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Preeclampsia: New Biomarkers and Risk Assessment Advancements

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Here are a few options for rewriting the provided text, focusing on different aspects and tones:

Option 1 (Concise and Action-Oriented):

Improving Preeclampsia Diagnosis and Management with PlGF Testing

Dr. John Kingdom highlights the significant role of placental growth factor (PlGF) testing in managing preeclampsia and related conditions. In high-risk pregnancies, real-time PlGF testing aids in diagnosing post-viability issues like fetal growth restriction. For those on aspirin prophylaxis from 12 weeks, a 16-week PlGF test combined with placental ultrasound can guide management, offering reassurance with normal results or prompting further intervention when levels are low.

Kingdom also advocates for PlGF testing in low-risk pregnancies, citing a decade-old UK study that demonstrated its ability to improve preterm preeclampsia identification when used with clinical risk assessment. His recent Mount Sinai Hospital study of over 9000 unselected patients found that a low PlGF level (<100 pg/mL) at 24-28 weeks was associated with a nearly 80-fold increased risk of preterm birth. He emphasizes that plgf testing is practical, cost-effective, and easily integrated into existing gestational diabetes screening. Future directions in Preeclampsia Prevention:

Experts anticipate that improved risk assessment will lead to greater adherence to aspirin prophylaxis and a broader adoption of evidence-based nonpharmacologic interventions. Research is also ongoing into other potential prophylactic agents like heparin, metformin, and statins, as aspirin alone only prevents a portion of the disease.

Studies suggest higher aspirin doses may be slightly more effective and equally safe. Metformin has shown promise in prolonging pregnancies in early-onset preeclampsia, while low-molecular-weight heparin may improve vascular health and boost plgf production. Statins,particularly pravastatin,are also being investigated for their potential to prevent preeclampsia in specific patient subgroups.

Option 2 (More Explanatory and Detailed):

PlGF Testing: A Key Tool for Preeclampsia Prediction and Management, Say experts

Dr. John Kingdom, MD, emphasizes the utility of placental growth factor (PlGF) testing in optimizing the care of pregnant individuals. For high-risk patients, real-time PlGF testing is instrumental in diagnosing conditions that arise after fetal viability, such as fetal growth restriction. Moreover, in high-risk individuals who begin aspirin prophylaxis at 12 weeks to prevent preeclampsia, a PlGF test at 16 weeks, coupled with placental ultrasound, can inform management decisions. “A normal result provides reassurance, while a low level prompts consideration of adjunctive therapies,” Dr. Kingdom explained.

He also asserts that PlGF testing can predict preeclampsia in patients without pre-existing high-risk factors.A study conducted over a decade ago in the UK indicated that plasma PlGF levels at 14-16 weeks gestation, when combined with clinical risk assessment, improved the identification of preterm preeclampsia in nulliparous women compared to clinical risk factors alone.

In a recent prospective cohort study led by Dr. Kingdom at Mount Sinai Hospital, Toronto, over 9000 unselected, predominantly low-risk patients were evaluated. The findings revealed that a low PlGF level (<100 pg/mL) detected during routine gestational diabetes screening (24-28 weeks) was associated with a significant 79.4-fold increased risk for preterm birth. Dr. Kingdom stressed the need for high precision,practicality,and widespread implementation in preeclampsia screening,noting that PlGF testing in mid-pregnancy is "cheap,easily interpreted,unimodalโ€ฆand can be tagged onto current diabetes screening." Advancing Preeclampsia Prevention: Future Therapies and Actions

Experts believe that as risk assessment becomes more precise, adherence to aspirin prophylaxis recommendations will rise, alongside a greater appreciation for evidence-based nonpharmacologic interventions.However, there is also hope for more data on the potential prophylactic benefits of other agents, including heparin, metformin, and statins. Dr. Bernstein commented,”Even when used in the right patient,aspirin prevents only a portion of disease.”

Ongoing research is exploring optimal aspirin regimens, with data suggesting that higher doses may offer slightly greater effectiveness with comparable safety. Dr. Kingdom noted that metformin has demonstrated in at least one randomized controlled trial the ability to prolong pregnancy by at least 10 days in patients diagnosed with early-onset preeclampsia.

Low-molecular-weight heparin, which can enhance vascular health through nonanticoagulant mechanisms, “has been shown to boost the production of PlGF by placental tissues and by the endothelial cells,” he added.

Dr. McElrath expressed interest in research investigating the role of statins in preeclampsia prevention, particularly the efficacy of pravastatin. He anticipates that further study may identify “specific subgroups who will benefit [most].”

Option 3 (Focus on the “Why” and Impact):

Unlocking Better Preeclampsia Outcomes: The Power of PlGF Testing and Emerging Therapies

Dr. John Kingdom,

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Health

Systemic Sclerosis and Pregnancy Risks: Increased Risks for Adverse Outcomes

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Systemic Sclerosis Increases Pregnancy Risks, Swedish Study Reveals

Stockholm, sweden – Women diagnosed with systemic sclerosis (SSc) face significantly elevated risks for adverse pregnancy outcomes, including preeclampsia adn preterm birth, according to a comprehensive Swedish cohort study. The findings underscore the critical need for enhanced maternal care and pre-pregnancy counseling for individuals with this autoimmune condition.

