Screening identifies preeclampsia cases more accurately, researchers say

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A personalized screening technique predicts preeclampsia more accurately than current guidelines relying on risk factors, recent research in the journal Hypertension suggests.

"A pregnancy complication marked by high blood pressure and signs of organ failure," preeclampsia develops in about 1 in 25 U.S. pregnancies, according to the Centers for Disease Control and Prevention. Worldwide, it accounts for more than 70,000 maternal deaths and 500,000 fetal deaths each year.

The new screening approach, which relies on blood biomarkers and ultrasound data in addition to information about maternal health, can accurately predict up to two-thirds of preterm preeclampsia cases, the study's authors say.

Researchers recruited 7,554 participants in Canada, all of whom were 11 to 14 weeks into their first pregnancy and gave blood samples and underwent fetal ultrasounds. Those who miscarried or whose children had fetal anomalies were excluded. Of the 7,325 who remained, 65 (0.9 percent) developed preterm preeclampsia and 22 (0.3 percent) developed early preeclampsia, which occurs before the 34th week of pregnancy and is associated with worse outcomes.

Guidelines from the American College of Obstetricians and Gynecologists (ACOG) identify preeclampsia risk in patients with factors such as a high BMI, family history of the condition or a variety of chronic illnesses. High-risk patients are usually prescribed a regimen of daily, low-dose aspirin to prevent preeclampsia.

Instead of using risk factors alone to predict possible cases, the study looked for blood and ultrasound markers of preeclampsia using an algorithm developed by the Fetal Medicine Foundation.

The algorithm correctly predicted 63.1 percent of preterm cases and 77.3 percent of early cases, with a false positive rate of 15.8 percent. Using the current ACOG risk factor criteria would have identified 61.5 percent of preterm cases and 59.1 percent of early-onset cases with a 34.3 percent false positive rate, the researchers write.

The study might have predicted even more cases if it had examined a broader population and not excluded some people at high risk for preeclampsia, the researchers write.

"The good news is that we now have a more precise screening approach using existing tests that can predict preeclampsia early in pregnancy," Emmanuel Bujold, a professor in the department of obstetrics and gynecology at Laval University in Quebec City and the study's senior author, said in a news release.

"The next step is to make this screening available to all pregnant women so that more women could receive a diagnosis early in pregnancy and begin preventive aspirin treatment, potentially preventing complications of severe preeclampsia," he added.