A 34-year-old woman with pre-eclampsia in her first pregnancy is now planning her second pregnancy. Which of the following factors would place her at the HIGHEST risk of recurrent pre-eclampsia in the current pregnancy?
- A Pre-eclampsia at 28 weeks in the first pregnancy requiring preterm delivery ✓
- B Pre-eclampsia at 38 weeks in the first pregnancy
- C Pre-eclampsia with a male fetus in the first pregnancy
- D Pre-eclampsia with mild features only in the first pregnancy
Correct answer: A. Pre-eclampsia at 28 weeks in the first pregnancy requiring preterm delivery
Explanation
Early-onset pre-eclampsia (before 34 weeks) in a prior pregnancy is the strongest risk factor for recurrence, with recurrence rates of 25-40% depending on severity and gestational age at onset. Pre-eclampsia at 38 weeks carries a much lower recurrence risk (5-10%). Fetal sex is not an established independent risk factor for recurrence. Mild pre-eclampsia at term has a lower recurrence rate than severe early-onset disease.
Reference: High-Risk Pregnancy: Management Options, 5th ed.
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Written and medically reviewed by the StethoPrep medical team.