The population-based study, drawing on Swedish national health registers from 1987 to 2021, meticulously analyzed pregnancy outcomes in women with and without SSc. Researchers classified pregnancies based on thier timing relative to an SSc diagnosis, examining those occurring before and after the condition was identified.

The study identified 972 pregnancies in women with SSc, with 94 occurring after diagnosis and 878 before. These were carefully matched with comparator pregnancies in women without SSc.

key findings from the research indicate a heightened risk profile for pregnant women with SSc:

Post-diagnosis pregnancies were associated with substantially increased risks for preeclampsia (adjusted relative risk [aRR] 3.8), preterm birth (aRR 3.3), and cesarean delivery (aRR 2.5).
 Primiparous women (those experiencing their first pregnancy) with SSc exhibited particularly alarming risks, with a 7.5-fold increase for preeclampsia and a 5.1-fold increase for preterm birth.
Pregnancies occurring within 0-3 years before an SSc diagnosis showed increased odds of preterm birth (adjusted odds ratio [aOR] 3.6) and delivering babies small for their gestational age (aOR 4.1).
 Even pregnancies occurring more than 3 years prior to an SSc diagnosis were linked to increased odds of preeclampsia (aOR 1.9) and preterm birth (aOR 1.6).

“Our observations highlight the need for multidisciplinary maternal care and pre-pregnancy counseling also for today’s women with SSc, with a special focus on primiparous women for whom the risks are the highest,” the study’s authors stated.

The research,led by Weng lan Che,PhD,from the Clinical Epidemiology Division at Karolinska Institutet in Stockholm,was published online on July 8,2025,in Arthritis & Rheumatology.

While the study provides valuable insights,its limitations include a lack of detailed information on disease activity,specific serologic patterns,and treatment regimens.

The study received support from the Dr Margaretha Nilsson Foundation, the Swedish Research Council, and the Swedish Cancer Foundation. Disclosure statements from authors indicated affiliations with the Myositis Association and the Swedish Medical Products Agency.

This article was developed with the assistance of editorial tools, including AI, and underwent thorough review by human editors prior to publication.

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Health

Early or late menarche may signal future health problems

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

First Period Age Signals Future Health Risks

Study Links Early and Late Menarche to Diverse Health Concerns

The age a woman experiences her first menstrual period may offer crucial insights into her predisposition for chronic health conditions later in life. New research presented at ENDO 2025 suggests that both unusually early and late onset of menstruation are associated with distinct long-term health challenges.

Early Puberty’s Health Implications

A comprehensive Brazilian study indicates that starting menstruation before the age of 10 correlates with an increased likelihood of developing obesity, hypertension, diabetes, heart complications, and issues during pregnancy such as pre-eclampsia. These findings highlight a significant connection between early pubertal development and metabolic and cardiovascular health.

Late Puberty: A Different Risk Profile

Conversely, women whose first period occurred after age 15 showed a reduced risk of obesity. However, this group faced a higher incidence of irregular menstrual cycles and certain types of heart disease, suggesting a complex relationship between menstrual timing and overall well-being.

โ€œWe now have evidence from a large Brazilian population that confirms how both early and late puberty can have different long-term health impacts. While early menarche increases the risk for multiple metabolic and heart problems, late menarche may protect against obesity but increase certain heart and menstrual issues. Most women can remember when they had their first period, but they might not realize that it could signal future health risks. Understanding these links can help women and their doctors be more proactive about preventing conditions like diabetes, high blood pressure and heart disease.โ€

โ€”Flรกvia Rezende Tinano, Study Author, University of Sao Paulo

The research, part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil), analyzed data from over 7,600 women aged 35 to 74. Participants were categorized based on their age at menarche: early (under 10), typical (10-15), or late (over 15). Health assessments included interviews, physical measurements, laboratory tests, and ultrasound imaging.

This study contributes vital data from a developing nation, a perspective often underrepresented in research on this topic. It underscores the importance of considering diverse populations when examining the long-term health effects of pubertal timing.

For instance, in the United States, a significant percentage of women experience early menarche. According to the Centers for Disease Control and Prevention, approximately 10% of girls in the US start puberty before age 8, which can be an indicator of early menarche (Source: CDC, 2023).

Personalized Prevention Strategies

Flรกvia Rezende Tinano emphasized the clinical value of this information, stating, “Our findings suggest that knowing a woman’s age at her first period can help doctors identify those at higher risk for certain diseases.” This data can inform more tailored screening and preventative health strategies, particularly beneficial for young girls and women in regions where access to early health education may be limited.

