The Preeclampsia Puzzle: Study Exploring Incidence and Birth Outcomes Across Parity

Recent study examines the incidence and trends of preeclampsia (PE) in Hebei Province, China, while assessing the adverse pregnancy outcomes associated with PE, specifically differentiating by parity and pregnancy type (singleton or twin). An extensive dataset was analyzed from the Hebei Maternal Near Miss Surveillance System, encompassing 455,456 pregnancies from January 2013 to December 2022. Findings indicate a prevalence of PE at 2.91%, with notable differences observed between singleton (2.76%) and twin pregnancies (12.67%). Increasing trends were detected in overall PE cases, particularly among primiparous women, with an average annual percentage change (AAPC) of 6.19% for this group.

Demographic Insights

Demographic analysis revealed that women with PE had higher rates of delivery in tertiary care facilities, advanced maternal age, and an increase in comorbidities, such as chronic hypertension and gestational diabetes, indicating a more complex clinical profile. Predictably, PE was associated with significant adverse maternal outcomes, including elevated risks of cesarean section, postpartum hemorrhage, placental abruption, and intensive care unit admissions. Neonatal complications also heightened, characterized by increased instances of preterm birth, small-for-gestational-age births, and neonatal asphyxia.

Subgroup Analysis

Subgroup analysis further indicated that while primiparous women showed higher PE incidence rates, the adverse outcomes did not significantly vary between parity groups or pregnancy types. Nevertheless, a substantial increase in maternal near-miss (MNM) events was correlated with multiparity. Noteworthy is that although the incidence of twin pregnancies did not show significant increases, they sustained elevated risks for certain complications, aligning with the notion of distinct pathophysiological processes in twin versus singleton gestations. The research highlights the increasing challenges posed by PE in Hebei, particularly amidst changes in reproductive patterns and health service improvements. Moreover, it underscores the necessity for targeted intervention strategies tailored to specifically manage the risks associated with PE in various patient populations. Findings assert that the upward trends in PE incidence and the breadth of adverse outcomes warrant attention from obstetric care providers, demanding collaborative efforts to enhance maternal and fetal health and mitigate associated risks. Limitations involving collected data variables, treatment protocols, and generalized conclusions suggest that further research be conducted for a comprehensive understanding of PE's implications across diverse demographics.

Key Points

- -Prevalence and Trends-: Preeclampsia (PE) prevalence in Hebei Province, China, was found to be 2.91%, with distinct rates of 2.76% in singleton pregnancies and 12.67% in twin pregnancies. An upward trend in PE cases was particularly noted among primiparous women, yielding an average annual percentage change (AAPC) of 6.19% for this demographic.

- -Demographic Characteristics-: Women diagnosed with PE displayed higher frequencies of delivery in tertiary care settings, advanced maternal age, and increased prevalence of comorbidities such as chronic hypertension and gestational diabetes, indicating a more intricate clinical profile among affected individuals.

- -Adverse Maternal Outcomes-: Significant associations were identified between PE and adverse maternal outcomes, such as elevated cesarean delivery rates, increased postpartum hemorrhage, higher instances of placental abruption, and greater demands for intensive care unit admissions.

- -Neonatal Complications-: Results pointed to heightened neonatal risks including preterm births, increased rates of small-for-gestational-age infants, and occurrences of neonatal asphyxia, underscoring the dual impact of PE on both maternal and neonatal health.

- -Subgroup Analysis Insights-: While incidence rates of PE were higher in primiparous women, adverse outcomes did not significantly differ by parity or pregnancy type. However, a notable rise in maternal near-miss (MNM) events was seen among multiparous women, suggesting different risk profiles based on parity.

- -Call for Targeted Interventions-: The study emphasizes the rising challenges posed by PE in the context of changing reproductive patterns and healthcare improvements in Hebei. It advocates for the creation of targeted interventions to manage PE-related risks and underscores the need for enhanced obstetric care focused on maternal and fetal health, as well as further research to deepen understanding of PE's impact across varied demographics.

Reference –

Runfang Wang et al. (2025). Trends And Adverse Pregnancy Outcomes Associated With Preeclampsia: A Multi-Centre Cross-Sectional Study In Hebei, China. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07609-w.