This approach represents personalised medicine, and has the potential to prevent the largest number of pre-eclampsia cases, while minimising any risks associated with early term birth”.Professor Laura A. Magee, lead author
11 April 2023
Scheduled childbirth could cut pre-eclampsia risk by 50%
Latest analysis of data shows that delivering babies earlier at term minimises occurrence of pre-eclampsia in women at increased risk of this important complication of pregnancy.
Pre-eclampsia is the most dangerous disorder of high blood pressure in pregnancy. The condition is a leading cause of mother and baby deaths worldwide, and in the UK specifically, maternal deaths due to pre-eclampsia are on the rise.
It is now established that women at increased risk of developing pre-eclampsia can be identified in early pregnancy, and when given aspirin, their risk of developing pre-eclampsia before 37 weeks of pregnancy is more than halved.
While women at increased risk of developing pre-eclampsia at term (at 37-42 weeks of pregnancy) can be identified at 35-36 weeks of pregnancy, there is currently no treatment available (including aspirin) to decrease their risk. This is a key gap in our knowledge.
For over 25 years, the Fetal Medicine Foundation (FMF) has undertaken focussed study of the prediction and prevention of pre-eclampsia. Using FMF data, researchers from King’s College London, King’s College Hospital, Medway Maritime Hospital, the University of Exeter and Canterbury Christ Church University, UK, have today published promising findings on the prevention of term pre-eclampsia in Hypertension.
Recently, this team published in the British Journal of Obstetrics and Gynaecology that term pre-eclampsia represents more than 75% of pre-eclampsia cases, and accounts for most of the complications for mothers and a substantial proportion of complications for babies.
In this latest paper, the researchers’ analysis of FMF data suggests that pre-eclampsia at term can be prevented. The authors propose a novel approach of timing birth according to a woman’s risk of term pre-eclampsia - earlier at term (from 37 weeks of pregnancy) for women at very high risk, and later at term (from 40 weeks of pregnancy) for those at lower risk. In taking this approach, term pre-eclampsia may be more than halved.
Professor Kypros Nicolaides, founder and chairman of the FMF, is about to launch a related UK randomised controlled trial:
This trial will establish definitely whether the approach published today in Hypertension will more than halve the occurrence of pre-eclampsia at term gestational age, and optimise outcomes for mothers and babies”.Professor Kypros Nicolaides
Read the full paper ‘Preeclampsia prevention by timed birth at term’ in Hypertension.