Introduction: It is well known that a multiparametric model including epidemiological maternal factors, uterine Doppler and biochemical parameters could be useful at 1st and 2nd Trimester for the prediction of early PE (<34 weeks of gestation) but less accurate for late PE (⩾34 weeks of gestation). Different physiopathologies have been suggested for these two entities. A new approach based in a 3rd trimester screening has been suggested for the predicton of late PE.

Objectives: To define the prediction capacity of maternal characteristics at 3rd trimester for late PE.

Material And Methods: 4724 pregnancies followed up and delivered in our centre from July 2010 to December 2012 were included in a cross sectional study. Out of these, 59 cases developed a late preeclampsia (1.2%). Controls were gestations with no diagnosis of PE nor gestational hypertension. All patients made a 3rd trimester visit at 31-33 weeks, where systolic and diastolic blood pressure and the absolute weight gain since the beginning of pregnancy were measured. Parity, maternal age and body mass index at the beginning of the pregnancy were also recorded. A multivariate logistic regression analysis was made to define the predictive capacity of these variables for late PE.

Results: MAP was significantly higher in those patients who developped PE (78.8 vs 88.8 mmHg, p<0.05). Although cases had a higher BMI at first visit ( BMI 25.9 vs 23, p<0.05), the total weight gain during pregnancy up to the 3rd trimester was similar among groups (9.3 vs 10.3kg, p>0.05). The mean GA at delivery of cases was 38 (range 35-41 weeks) and of controls 39.1 (range 34-42 weeks). In a multivariate logistic regression analysis, MAP and BMI were independent and significant predictors of late PE at 3rd Trimester. The model including BMI and MAP has an AUC of 0.76 (0.683-0.837).

Conclusions: A 3rd trimester screening could be useful in the prediction of late-onset PE.

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http://dx.doi.org/10.1016/j.preghy.2013.04.092DOI Listing

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