Family history of pre‐eclampsia as a predictor for pre‐eclampsia in primigravidas

Abstract

Objective: To assess the clinical utility of knowledge of a family history of pre‐eclampsia as a predictor for the development of pre‐eclampsia in primigravid women. Methods: 368 primigravid women were prospectively recruited from the outpatients department of an obstetric teaching hospital. Details of any family history of pre‐eclampsia were obtained from the women and their subsequent obstetric outcomes were observed. Results: Of 368 primigravid women, 34 (9.2%) developed pre‐eclampsia. Eighteen (4.9%) women of the total group stated that they had a mother (12), sister (five) or both (one) who had had pre‐eclampsia. Of these 18 women, five (27.8%) developed pre‐eclampsia. Of the women who had no family history, 29 (8.3%) developed pre‐eclampsia (relative risk, RR = 3.4; 95% CI, 1.5–7.6; P = 0.018). Four (22.2%) of the women with a positive family history developed severe pre‐eclampsia compared to 18 (5.1%) with a negative family history (RR = 4.3; 95% CI, 1.6‐11.5; P = 0.017). Conclusions: In a primigravida, a family history of pre‐eclampsia is associated with a fourfold increased risk of severe pre‐eclampsia. This clinical history identifies a group who warrant close clinical surveillance during pregnancy and who may be suitable for trials of prophylactic interventions.