Risk factors for severe preeclampsia.

OBJECTIVE: To identify risk factors associated with severe preeclampsia and to determine whether these factors are similar in nulliparous and multiparous patients. METHODS: Patients whose pregnancies were complicated by severe preeclampsia (n = 70) were compared retrospectively to 18,964 non-preeclamptic controls. Information on maternal demographic factors; medical, obstetric, and family histories; and neonatal outcome was retrieved and analyzed by univariate and multivariate analysis. RESULTS: By logistic regression, the only risk factors associated with the development of severe preeclampsia were severe obesity in all patients (adjusted odds ratio 3.5, 95% confidence interval [CI] 1.68-7.46) and a history of preeclampsia in multiparous patients (adjusted odds ratio 7.2, 95% CI 2.74-18.74). CONCLUSION: Severe obesity and a history of preeclampsia are the only maternal risk factors identified for the development of severe preeclampsia.