Timed Childbirth Could Potentially Prevent Over 50% Of Preeclampsia Cases Occurring Between 37 and 42 Weeks Of Pregnancy, New Research Finds
New research published in Hypertension has revealed that over 50% of preeclampsia cases occurring between 37 and 42 weeks of pregnancy could be prevented via timed births, including scheduled inductions or Cesarean deliveries.
According to the Cleveland Clinic, preeclampsia is a dangerous blood pressure condition that develops during gestation– causing blood pressure to rise above 140/90 mmHg. This makes the condition the leading cause of maternal death around the globe.
Preeclampsia impacts one in 25 pregnancies in the U.S. and could be life-threatening. Symptoms include vision changes, headaches, and swelling of the face, eyes, hands, and feet of the mother, as well as health changes in the baby.
The condition is usually diagnosed following 20 weeks of pregnancy and can indicate that women are at a greater risk of developing heart health complications in the long term.
For women who develop preeclampsia between weeks 20 and 26 of pregnancy, preterm delivery might be an option. But, the majority of preeclampsia cases occur between weeks 37 and 42– also known as “at term.”
And while preeclampsia screenings are routine throughout the gestation period, there are still a limited amount of treatment options proven to be effective and safe.
One option, administering low doses of aspirin, does cut down the risk of preterm preeclampsia by more than 50% among at-risk women. But, low aspirin doses do not impact at-term preeclampsia risk– which is three times more common and associated with more significant complications among both mothers and babies.
Timed births, such as Cesarean deliveries and included labor, are also methods widely used for a variety of reasons. But, they are rarely used for at-term preeclampsia intervention– which the researchers believe is a viable application.
“Timed birth is achievable in many hospitals or health centers, so our proposed approach to preventing at-term preeclampsia has huge potential for global good in maternity care,” explained Laura A. Magee, the study’s lead author.
Denys Kurbatov – stock.adobe.com – illustrative purposes only, not the actual person
For the study, the researchers analyzed over 10 years’ worth of health records from two hospitals, Medway Maritime Hospital in Gillingham and Kings College Hospital in London, which included almost 90,000 pregnancies.
Of this group, 57,131 pregnancies from 2006 to 2017 had health records from 11 to 13 weeks. And within this subset, 1,138 cases had at-term preeclampsia.
From 2016 to 2018, there were 29,035 pregnancies with health records at 35 to 36 weeks. And 619 of these pregnancies had at-term preeclampsia.
Through this analysis, the team worked to evaluate the risk of preeclampsia as well as the prospective benefits of timed births among both groups of women.
This was made possible by combining the standard preeclampsia clinical criteria with a risk prediction model– or a computer program able to predict preeclampsia risk using numerous individual risk factors, including blood pressure, blood tests, maternal history, and ultrasounds.
Most of the women were in their early 30s, had a body mass index (BMI) at the upper end of “normal,” and self-identified as white. Approximately 10% of the participants also reported they smoked; meanwhile, less than 3% had a history of Type 2 diabetes, high blood pressure, or an autoimmune disease.
Additionally, just 3.9% of the women reported having a family history of preeclampsia.
After comparing patients screened during their first trimester with those screened during their third trimester, the team found that at-term preeclampsia frequency rates were similar.
About two-thirds of the participants experienced spontaneous labor onset; meanwhile, approximately one-fourth of the participants had Cesarean deliveries.
On average, the women also delivered their babies at 40 weeks.
According to the researchers, though, their analysis– which used risk modeling instead of standard clinical screening– revealed that timed births might be a more effective intervention. In fact, it has the potential to reduce the risk of at-term preeclampsia by more than 50%.
“Our findings suggest that over half of the cases of at-term preeclampsia may be prevented by timed (planned) birth,” Magee said.
“It is important to note that being at higher risk of at-term preeclampsia was associated with earlier spontaneous onset of labor, so women at the highest risk were already less likely to deliver close to their due date.”
It is crucial to note that the research did include limitations– most notably, the fact that no interventions were physically provided to the participants. The study only calculated potential risk solely via risk modeling. Additionally, the research did not examine potential preeclampsia post-delivery.
Despite the study being observational, though, the researchers believe the study was strong, being that it included a vast population of women. Plus, both Cesarean deliveries and labor induction are already widely available birthing options.
But, moving forward, randomized clinical trials will be needed to evaluate whether or not timed birth is a safe, effective, and appropriate intervention method to reduce at-term preeclampsia risk.
To read the study’s complete findings, visit the link here.
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