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SYSTEMATIC REVIEW article
Front. Med.
Sec. Obstetrics and Gynecology
Volume 11 - 2024 |
doi: 10.3389/fmed.2024.1459289
Prediction and Prevention of Late-Onset Pre-eclampsia: A Systematic Review
Provisionally accepted- The University of Melbourne, Parkville, Australia
Background: Pre-eclampsia is a major cause of perinatal morbidity and mortality worldwide. Lateonset pre-eclampsia (LOP), which results in delivery > 34 weeks gestation, is the most common type. However, there is a lack of knowledge in its prediction and prevention. Improving our understanding in this area will allow us to have better surveillance of high-risk patients and thus improve clinical outcomes. Methods: A systematic review was performed using a search of articles on PubMed. The search terms were ((late-onset) AND (pre-eclampsia)) AND ((risk factor) OR (risk) OR (prediction) OR (management) OR (prevention)). Primary literature published between 1 January 2013 to 31 December 2023 was included. Human studies assessing the prediction or prevention of late-onset pre-eclampsia were eligible for inclusion. Results: 16 articles were included in the final review. The key risk factors identified were Body Mass Index (BMI), chronic hypertension, elevated mean arterial pressures (MAPs), nulliparity, and maternal age. No clinically useful predictive model for LOP was found. Initiating low dose aspirin before 17 weeks gestation in high-risk patients may help reduce the risk of LOP. Conclusion: While aspirin is a promising preventor of LOP, preventative measures for women not deemed to be at high-risk or measures that can be implemented at a later gestation are required. Biomarkers for LOP need to be identified, and examining large cohorts during the second or third trimester may yield useful results, as this is when the pathogenesis is hypothesised to occur. Biomarkers that identify high-risk LOP patients may also help find preventative measures.
Keywords: Late-onset pre-eclampsia, prediction, prevention, risk factor, Management
Received: 04 Jul 2024; Accepted: 11 Nov 2024.
Copyright: © 2024 Baylis, Zhou, Menkhorst and Dimitriadis. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Evdokia Dimitriadis, The University of Melbourne, Parkville, Australia
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