First-trimester screening for preeclampsia between 11 and 13 + 6 weeks of gestation and adverse perinatal outcomes

To evaluate the impact of first-trimester screening for preeclampsia (PE) and its association with adverse perinatal outcomes.

A retrospective cohort study was conducted in women with (Group I) or without (Group II) first-trimester screening for PE between 11 and 13 + 6 weeks using maternal characteristics, mean arterial pressure, and uterine artery Doppler. Women were classified as low and high risk using a cut-off value of 1:150 according to the Fetal Medicine Foundation guidelines.

A total of 2442 pregnant women were analysed, 988 in Group I and 1434 in Group II, of whom 204 were at high risk and 1230 at low risk for PE. Group II had higher maternal age (28.0 vs. 26.0 years, p < 0.001), Apgar score at the 1st minute (9.0 vs. 8.0, p < 0.001), Apgar score at the 5th minute (9.0 vs. 8.0, p < 0.001) and lower gestational age at delivery (39.1 vs. 39.4 weeks, p < 0.001) than Group I. Group II was found to have a lower risk of gestational hypertension (p < 0.001), higher risk of delivery < 34 weeks (p = 0.06), and lower risk of spontaneous delivery < 37 weeks (p < 0.001). Women at high risk of PE had a higher risk of delivery < 34 weeks (6.9% vs. 1.2%, p < 0.001), delivery < 37 weeks (16.7% vs. 8.0%, p < 0.001), PE < 34 weeks (2.9% vs. 0.5%, p = 0.005), PE < 37 weeks (4.9% vs. 1.0%, p = 0.0007) and PE > 37 weeks (2.9% vs. 0.5%, p = 0.005). Among women at high risk of PE, 61.3% (125/204) used aspirin (ASA) 100 mg by 37 weeks' gestation. The ASA use was associated with a lower risk of PE > 37 weeks' gestation (0.8% vs. 6.3%, p = 0.033).

First-trimester screening for PE did not reduce the risk of preterm or term PE. First-trimester screening was associated with a lower risk of gestational hypertension and preterm PE. High risk pregnancies had a higher risk of preterm and term PE and of preterm and term delivery. ASA use was associated with lower risk of term PE.