44. Evaluation of the clinical impact of the revised ISSHP and ACOG definitions on preeclampsia and on severe preeclampsia

Background In 2013/2014 both ISSHP and ACOG revised their original statement and postulated new criteria for (severe) preeclampsia, by which the diagnosis preeclampsia can also be established in the absence of proteinuria when other specific symptoms are present. Objective What is the clinical impact of the use of three different new criteria for the diagnosis of preeclampsia and severe preeclampsia? Methods Retrospective cohort study of all pregnant women who gave birth in the Erasmus MC between 01-01-2014 and 01-01-2016. Hypertensive disorders of pregnancy (HDP) were defined when ⩾2 times during pregnancy high blood pressure (⩾140 mmHg systolic and/or ⩾90 mmHg diastolic) was measured. All HDP cases were then classified according to the ISSHP 2001, ISSHP 2013/2014 and ACOG 2013 criteria. Results In our cohort (N = 4395) 878 patients had HDP (20,0%). The ISSHP 2014/ACOG 2013 criteria cause a significant increase in patients with (superimposed) preeclampsia versus the ISSHP 2001 criteria, from 272 patients (6,2%) to respectively 360 (8,2%)/290 (6,6%) (p  Discussion Implementation of the ISSHP 2014/ACOG 2013 criteria causes a shift from gestational hypertension and chronic hypertension towards (superimposed) preeclampsia (relative increase 10%/2%) and severe preeclampsia (4.6%). Since women with preeclampsia have an increased risk of developing cardiovascular disease later in life, we recommend further research into the course and prognosis of especially non-proteinuric preeclampsia.