OBJECTIVES : Preeclampsia is a pregnancy-related complication characterized by the onset of high blood pressure occurring after 20 weeks of gestation and up to six weeks postpartum. It is the leading cause of maternal death in the United States. Few risk factors include age, race, and certain preexisting medical conditions. Medication prescribing is generally dependent on preeclampsia severity. The main objective of the present study was to examine risk factors, complications, and medication prescribing in preeclampsia patients.

METHODS : This retrospective study examined data from a U.S. electronic health record database (Cerner Health Facts®). All outpatients (≥ 12 years) between 2012 and 2016, with an ICD9/10 diagnosis of preeclampsia, were included in the analysis. Complications and comorbid conditions were characterized by corresponding ICD9/10 diagnosis codes. Medications were grouped into three major classes (antihypertensives, corticosteroids, and anticonvulsants) for evaluation.

RESULTS : The study included 864,450 pregnant patients, with 18% of patients having severe preeclampsia. Preeclampsia occurred in the third trimester in majority of patients (81.1%) and was more prevalent in the age group of ‘35+ years’ (1.4%) as compared to other age groups. In addition, African-American women had the highest preeclampsia rates (1.0%) as compared to Asian/Pacific Islander (0.9%), Caucasian (0.9%), and Hispanic (0.4%). Three percent of preeclampsia patients had preexisting hypertension. Rates of eclampsia and HELLP syndrome were 1.6% and 1.1%, respectively, in preeclampsia patients. Corticosteroids and anticonvulsants were highly prescribed across both preeclampsia severity types (73.1% and 80.7% of severe cases vs. 53.7% and 48.6% of non-severe cases). Among severe preeclampsia patients, the most commonly prescribed anticonvulsant medication was magnesium sulfate (80.7%).

CONCLUSIONS : This large database analysis examined risk factors of preeclampsia and provides detailed description of several clinical characteristics of preeclampsia patients including relevant complications and medication usage.