Association between carotid intima-media thickness and preeclampsia: Prospective observational comparative study

Preeclampsia is associated with widespread endothelial dysfunction and shares several pathophysiological mechanisms with atherosclerosis. Carotid intima-media thickness (CIMT) is a well-established marker of subclinical atherosclerosis and may reflect early maternal vascular remodeling. This study aimed to compare CIMT between pregnant women with and without preeclampsia and to evaluate the association between CIMT and preeclampsia.

In this prospective observational cohort study, pregnant women with singleton pregnancies who attended the outpatient obstetrics clinic between 24 and 37 weeks of gestation and met the eligibility criteria were prospectively enrolled. Participants diagnosed with preeclampsia formed the study group, and pregnant women who were not diagnosed with preeclampsia during the evaluation phase and during pregnancy formed the control group. CIMT measurements were performed at the time of evaluation for all patients, concurrently with the clinical and laboratory assessment used for diagnosis. Demographic characteristics, routine laboratory parameters, and CIMT measurements were compared between groups. Correlation analyses and receiver operating characteristic curve analysis were performed to evaluate the association between CIMT and preeclampsia.

Women with preeclampsia had significantly greater CIMT than pregnant women without preeclampsia. Maternal age, body mass index, serum uric acid, urea, and creatinine levels were significantly higher, whereas serum albumin levels were significantly lower in the preeclampsia group. CIMT demonstrated significant correlations with several biochemical parameters related to renal function and systemic vascular involvement. In multivariable logistic regression analysis, median CIMT remained independently associated with preeclampsia after adjustment for maternal age, body mass index, and gestational age at CIMT measurement (adjusted odds ratio 2.53 per 0.1 mm increase; 95% confidence interval 1.36-4.71; P = 0.003). Receiver operating characteristic analysis showed that CIMT had a moderate ability to discriminate women with and without preeclampsia (area under the curve 0.75).

Women with preeclampsia exhibited significantly increased CIMT compared with pregnant women without preeclampsia. Median CIMT demonstrated moderate discriminatory performance for distinguishing women with and without established preeclampsia; however, the clinical utility of CIMT for preeclampsia screening remains to be established. Larger prospective studies are required to validate the observed association and determine the clinical utility of CIMT in preeclampsia assessment.