Abstracts a reduction in proportion of women (median gestation 35 weeks) who had never previously had a BP in pregnancy, (25.1% to 16.9%, OR 0.58, p = 0.001, CI 0.42-0.79). In Zimbabwe there was an additional significant increase in the proportion of women who had sustained hypertension (12.8% to 21.3%, OR 1.09, p = 0.03, CI 1.06-3.43). Conclusion Equipping low-skilled community health providers with a novel BP device is feasible and widely accepted, and increased community referrals for suspected pre-eclampsia. A cluster RCT to evaluate the effect of these monitors equipped with traffic light early warning systems, on maternal and fetal outcomes is planned.
Objective
To assess the association between pre-eclampsia (PE) and levels of PAPP-A and UtaPI in first trimester.
Methods
Retrospective study of singleton pregnancies attending for first trimester screening for trisomy 21. PAPP-A was expressed as multiples of the median (MOM). We defined low PAPP-A as levels below 5th percentile and high PI as levels above the 95th percentile. PE was defined according the ISSHP criteria. PE requiring delivery before 34 weeks was designated as early, and after 34 weeks as late. UtaPI was preformed at 11-14 weeks.
Results
PAPP-A levels were available for 12729 women and values for mean UtaPI for 8020. In the population, 302 (2.43%) women developed PE, including 35 (0.5%) early PE and 267 (2.1%) late PE. The median maternal serum PAPP-A MOM was significantly lower in women with PE, and early PE (1.10 and 0.72 MOM, respectively) than normotensive women (1.14 MOM, p < 0.01). There was a significant association between low PAPPA and development of PE (OR: 1.9, 95% CI: 1.3 to 2.8) and with early PE (OR: 6.6, 95% CI:3.1 to 14.3), but not with late PE. Mean UtaPI was higher in women who developed PE, early PE and late PE.
Conclusion
There is a significant association between low PAPP-A, all preeclampsia and early pre-eclampsia. High UtaPI in the first trimester is associated with all, early and late pre-eclampsia.
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