Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study

Abstract Introduction The association between preeclampsia and coronavirus disease 2019 (COVID‐19) is under study. Previous publications have hypothesized the existence of shared risk factors for both conditions or a deficient trophoblastic invasion as possible explanations for this association. The...

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Main Authors: Berta Serrano, Manel Mendoza, Paula Garcia‐Aguilar, Erika Bonacina, Itziar Garcia‐Ruiz, Pablo Garcia‐Manau, Judit Gil, Mireia Armengol‐Alsina, Nuria Fernandez‐Hidalgo, Elena Sulleiro, Rosa Maria Lopez‐Martinez, Marta Ricart, Lourdes Martin, Eva Lopez‐Quesada, Angels Vives, Anna Maroto, Nerea Maiz, Anna Suy, Elena Carreras
Format: Article
Language:English
Published: Wiley 2022-07-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14371
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author Berta Serrano
Manel Mendoza
Paula Garcia‐Aguilar
Erika Bonacina
Itziar Garcia‐Ruiz
Pablo Garcia‐Manau
Judit Gil
Mireia Armengol‐Alsina
Nuria Fernandez‐Hidalgo
Elena Sulleiro
Rosa Maria Lopez‐Martinez
Marta Ricart
Lourdes Martin
Eva Lopez‐Quesada
Angels Vives
Anna Maroto
Nerea Maiz
Anna Suy
Elena Carreras
author_facet Berta Serrano
Manel Mendoza
Paula Garcia‐Aguilar
Erika Bonacina
Itziar Garcia‐Ruiz
Pablo Garcia‐Manau
Judit Gil
Mireia Armengol‐Alsina
Nuria Fernandez‐Hidalgo
Elena Sulleiro
Rosa Maria Lopez‐Martinez
Marta Ricart
Lourdes Martin
Eva Lopez‐Quesada
Angels Vives
Anna Maroto
Nerea Maiz
Anna Suy
Elena Carreras
author_sort Berta Serrano
collection DOAJ
description Abstract Introduction The association between preeclampsia and coronavirus disease 2019 (COVID‐19) is under study. Previous publications have hypothesized the existence of shared risk factors for both conditions or a deficient trophoblastic invasion as possible explanations for this association. The primary aim of this study was to examine baseline risk factors measured in the first‐trimester combined screening for preeclampsia in pregnant women with COVID‐19 compared with the general population. A secondary aim of this study was to compare risk factors among patients with mild and severe COVID‐19. Material and Methods This was an observational retrospective study conducted at Vall d'Hebron Hospital Campus (Catalonia, Spain). Study patients were 231 pregnant women undergoing the first‐trimester screening for preeclampsia and positive for severe acute respiratory syndrome coronavirus 2 between February 2020 and September 2021. The reference cohort were 13 033 women of the general population from six centers across Catalonia from May 2019 to June 2021. Based on the need for hospitalization, patients were classified in two groups: mild and severe COVID‐19. First‐trimester screening for preeclampsia included maternal history, mean arterial blood pressure, mean uterine artery pulsatility index (UtAPI), placental growth factor (PlGF), and pregnancy‐associated plasma protein‐A (PAPP‐A). Results The proportion of cases at high risk for preeclampsia was significantly higher among the COVID‐19 group compared with the general population (19.0% and 13.2%, respectively; p = 0.012). When analyzing risk factors for preeclampsia individually, women with COVID‐19 had higher median body mass index (25.2 vs 24.5, p = 0.041), higher UtAPI multiple of the median (MoM) (1.08 vs 1.00, p < 0.001), higher incidence of chronic hypertension (2.8% vs 0.9%, p = 0.015), and there were fewer smokers (5.7% vs 11.6%, p = 0.007). The MoMs of PlGF and PAPP‐A did not differ significantly between both groups (0.96 vs 0.97, p = 0.760 and 1.00 vs 1.01, p = 0.432; respectively). Conclusions In patients with COVID‐19, there was a higher proportion of women at high risk for preeclampsia at the first‐trimester screening than in the general population, mainly because of maternal risk factors, rather than placental signs of a deficient trophoblastic invasion.
