A 27-year-old woman with no prior medical illness is diagnosed with pre-eclampsia at 34 weeks. She asks about her risk in a future pregnancy. According to established epidemiological data, which of the following factors carries the HIGHEST recurrence risk for pre-eclampsia in a subsequent pregnancy?

• A Pre-eclampsia delivered at term (≥37 weeks) in the index pregnancy
• B Pre-eclampsia with severe features delivered before 34 weeks in the index pregnancy ✓
• C Maternal age over 35 years in the index pregnancy
• D Gestational hypertension without proteinuria in the index pregnancy

Explanation

Early-onset pre-eclampsia with severe features delivered before 34 weeks carries the highest recurrence risk, reported at 25-40% in subsequent pregnancies, because it reflects underlying placental vascular pathology or maternal comorbidities. Term pre-eclampsia recurs in roughly 5-10%. Gestational hypertension without proteinuria has the lowest recurrence. Advanced maternal age is a moderate risk factor but not the strongest predictor of recurrence.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.