Page 39 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

the probability of censoring. Therefore, given the clinical features the censoring mechanism could have been independent from the time of resolution. In this case, as the resolution curves obtained from the AFT models are conditional on the clinical features, they would provide valid estimate of survival probability for the group with a given value of clinical features92.
The second limitation of this study is that the follow-up period is two years. Hereby we preclude any estimate of later resolution. However, we believe it is unlikely that resolution would occur beyond two years postpartum. Because we found an incidence of hypertension of 18% at two years postpartum. This is comparable with other studies that showed similar proportions of women with hypertension until seven years after preeclampsia18 24 87 96.
The third limitation of this study is that, due to the fact that our hospital is a referral center, a large proportion of women have had severe preeclampsia (89%). This may limit the ability to generalize our findings to women with mild preeclampsia.
The period of recruitment of this study was 1990 to 1992 for two reasons. First, the data of this cohort had already been processed to minimize missing data. However, proper analysis had never been conducted. Recent development of the accelerated failure time model92 made it possible to analyze the dataset as presented and quantify the effect of blood pressure, proteinuria and temporizing treatment of preeclampsia on postpartum resolution. Second, temporizing treatment was more common during the study-period, compared to current practice. This allowed a better analysis of effect of temporizing treatment on postpartum recovery, than if we had used more recent data.
Since women with a preeclamptic pregnancy are at risk for cardiovascular disease and end stage renal disease, proper follow-up after delivery is necessary. However, this is not always the case: In 2004 Samwiil et al reported that of 257
2.1 Resolution of hypertension and proteinuria| 37