The role of shared risk factors for COVID-19 and preeclampsia: An
observational study
Abstract
Objective: To examine baseline risk factors measured in the
first-trimester screening for preeclampsia (PE) in pregnant women with
COVID-19 versus the general population. To compare risk factors among
patients with mild and severe COVID-19. Design: Observational
retrospective study. Setting: Six maternities in Catalonia. Population:
Study patients were 231 pregnant women undergoing first-trimester
screening for PE and positive for SARS-CoV-2. Reference cohort were
13,033 pregnant women with first-trimester screening for PE from 6
maternities. Methods: Recording of maternal history, mean arterial blood
pressure (MAP), mean uterine artery pulsatility index (UtAPI), placental
growth factor (PlGF) and pregnancy-associated plasma protein-A at first
trimester. Confirmation of SARS-CoV-2 infection. Based on the need for
hospitalization, patients were classified into mild and severe COVID-19.
Main outcome measures: Comparison of proportion of cases at a high risk
for PE and of risk factors for PE among groups. Results: High risk for
PE was significantly higher amongst COVID-19 patients compared to the
general population, showing higher rates of obesity, chronic
hypertension, higher UtAPI, and lower rates of smokers. PlGF did not
differ significantly. In women with severe COVID-19, compared with mild
COVID-19, BMI and MAP were significantly higher, whereas PlGF and UtAPI
did not differ significantly. Conclusions: In patients with COVID-19
there was a higher proportion of women at a high risk for PE than in the
general population, mainly due to maternal risk factors, rather than
placental signs of a deficient trophoblastic invasion. Likewise,
according to COVID-19 severity, differences were due to maternal risk
factors only.