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

• DOI: 10.1111/aogs.14371
• Publication Date: 2022-05-04T05:43:56Z
• Authors: Berta Serrano; Manel Mendoza; Paula Garcia‐Aguilar; Erika Bonacina; Itziar Garcia‐Ruiz; Pablo Garcia‐Manau; Judit Gil; Mireia Armengol‐A...; Nuria Fernandez‐H...; Elena Sulleiro; Rosa Maria Lopez‐...; Marta Ricart; Lourdes Martin; Eva Lopez‐Quesada; Angels Vives; Anna Maroto; Nerea Maiz; Anna Suy; Elena Carreras
• Keywords: placental growth factor; Placenta; Embaràs; :enfermedades de los genitales femeninos y complicaciones del embarazo::complicaciones del embarazo::hipertensión inducida en el embarazo::preeclampsia [ENFERMEDADES]; COVID-19 (Malaltia); preeclampsia; coronavirus disease 2019; 03 medical and health sciences; Preeclàmpsia; 0302 clinical medicine; Pre-Eclampsia; Pregnancy; Risk Factors; :virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES]; risk factors; Humans; Pregnancy-Associated Plasma Protein-A; Placenta Growth Factor; Retrospective Studies; :Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Pregnancy Trimesters::Pregnancy Trimester, First [PHENOMENA AND PROCESSES]; uterine artery Doppler; screening; COVID-19; :Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES]; :fenómenos fisiológicos reproductivos y urinarios::fenómenos fisiológicos de la reproducción::trimestres del embarazo::primer trimestre del embarazo [FENÓMENOS Y PROCESOS]; 3. Good health; Pregnancy Trimester, First; Uterine Artery; Female; :Female Urogenital Diseases and Pregnancy Complications::Pregnancy Complications::Hypertension, Pregnancy-Induced::Pre-Eclampsia [DISEASES]; first trimester; Biomarkers; severe acute respiratory syndrome coronavirus 2

AbstractIntroductionThe 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 MethodsThis 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).ResultsThe 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).ConclusionsIn 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.