Preeclampsia in first trimester linked to higher spontaneous preterm birth risk: AJOG

A recent research published in the American Journal of Obstetrics and Gynecology unveiled a highly effective method for predicting preterm birth risk in the first trimester of pregnancy. This study was conducted by the Fetal Medicine Foundation that indicates a combination of maternal risk factors, mean arterial pressure, uterine artery pulsatility index and placental growth factor which can accurately identify women at risk for preterm preeclampsia.

This study highlights the critical role of early screening in anticipating the complications during pregnancy. Thereby, this screening method offers a valuable tool for clinicians to intervene and reduce the risks by detecting signs of placental dysfunction that often precedes preterm birth.

This secondary analysis of data from the Screening Programme for Pre-eclampsia trial examined over 10,000 cases of spontaneous labor onset in pregnant women. The participants were categorized into low, intermediate and high-risk groups based on their estimated risk for preterm preeclampsia in the first trimester. The outcomes revealed a significant correlation between the level of risk and the gestational age at onset of spontaneous delivery.

The women classified as high-risk faced a fourfold increase in the spontaneous birth risk between 24 to 26 weeks gestation when compared to those in the low-risk group. The risk was three times higher at 28 to 32 weeks and twice as high at 34 to 39 weeks. These results elucidate the critical importance of early identification and proactive management in high-risk pregnancies. Overall, the study emphasized the implications of these outcomes for antepartum counseling, monitoring and interventions by focusing on the personalized care pathways based on early risk assessment.

Reference:

Cavoretto, P. I., Farina, A., Salmeri, N., Syngelaki, A., Tan, M. Y., & Nicolaides, K. H. (2024). First trimester risk of preeclampsia and rate of spontaneous birth in patients without preeclampsia. In American Journal of Obstetrics and Gynecology. Elsevier BV. https://doi.org/10.1016/j.ajog.2024.01.008