Epidemiological profile of pregnant women undergoing first-trimester preeclampsia screening at a tertiary reference center in Brazil.

OBJECTIVE

The aim of this study was to evaluate the epidemiological profile of first-trimester pregnant women attending a tertiary reference center in São Paulo, Brazil, and to assess its association with the development of preeclampsia.

METHODS

This study involved retrospective and prospective cohorts of pregnant women undergoing first-trimester ultrasound for aneuploidy screening between 11 and 13+6 weeks' gestation from 2020 to 2023. Maternal, obstetric, and clinical characteristics, including mean arterial pressure, were collected via questionnaire and clinical measurements. Statistical analyses included descriptive statistics and stepwise forward logistic regression to identify factors associated with preeclampsia development.

RESULTS

A total of 104 pregnant women were included, with a mean age of 30.9 years. Most were White (48.3%), non-smokers (86.5%), overweight (mean body mass index: 28.5 kg/m2), and had spontaneous pregnancies (100%). Nulliparous and primiparous women accounted for 71.9% of the sample. Low risk for preeclampsia was observed in 84.3% and high risk in 15.7%. History of previous preeclampsia (OR 46.0, 95%CI 3.2-654.2), chronic arterial hypertension (OR 11.2, 95%CI 1.9-64.6), and increased first-trimester mean arterial pressure (OR 1.2, 95%CI 1.1-1.4) were independently associated with higher preeclampsia risk. Other variables, including race, parity, body mass index, and uterine artery Doppler indices, were not significant predictors.

CONCLUSION

Prior history of preeclampsia, chronic hypertension, and elevated first-trimester mean arterial pressure were key predictors of preeclampsia development. These findings support the importance of first-trimester risk stratification using maternal history and mean arterial pressure measurement to guide early preventive interventions, particularly in settings where biochemical markers are not routinely available.