Objective: To investigate the potential value of measuring mean arterial pressure (MAP), systolic (sBP) and diastolic (dBP) blood pressure at 30-33 weeks' gestation in the prediction of preeclampsia (PE) developing at or after 34 weeks. Methods: Screening study in singleton pregnancies at 30-33 weeks' gestation including 4,294 that were unaffected by PE, gestational hypertension (GH) or delivery of small-for-gestational-age neonates (normal group), 145 that subsequently developed PE [37 cases requiring delivery at 34-37 weeks (intermediate PE) and 108 delivering at or after 38 weeks (late PE)] and 161 that developed GH. The a priori risks for intermediate and late PE from maternal demographic characteristics and medical history were determined. The a posteriori risks were calculated by combining the a priori risks with the likelihood ratios for MAP, sBP and dBP, which were calculated from fitted bivariate gaussian distributions. Results: The mean multiple of median MAP, sBP and dBP were significantly higher in the intermediate and late PE groups than in the normal group. In screening by a combination of maternal characteristics and MAP, the estimated detection rates of intermediate and late PE, at a false-positive rate of 10%, were 70.3 and 62.0%, respectively. The respective detection rates for sBP were 62.2 and 59.3% and for dBP were 62.2 and 57.4%. Conclusion: Combined testing by maternal characteristics and blood pressure at 30-33 weeks could effectively identify women at high risk for subsequent development of PE.

Objective: Women who develop gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes and subsequent cardiovascular mortality and morbidity. Individuals with cardiovascular disorders have increased central aortic systolic blood pressure (SBP_Ao) and arterial stiffness. The hypothesis of this study is that increased SBP_Ao and arterial stiffness are apparent before the development of GDM. Methods: In this screening study, SBP_Ao, pulse wave velocity (PWV) and augmentation index (AIx) were measured in women with singleton pregnancies attending for routine antenatal care at 11–13 weeks’ gestation. We compared SBP_Ao, PWV and AIx, expressed as multiples of the median (MoM), after adjustment for maternal characteristics affecting these measurements, in women who subsequently developed GDM (n = 105) with the values in non-GDM controls (n = 6,736). Results: In the GDM group, compared to non-GDM controls, there was an increase in PWV [1.04 MoM, interquartile range (IQR) 0.93–1.15 vs. 1.00 MoM, IQR 0.90–1.12; p = 0.013] and SBP_Ao (1.03 MoM, IQR 0.98–1.14 vs. 1.00 MoM, IQR 0.94–1.08; p < 0.0001) but no significant difference in the AIx (1.02 MoM, IQR 0.89–1.22 vs. 1.00 MoM, IQR 0.87–1.17; p = 0.118). Conclusion: Women who develop GDM haveincreased SBP_Ao and arterial stiffness from the first trimester of pregnancy before the clinical onset of GDM.

Objective Women who experience preterm birth (PTB)