[Links between preeclampsia and intrauterine growth restriction]

Abstract

Objectives: Preeclampsia is one of the most frequent and most serious complications of pregnancy. Its occurrence is around 5% of the pregnancies. Its pathophysiology is complex and includes several hypotheses. Preeclampsia is inconsistently associated with intrauterine growth retardation (IUGR). The determinants that explain the variability of this association are unknown. The objective of our study was to identify in a population of French patients who had preeclampsia and/or HELLP syndrome, incidence and risk factors of IUGR to isolate specific characteristics of these women.

Patients and methods: We studied 578 pregnant women treated for preeclampsia or HELLP syndrome according to the presence or absence of IUGR (database compiled since 1996). Comparisons between the groups were done with Wilcoxon test (quantitative data) or Fisher's exact test (qualitative data).

Results: We found that pre-eclampsia appeared earlier and was more severe in the group with IUGR. In addition foetal issues were more defavorable when IUGR was associated with preeclampsia.

Conclusion: Combination of IUGR and pre-eclampsia or HELLP syndrome is a criterion of severity for both the mother and the fetus. Our data do not allow distinguishing physiopathological mechanism to explain these differences.

Keywords: Facteur pronostique; Intrauterine growth restriction; Preeclampsia; Prognosis factor; Prééclampsie; Retard de croissance in utero.