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Preeclampsia trial pegs risk factors for SGA neonates: VIP trial data also show additive aspects.(News)
LISBON -- Smoking, high blood pressure, advanced maternal age, history of preeclampsia, and lack of folate supplementation all boosted the risk of small-for-gestational-age neonates, based on data collected in the Vitamins in Preeclampsia trial.
Another new analysis of results from this landmark trial showed that several of the risk factors for preeclampsia were additive, producing risks in some women of more than 30%, Dr. Andrew H. Shennan said at the 15th World Congress of the International Society for the Study of Hypertension in Pregnancy.
The Vitamins in Preeclampsia (VIP) trial assessed the impact of daily supplements of vitamins C and E in a study with about 2,400 pregnant women at 14-21 weeks gestational age who were at high risk for developing preeclampsia. Although the incidence of preeclampsia was the primary end point, a secondary analysis looked at the incidence of small-for-gestational-age (SGA) newborns. The primary outcome showed no benefit from these vitamin supplements on preeclampsia rates.
The overall incidence of neonates who were SGA at less than the 10th percentile was about 27% (Lancet, 2006;367:1145-54).
However, a more detailed analysis showed that the risk of SGA varied by 5- to 10-fold depending on whether the mother had one or more of five risk factors: smoking status, systolic blood pressure, history of preeclampsia, age, and folate supplementation, said Dr. Shennan, a professor of obstetrics at King's College, London.
The age cutoff for defining a higher-risk group was 35. Systolic blood pressure was divided into three risk levels. The lowest was women with pressures of 105 mm Hg or less. Medium risk was a pressure of 110-130 mm Hg, and high risk was defined as a pressure of 135 mm Hg or more.
At one extreme for these risk factors were women who were nonsmokers or ex-smokers, younger than 35, with no history of early preeclampsia, who had a systolic pressure at entry of 105 mm Hg or less, and who used folate starting prepregnancy. Their risk for an SGA birth was 5%-10%.
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Source: HighBeam Research, Preeclampsia trial pegs risk factors for SGA neonates: VIP trial data...