Table 2 Definitions of preeclampsia-associated conditions and of maternal and fetal outcomes

Preeclampsia-associated conditions

Hypertension

• Systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg (on two occasions ≥6 hours apart, but within 1 week)

• Hypertension according to diagnostic criteria above (documented in medical history) controlled by antihypertensive drug use irrespective of current systolic and diastolic BP values

Chronic hypertension

• Hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) diagnosed before conception or in the first half of pregnancy (<20 weeks of gestation) persisting >12 weeks postpartum

Proteinuria

• ≥0.3 g protein/24 hours

• In emergency cases only if a 24-hour urine protein collection cannot be obtained: dipstick ≥2+ or ≥30 mg/dL protein in spot urine or spot urine protein/creatinine ratio ≥30 mg protein/mmol creatinine

Gestational hypertension

• New onset of hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) alone without proteinuria after gestational week 20

Preeclampsia [1]

• New onset of both hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) and proteinuria after 20 weeks’ gestation

Suspected preeclampsia

• Suspicion of clinical diagnosis of preeclampsia according to inclusion criteria

Severe preeclampsia [20]

Preeclampsia plus one or more of the following criteria:

• Systolic BP ≥160 mmHg and/or diastolic BP ≥110 mmHg (on two occasions ≥6 hours apart, but within 1 week)

• Proteinuria (>5 g protein/24 hours or dipstick ≥3+ on two random urine samples collected at least 4 hours apart)

• Impaired renal function (serum creatinine ≥0.9 mg/dL or oliguria <500 mL/24 hours)

• Pulmonary edema

• Impaired liver function (elevated liver enzymes, epigastric or right upper-quadrant pain)

• Neurologic symptoms (cerebral or visual disturbances, severe headache)

• Hematologic disorders (thrombocytopenia, hemolysis)

• IUGR

Eclampsia [20]

• New onset of tonic-clonic seizures in a woman with preeclampsia, which cannot be assigned to any other cause

Superimposed preeclampsia

• Chronic hypertension plus new onset of proteinuria after gestational week 20 or

• Chronic hypertension and proteinuria before gestational week 20

AND

• Sudden increase of proteinuria or

• Sudden increase of BP or

• Clinical or laboratory signs/symptoms of severe preeclampsia

Early-/late-onset preeclampsia [22]

• Early-onset preeclampsia: onset at <34 + 0 weeks of gestation

• Late-onset preeclampsia: onset at ≥34 + 0 weeks of gestation

HELLP syndrome [21]

• Increased aspartate transaminase (>70 IU/L)

• Reduced thrombocyte counts (<100,000/μL)

• Increased lactate dehydrogenase levels (>600 IU/L)

Maternal and fetal outcomes

Intrauterine growth restriction [24]

• Estimated fetal weight or abdominal circumference <5th percentile (adjusted for gender and ethnicity according to the charts routinely used by the study site)

• Presence of pathologic process that inhibits expression of normal intrinsic growth potential. Pathologic process to be demonstrated on at least one occasion after gestational week 22 by one of the below criteria:

-Oligohydramnios (Amniotic Fluid Index <10th percentile)

-Pathologic flow in umbilical artery (pulsatility index >95th percentile)

• Serial ultrasonography growth curve anomalies*

• Serial growth curve anomalies based on local measurement technique (manual measurement)*

Small for gestational age [24]

• Estimated fetal weight or abdominal circumference <5th percentile (adjusted for gender and ethnicity according to charts routinely used by the study site)

• Absence of pathologic process (i.e. absence of pathologic criteria for oligohydramnios and umbilical artery flow as per IUGR criteria)

Preterm delivery [23]

• Birth before the completion of 37 weeks’ gestation (e.g. 36 weeks + 6 days is recorded as 36 completed weeks of gestation, so the baby is defined as preterm)