Abstract：
This study aimed to explore the different characteristics between early-onset severe preeclampsia (ESPE) and late-onset severe preeclampsia (LSPE) to improve pregnancy outcomes. We performed a retrospective cohort study between January 2016 and December 2021. Eligible hospitalized pregnant women with severe preeclampsia were assigned into the early-onset or late-onset group, depending on the gestational age at the time of severe preeclampsia onset (< or ≥ 34 gestational weeks, respectively). The clinical characteristics, laboratory results, maternal complications, and fetal and neonatal outcomes were recorded and compared between the two groups. A total of 1,238 pregnant women were included, with 525 in the early-onset group and 713 in the late-onset group. The late-onset group had more cases of gestational diabetes, whereas the early-onset group had a higher blood pressure, showed more proteinuria, had more liver and renal damage, exhibited more serious adverse maternal, fetal, and neonatal outcomes, was more likely to be admitted to the intensive care unit, and required longer hospital stays (all P < 0.05). In addition, the early-onset group had fewer prenatal care appointments and was more often transferred from a primary or secondary care hospital. The logistic regression analysis showed that a weekly weight gain of > 100 g was a risk factor for ESPE and that fewer prenatal care appointments were a risk factor for ESPE in pregnant women with female fetuses. Moreover, logistic regression analysis indicated that nulliparity and gestational diabetes during the current pregnancy were risk factors for LSPE. In conclusion, compared with the women with LSPE, those with ESPE usually had worse maternal, fetal, and neonatal outcomes. More frequent prenatal screening and care should be provided for pregnant women with high-risk factors.
摘要：
本研究旨在探讨早发型重度子痫前期(ESPE)与晚发型重度子痫前期(LSPE)的不同特征,以改善妊娠结局。我们在2016年1月至2021年12月之间进行了一项回顾性队列研究。符合资格的重度先兆子痫住院孕妇被分配到早发型或晚发型组。根据重度子痫前期发病时的孕龄（<或≥34孕周，分别)。临床特点,实验室结果,产妇并发症,记录并比较两组的胎儿和新生儿结局。共包括1238名孕妇,早发型组525例，晚发型组713例。晚发型组的妊娠期糖尿病病例较多，而早发型组的血压较高，显示更多的蛋白尿，有更多的肝和肾损伤，表现出更严重的不良产妇，胎儿,和新生儿结局，更有可能被送进重症监护室,并且需要更长的住院时间（均P<0.05）。此外,早发型组的产前护理预约次数较少,且更常从初级或二级护理医院转院.逻辑回归分析显示，每周体重增加>100g是ESPE的危险因素，而较少的产前护理预约是女性胎儿孕妇ESPE的危险因素。此外，logistic回归分析显示，本次妊娠期间无胎儿和妊娠期糖尿病是LSPE的危险因素。总之,与LSPE女性相比，那些患有ESPE的人通常有更糟糕的母体，胎儿,和新生儿结局。对有高危因素的孕妇应提供更频繁的产前筛查和护理。
