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Background <p>Hypertensive disorders of pregnancy (HDP), including preeclampsia, are significant contributors to maternal and perinatal morbidity and mortality. Early identification of women at risk for HDP could enable timely monitoring and intervention. This study evaluates the predictive value of maternal characteristics, ophthalmic artery Doppler (OAD) parameters, mean arterial pressure (MAP), uterine artery pulsatility index (UTPI), and placental growth factor (PLGF) in first-trimester screening for HDP.</p> Methods <p>This prospective observational cohort study was conducted at a tertiary perinatal center in South India. Singleton pregnancies between 11 and 13&#xa0;weeks and 6&#xa0;days of gestation were recruited. Maternal demographic characteristics, biophysical markers (BMI, MAP, UTPI), and biochemical markers (PLGF) were recorded. OAD was performed to assess vascular resistance. Participants were followed throughout pregnancy to identify HDP development. Statistical analyses included ROC curves and multivariate models to evaluate predictive performance.</p> Results <p>Of 368 enrolled women, 311 completed follow-ups, with 32 (10.3%) developing HDP. Significant risk factors included higher maternal age (<i>p</i> = 0.047), increased BMI (<i>p</i> = 0.006), primiparity (<i>p</i> &lt; 0.001), pre-existing diabetes (<i>p</i> &lt; 0.001), chronic hypertension (<i>p</i> = 0.001), and a family history of HDP (<i>p</i> &lt; 0.001). MAP and PSV ratio from OAD were significantly higher in the HDP group. Screening models incorporating maternal factors and OAD achieved the highest predictive accuracy (AUC = 0.8324), with the combination of maternal factors, PSV ratio, and PLGF yielding the highest detection rate (62.5%).</p> Conclusion <p>First-trimester screening integrating maternal characteristics, OAD, and PLGF improves HDP risk stratification. These findings support the inclusion of OAD in early pregnancy screening protocols to enhance predictive accuracy and guide early intervention strategies.</p>

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Prediction of Pre-Eclampsia Based on Maternal Clinical Characteristics, Placental Growth Factor, Mean Arterial Pressure, First-Trimester Uterine and Ophthalmic Artery Doppler: A Prospective Observational Cohort Study

  • 期刊论文

  • 发表日期：

    2025年9月17日

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  • Saritha Redishetty,
  • Greeshma More,
  • S. Tarakeshwari,
  • V. Suseela,
  • K. Geeta,
  • S. Swapna

摘要

Background

Hypertensive disorders of pregnancy (HDP), including preeclampsia, are significant contributors to maternal and perinatal morbidity and mortality. Early identification of women at risk for HDP could enable timely monitoring and intervention. This study evaluates the predictive value of maternal characteristics, ophthalmic artery Doppler (OAD) parameters, mean arterial pressure (MAP), uterine artery pulsatility index (UTPI), and placental growth factor (PLGF) in first-trimester screening for HDP.

Methods

This prospective observational cohort study was conducted at a tertiary perinatal center in South India. Singleton pregnancies between 11 and 13 weeks and 6 days of gestation were recruited. Maternal demographic characteristics, biophysical markers (BMI, MAP, UTPI), and biochemical markers (PLGF) were recorded. OAD was performed to assess vascular resistance. Participants were followed throughout pregnancy to identify HDP development. Statistical analyses included ROC curves and multivariate models to evaluate predictive performance.

Results

Of 368 enrolled women, 311 completed follow-ups, with 32 (10.3%) developing HDP. Significant risk factors included higher maternal age (p = 0.047), increased BMI (p = 0.006), primiparity (p < 0.001), pre-existing diabetes (p < 0.001), chronic hypertension (p = 0.001), and a family history of HDP (p < 0.001). MAP and PSV ratio from OAD were significantly higher in the HDP group. Screening models incorporating maternal factors and OAD achieved the highest predictive accuracy (AUC = 0.8324), with the combination of maternal factors, PSV ratio, and PLGF yielding the highest detection rate (62.5%).

Conclusion

First-trimester screening integrating maternal characteristics, OAD, and PLGF improves HDP risk stratification. These findings support the inclusion of OAD in early pregnancy screening protocols to enhance predictive accuracy and guide early intervention strategies.