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spelling doaj-art-042eed50630e41edaef9231345bef67f2025-08-20T03:30:53ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-07-01101780380810.1111/aogs.14371Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational studyBerta Serrano0Manel Mendoza1Paula Garcia‐Aguilar2Erika Bonacina3Itziar Garcia‐Ruiz4Pablo Garcia‐Manau5Judit Gil6Mireia Armengol‐Alsina7Nuria Fernandez‐Hidalgo8Elena Sulleiro9Rosa Maria Lopez‐Martinez10Marta Ricart11Lourdes Martin12Eva Lopez‐Quesada13Angels Vives14Anna Maroto15Nerea Maiz16Anna Suy17Elena Carreras18Maternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainDepartment of Infectous Diseases Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainDepartment of Microbiology Vall d'Hebron Barcelona Hospital Campus Barcelona SpainBiochemistry Department Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal‐Fetal Medicine Unit, Department of Obstetrics Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona Badalona SpainMaternal‐Fetal Medicine Unit, Department of Obstetrics Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili Tarragona SpainMaternal‐Fetal Medicine Unit, Department of Obstetrics Hospital Universitari Mútua Terrassa, Universitat de Barcelona Terrassa SpainMaternal‐Fetal Medicine Unit, Department of Obstetrics, Consorci Sanitari de Terrassa Universitat Internacional de Catalunya Terrassa SpainMaternal‐Fetal Medicine Unit, Department of Obstetrics Hospital Universitari de Girona Doctor Josep Trueta, Universitat de Girona Girona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainMaternal Fetal Medicine Unit, Department of Obstetrics Vall d'Hebron Barcelona Hospital Campus, Universitat Autònoma de Barcelona Barcelona SpainAbstract Introduction The association between preeclampsia and coronavirus disease 2019 (COVID‐19) is under study. Previous publications have hypothesized the existence of shared risk factors for both conditions or a deficient trophoblastic invasion as possible explanations for this association. The primary aim of this study was to examine baseline risk factors measured in the first‐trimester combined screening for preeclampsia in pregnant women with COVID‐19 compared with the general population. A secondary aim of this study was to compare risk factors among patients with mild and severe COVID‐19. Material and Methods This was an observational retrospective study conducted at Vall d'Hebron Hospital Campus (Catalonia, Spain). Study patients were 231 pregnant women undergoing the first‐trimester screening for preeclampsia and positive for severe acute respiratory syndrome coronavirus 2 between February 2020 and September 2021. The reference cohort were 13 033 women of the general population from six centers across Catalonia from May 2019 to June 2021. Based on the need for hospitalization, patients were classified in two groups: mild and severe COVID‐19. First‐trimester screening for preeclampsia included maternal history, mean arterial blood pressure, mean uterine artery pulsatility index (UtAPI), placental growth factor (PlGF), and pregnancy‐associated plasma protein‐A (PAPP‐A). Results The proportion of cases at high risk for preeclampsia was significantly higher among the COVID‐19 group compared with the general population (19.0% and 13.2%, respectively; p = 0.012). When analyzing risk factors for preeclampsia individually, women with COVID‐19 had higher median body mass index (25.2 vs 24.5, p = 0.041), higher UtAPI multiple of the median (MoM) (1.08 vs 1.00, p < 0.001), higher incidence of chronic hypertension (2.8% vs 0.9%, p = 0.015), and there were fewer smokers (5.7% vs 11.6%, p = 0.007). The MoMs of PlGF and PAPP‐A did not differ significantly between both groups (0.96 vs 0.97, p = 0.760 and 1.00 vs 1.01, p = 0.432; respectively). Conclusions In patients with COVID‐19, there was a higher proportion of women at high risk for preeclampsia at the first‐trimester screening than in the general population, mainly because of maternal risk factors, rather than placental signs of a deficient trophoblastic invasion.https://doi.org/10.1111/aogs.14371coronavirus disease 2019first trimesterplacental growth factorpreeclampsiarisk factorsscreening
spellingShingle Berta Serrano
Manel Mendoza
Paula Garcia‐Aguilar
Erika Bonacina
Itziar Garcia‐Ruiz
Pablo Garcia‐Manau
Judit Gil
Mireia Armengol‐Alsina
Nuria Fernandez‐Hidalgo
Elena Sulleiro
Rosa Maria Lopez‐Martinez
Marta Ricart
Lourdes Martin
Eva Lopez‐Quesada
Angels Vives
Anna Maroto
Nerea Maiz
Anna Suy
Elena Carreras
Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study
Acta Obstetricia et Gynecologica Scandinavica
coronavirus disease 2019
first trimester
placental growth factor
preeclampsia
risk factors
screening
title Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study
title_full Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study
title_fullStr Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study
title_full_unstemmed Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study
title_short Shared risk factors for COVID‐19 and preeclampsia in the first trimester: An observational study
title_sort shared risk factors for covid 19 and preeclampsia in the first trimester an observational study
topic coronavirus disease 2019
first trimester
placental growth factor
preeclampsia
risk factors
screening
url https://doi.org/10.1111/aogs.14371
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