Previous preeclampsia and risks of adverse outcomes in subsequent nonpreeclamptic pregnancies

OBJECTIVE: We hypothesized that preeclampsia partly shares pathophysiology with stillbirth, placental abruption, spontaneous preterm birth, and giving birth to a small-for-gestational-age infant, and that women who develop preeclampsia in the first pregnancy may have increased risks of the other outcomes in the second pregnancy, even in the absence of preeclampsia. STUDY DESIGN: In a nationwide Swedish cohort (n = 354,676) we estimated risks of adverse outcomes in the second pregnancy related to preterm (<37 weeks) and term (>= 37 weeks) preeclampsia in the first pregnancy, using women without preeclampsia in the first pregnancy as reference. RESULTS: Women with prior preterm preeclampsia had, in second pregnancy, more than doubled risks of stillbirth, placental abruption, and preterm births, and an even greater risk of giving birth to a small-for-gestational-age infant. CONCLUSION: Women with previous preterm preeclampsia have increased risks of adverse pregnancy outcomes in a second pregnancy despite the absence of preeclampsia.