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Cited by 32Pregnancy and preeclampsia studiesNeurological Complications and SyndromesMaternal Mental Health During Pregnancy and Postpartum

Reviewing Accuracy of First Trimester Screening for Preeclampsia Using Maternal Factors and Biomarkers

Open access
Malone, Sarah L, Haj Yahya, Rani, Kane, Stefan C·2022·International Journal of Women's Health
DOI 10.2147/ijwh.s283239PMC PMC9507456
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Abstract

Preeclampsia is a common and important complication of pregnancy, one with potentially significant morbidity and even mortality to both mother and baby. Identifying those at high risk of developing the condition is helpful as there is evidence that the incidence of preeclampsia can be reduced with low dose aspirin taken in pregnancy. Accurately predicting the risk of preeclampsia allows for more targeted aspirin prophylaxis and a greater opportunity for early detection of maternal and/or fetal complications associated with impaired placentation through a schedule of enhanced antenatal surveillance. Traditional preeclampsia prediction models use maternal characteristics and risk factors and have been shown to be of low predictive value. Multiparametric screening tests combine patient characteristics with serum biomarkers and ultrasound Doppler indices and have been shown to be more effective at detecting those at high risk of preeclampsia - more specifically, early-onset preeclampsia (onset of preeclampsia <34 weeks' gestation). Multiparametric screening has now been validated in different populations. The true cost effectiveness of a multiparametric screening model for preeclampsia screening is not yet fully known and will vary depending on the clinical setting. Despite the growing body of evidence for its improved detection rates, first trimester preeclampsia screening using multiparametric models is not widely implemented and is not part of the recommendations for antenatal screening from most international bodies. The International Federation of Gynecology and Obstetrics has advised universal preeclampsia screening using maternal risk factors and biomarkers and has strongly encouraged its promotion worldwide. Various barriers to implementation must be considered such as the immediate cost of equipment and training, the need for audit and quality control, and the expected benefit to the population. Low to middle income settings may require a pragmatic approach to the implementation of multiparametric screening given limited resources.

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  • An association has been found between certain maternal bloodstream biomarkers and the development of preeclampsia, impaired fetal growth, and stillbirth.

    “Biomarkers in the maternal bloodstream have been investigated extensively and an association has been found between certain biomarkers and the development of preeclampsia, impaired fetal growth and stillbirth16–18.”

    From Multi-centre deep learning for placenta segmentation in obstetric ultrasound with multi-observer and cross-country generalization (2023) · cites this paper as [16]

    The ‘Competing Risk Model Using Multiparametric Screening Tests’ section reports that maternal serum PlGF and PAPP-A are associated with preeclampsia risk. The Introduction reports lower birth weight and increased stillbirth in pregnancies affected by early-onset preeclampsia, but does not establish an association between those outcomes and the biomarkers themselves. Page numbers were not available in our copy. (LLM, conf=0.86)

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Research works printed but not linked: 4

  1. [32]WHO. WHO Recommendations for Prevention and Treatment of Pre-Eclampsia and Eclampsia. WHO; 2021. 23741776
  2. [37]NIfHaCE. Hypertension in Pregnancy: Diagnosis and Management. NICE; 2019. 31498578
  3. [73]Gynaecologists RCoOa. The Investigation and Management of the Small-for-Gestational-Age Fetus. Green-Top Guideline No. 2014; 31: 548.
  4. [79]Gynecologists ACoOa. Low Dose Aspirin Use for the Prevention of Preeclampsia and Related Morbidity and Mortality. Practive Advisory. 2021; 1: 548.

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Authors
Malone, S. L., Haj Yahya, R., & Kane, S. C.
Affiliations
Royal Women's Hospital (AU)
ORCID
Venue
International Journal of Women's Health
Publisher
Informa UK Limited
Published
2022-09
Volume
Volume 14
Pages
1371-1384
ISSN
1179-1411 (ISSN-L)
DOI
10.2147/ijwh.s283239
PMC
PMC9507456
OpenAlex
W4296306937
Cited by
32
References
78
Citations by year
2026: 8 · 2025: 10 · 2024: 3 · 2023: 11
FWCI
1.21
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Women s Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by-nc)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
preeclampsia, first-trimester screening, serum biomarkers, maternal risk factors, low-dose aspirin prophylaxis, early-onset preeclampsia, barriers to screening, cost-effectiveness, low- and middle-income settings

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