Early Pregnancy Risk Factors for Pre-Eclampsia Identified

MedicalResearch.com Interview with:

Joel Ray, MD MSc FRCPC Clinician-Scientist St. Michael’s Hospital Toronto, ON

Dr. Joel Ray

Joel Ray, MD MSc FRCPC
St. Michael’s Hospital
Toronto, ON

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Ray:

  • Clinical practice guidelines strongly recommend that physicians and midwives start aspirin before 20 weeks gestation in a woman at high risk of preeclampsia (PE).
  • However, these guidelines do not provide a systematic approach for identifying a woman at high risk of pre-eclampsia (PE), using readily available clinical risk factors (RFs) known before 20 weeks gestation.
  • Thus, there is a need for a clear, concise and evidence-based list of risk factors that clinicians can use, before 20 weeks gestation, to estimate a woman’s risk of pre-eclampsia.
  • We systemically analyzed large cohort studies and estimates of the absolute pooled risk of developing pre-eclampsia in the presence vs. absence of one of 14 common risk factors.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Ray: By quantifying the risk of pre-eclampsia conferred by various individual clinical risk factors a clinician may be better equipped to estimate a woman’s risk of pre-eclampsia, and her candidacy for heightened surveillance or prophylactic measures, including aspirin.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Ray: We recommend that the risk factors identified in our study need to be evaluated in various combinations. Additionally, our findings could enhance the choice and weighting of first-trimester clinical factors in future clinical prediction models for pre-eclampsia.

MedicalResearch.com: Is there anything else you would like to add?

Dr. Ray: Some risk factors identified in our study are certainly strong enough that a woman should likely be started on aspirin when she has only one of them, as shown the following link: http://goo.gl/ldzPbx.


Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies

BMJ 2016; 353 doi: http://dx.doi.org/10.1136/bmj.i1753 (Published 19 April 2016) Cite this as: BMJ 2016;353:i1753

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