A new trial shows that planned birth reduces the risk of preeclampsia in at-risk women without increasing the need for emergency cesarean deliveries or admission to neonatal units.
The PREVENT-PE trial, led by researchers from King’s College London and King's College Hospital of the British National Health Service, is the first study to show that screening for preeclampsia risk at week 36 of pregnancy, followed by a planned early birth depending on the risk level, can reduce the incidence of preeclampsia later by 30% compared to usual care.
Trial design and risk assessment
More than 8000 women from King's College Hospital and the associated NHS Midway Trust participated in the trial. The women were randomly distributed into two groups:
Intervention group: Risk assessment for preeclampsia followed by planned early birth depending on the risk level.
Control group: Usual care at full term.
And a planned birth plan was provided in weeks 37, 38, 39, or 40 for women at high risk, while women at low risk received usual care according to hospital protocols and UK care standards.
Results and comments
The results showed a reduction in the preeclampsia rate from 5.6% to 3.9%, a 30% reduction, without an increase in emergency cesarean deliveries or the need for neonatal care.
Professor Kypros Nicolaides, founder and president of the Fetal Medicine Foundation said: "This reduction is greater than what can be achieved using aspirin, and represents an important step in improving maternal and child health."
Dr. Argiro Syngelaki, Associate Professor in Maternal and Fetal Medicine added: "Following a personalized approach based on risk assessment shows that early planned care is feasible and acceptable, and achieves tangible results for women, children, and maternity services."
Background on preeclampsia
Preeclampsia is elevated blood pressure that develops during pregnancy, often occurring in the later stages, affecting 2% to 8% of pregnancies worldwide. It can be life-threatening, with about 46,000 maternal deaths and about 500,000 fetal and neonatal deaths annually.
Preeclampsia usually develops after week 20 of pregnancy or shortly after childbirth. While aspirin can reduce the risk if taken before week 37, no treatments are available to reduce this risk after full-term pregnancy (37–42 weeks).
The results were published in the journal "Lancet".
