Preeclampsia Screening and Risk Assessment Methods

Preeclampsia is a multisystem disorder of pregnancy characterised by new‐onset hypertension and end‐organ dysfunction. Early identification of women at high risk enables targeted prophylaxis, closer surveillance and timely intervention to reduce maternal and perinatal morbidity. Contemporary screening approaches combine maternal demographic and medical history with biophysical measures—such as mean arterial pressure and uterine artery Doppler flow—and biochemical markers, notably placental growth factor and pregnancy‐associated plasma protein-A. Risk assessment algorithms integrate these inputs within statistical frameworks, for example competing-risks models, to generate individualised probability scores. In practice, first-trimester combined screening facilitates initiation of low-dose aspirin in high-risk women before 16 weeks’ gestation, which has been shown to lower the incidence of preterm preeclampsia substantially. Second- and third-trimester strategies leverage emerging biomarkers and longitudinal monitoring of uteroplacental perfusion to adjust risk estimates and optimise timing of delivery. Global trials have validated these protocols across diverse populations, demonstrating consistent improvements in early-onset preeclampsia detection rates compared with traditional risk-factor–based guidelines. Ongoing advances in machine learning and novel omics markers promise to refine predictive accuracy and extend screening to under-resourced settings, thereby enhancing equity in maternal care.

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Preeclampsia Screening and Risk Assessment Methods publication trend

The graph below shows the total number of articles in preeclampsia screening and risk assessment methods across all publications each year (not limited to Nature Index journals).

Technical terms

Preeclampsia: Pregnancy complication defined by hypertension after 20 weeks’ gestation with organ dysfunction or proteinuria.

Mean arterial pressure (MAP): Average arterial blood pressure calculated from systolic and diastolic readings, used as a biophysical screening marker.

Uterine artery pulsatility index (UtA-PI): Doppler ultrasound measure of resistance in uteroplacental circulation.

Placental growth factor (PlGF): Angiogenic protein produced by the placenta; low levels predict impaired placentation.

Pregnancy-associated plasma protein-A (PAPP-A): Protease secreted by trophoblasts; reduced concentrations are linked to adverse placental function.

Competing-risks model: Statistical framework that integrates multiple risk factors to estimate individual probability of developing preeclampsia.

References

1. Preeclampsia Prevention by Timed Birth at Term. Hypertension (2023).
2. Pre‐eclampsia screening in Denmark (PRESIDE): national validation study. Ultrasound in Obstetrics and Gynecology (2023).
3. Prediction model of preeclampsia using machine learning based methods: a population based cohort study in China. Frontiers in Endocrinology (2024).