The prevalence and perinatal repercussions of preeclampsia after the implementation of a prophylaxis protocol with...

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Clinical Epidemiology

Background:

• Preeclampsia (PE) is a significant complication of pregnancy with potential adverse perinatal outcomes.
• Aspirin prophylaxis is increasingly used, but its effectiveness based on clinical risk factors needs evaluation in real-world settings.
• Understanding the prevalence and repercussions of PE is crucial for improving maternal and infant health.

Purpose of the Study:

• To determine the prevalence and perinatal consequences of preeclampsia (PE) in singleton pregnancies.
• To evaluate the effectiveness of an aspirin prophylaxis protocol implemented at a tertiary care center.
• To assess the association between PE and adverse perinatal outcomes like prematurity, small for gestational age (SGA), and fetal death.

Main Methods:

• Retrospective analysis of data from 3468 singleton pregnancies between 2015 and 2016.
• Calculation of PE prevalence by gestational age and prevalence ratios (PR) for prematurity, SGA, and fetal death.
• Comparison of findings with previously published results.

Main Results:

• PE occurred in 10.75% of cases, with 2.79% occurring before 37 weeks and 7.95% after 37 weeks.
• PE was significantly associated with an increased risk of SGA (PR 1.16) and fetal death (PR 7.46).
• Premature PE (<37 weeks) showed a higher association with SGA (PR 1.42) and fetal death (PR 2.62).

Conclusions:

• Preeclampsia is strongly linked to SGA newborns, especially when occurring prematurely.
• Aspirin prophylaxis for PE, when based solely on clinical risk factors in a real-world setting, demonstrated limited effectiveness.
• The study prompted a review and update of the PE screening and prophylaxis protocol at the institution.