Preeclampsia in First and Subsequent Pregnancies
Obie Editorial Team
Pre-eclampsia has been defined as a disease of first pregnancies. The association between primiparity and pre-eclampsia is so widely accepted that it is at the core of several pathophysiological theories. For example, it has been proposed that pre-eclampsia is the consequence of a maternal immune reaction against paternal antigens expressed in the placenta and that this reaction might result in defective trophoblast invasion and subsequent placental dysfunction.
The lower risk of pre-eclampsia among multiparous women has been attributed to desensitization after exposure to paternal antigens in the placenta during previous pregnancies. The lower risk has also been attributed to smoother trophoblastic invasion after modification of maternal spiral arteries during the first pregnancy.
RESULTS:
Source: Sonia Hernández-Díaz Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study BMJ 2009;338:b2255