusion: Early-onset and late-onset preeclampsia had a significant difference in parity, gravidity, and hypertension disease.


2021 ◽  
Vol 9 (B) ◽  
pp. 1224-1228
Author(s):  
Ni Made Reditya Noviyani ◽  
I Made Kardana ◽  
Dewi Sutriani Mahalini ◽  
Ida Bagus Gede Suparyatha ◽  
Ketut Ariawati ◽  
...  

BACKGROUND: Neonatal bacterial meningitis has a significant contribution on neonatal morbidity and mortality. It is the most common complication of late-onset neonatal sepsis. An understanding of the risk factors for bacterial meningitis in late-onset neonatal sepsis is required to provide comprehensive management. AIM: To identify the risk factors of bacterial meningitis in late-onset neonatal sepsis. METHODS: This is an analytical study with a case–control design, conducted in May 2019-February 2021, involving neonates aged 4–28 days who suffered from late-onset neonatal sepsis in Level II and III Neonatal Care Unit, Sanglah General Hospital Denpasar. Statistical analysis was performed using Chi-square and logistic regression. RESULTS: A total of 54 patients were analyzed in this study. The mean age of subjects with neonatal bacterial meningitis was 13 days and the majority of them were male (51.9%). The risk factor of bacterial meningitis in late-onset neonatal sepsis was gestational age <37 weeks with odds ratio 4.22 (95% confidence interval 1.28–13.86, p = 0.01). There was no significant association of birth weight <2500 g, neonatal asphyxia, and invasive procedure on neonatal bacterial meningitis. CONCLUSION: Gestational age <37 weeks is a risk factor for bacterial meningitis in late-onset neonatal sepsis.


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