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Health

Antivirals in Pregnancy: Preeclampsia Risk – New Study Findings

by Dr. Michael Lee โ€“ Health Editor
written by Dr. Michael Lee โ€“ Health Editor

Antiviral Medication Use During Pregnancy and Preeclampsia Risk: A Swedish Study

Table of Contents



A recent study from Sweden is shedding light on the potential association between the use of antiviral medications during pregnancy and the risk of developing preeclampsia. preeclampsia, a serious pregnancy complication characterized by high blood pressure and organ damage, affects 2-8% of pregnancies worldwide and can lead to significant health risks for both mother and child. The research,leveraging comprehensive data from Swedish national registers,aims to provide clarity on this important issue.

Swedish Registry Data Examines Antiviral Use and Preeclampsia

Researchers in sweden conducted a register-based study using data from several national sources, including the Swedish Medical Birth Register (MBR), the Swedish National Patient Register (NPR), the Swedish National Prescribed Drug Register (NPDR), and Statistics Sweden. The MBR, which has been collecting data on all births in Sweden as 1973, records information from the mother’s first antenatal visit through hospital discharge. The NPR provides data on the mother’s medical history, while the NPDR tracks all medications dispensed by Swedish pharmacies.

The study focused on women giving birth to their first child in Sweden between 2007 and 2019. Pregnancies ending in stillbirth after the 22nd gestational week were included, but twin pregnancies were excluded from the analysis. Gestational length at delivery was primarily calculated based on routine antenatal ultrasounds.

Did You Know? The Swedish Medical Birth Register has been collecting comprehensive data on births for over 50 years, providing a rich resource for epidemiological research.

Defining and Categorizing preeclampsia

Preeclampsia was identified using ICD-10 codes (O11, O14, O15 and O16) recorded in the NPR. The researchers distinguished between different preeclampsia outcomes based on gestational age at delivery and infant growth:

  • Preeclampsia with early preterm delivery (before week 34)
  • Preterm preeclampsia (before week 37)
  • term preeclampsia (after week 37)
  • preeclampsia with a small-for-gestational-age infant (SGA), defined as birthweight below two standard deviations of mean birthweight for gestational age and fetal sex.

Statistical Analysis Methods

The study presented population characteristics according to antiviral medication use, further categorizing women by the timing of their first dispensed prescription. Results were presented as unadjusted and adjusted odds ratios, with 95% confidence intervals. as a sensitivity analysis, the group unexposed to antiviral medications was divided according to HSV status, and logistic regression was used to explore differences in preeclampsia likelihood among the three groups.

All statistical analyses were performed using R Statistical Software.A p-value below 0.05 was considered statistically significant.

Pro Tip: Directed acyclic graphs (DAGs) are valuable tools for identifying potential confounders in observational studies, helping researchers to minimize bias in their analyses.

Addressing Confounders and Bias

Possible confounders were evaluated using a directed acyclic graph (DAG), considering clinical risk factors for preeclampsia from existing literature. The identified confounders included maternal age, BMI, country of birth, IVF use, smoking at the first antenatal visit, pre-gestational diabetes, chronic hypertension, chronic kidney disease, and systemic lupus erythematosus.

To further address potential bias, the researchers used inverse probability of treatment weighting (IPTW) to adjust for baseline characteristics between women who used antiviral medications and those who did not. Propensity scores were calculated using the exposure as the outcome, and covariate balance was assessed graphically. Missing BMI values were imputed using the mice R package with predictive mean matching (pmm), and the analysis was repeated for each imputed dataset.

Outcome Definition
Preeclampsia with early preterm delivery Preeclampsia with delivery before week 34
Preterm preeclampsia Preeclampsia with delivery before week 37
Term preeclampsia Preeclampsia with delivery after week 37
Preeclampsia with SGA Preeclampsia with a small-for-gestational-age infant

Model fit and adjusted odds ratios were calculated for each BMI imputation, with results pooled using Rubin’s combining rule.For time of exposure subgroup analysis, a new propensity score was calculated for each of the three timepoints.

eight individuals were excluded from analyses involving different preeclampsia outcomes due to unknown gestational age.

Future Research and Implications

This study provides valuable insights into the potential relationship between antiviral medication use and preeclampsia risk during pregnancy. Further research is needed to confirm these findings and to explore the underlying mechanisms. Understanding these associations can definitely help inform clinical guidelines and improve pregnancy outcomes.

What are your thoughts on the use of antiviral medications during pregnancy? How can we better inform pregnant women about the potential risks and benefits?

Evergreen Insights: Understanding Preeclampsia

Preeclampsia is a pregnancy-specific condition characterized by the onset of hypertension and proteinuria (or other organ dysfunction) after 20 weeks of gestation.It is a leading cause of maternal and perinatal morbidity and mortality worldwide. Risk factors for preeclampsia include nulliparity (first pregnancy), multiple gestation, pre-existing hypertension, diabetes, kidney disease, and autoimmune disorders. Early detection and management are crucial to prevent severe complications such as eclampsia (seizures), stroke, and organ failure.

According to the Centers for Disease Control and Prevention (CDC), preeclampsia affects about 1 in 25 pregnancies in the United States. while the exact cause of preeclampsia is unknown, it is indeed thought to involve abnormal progress of the placenta. Treatment typically involves close monitoring of blood pressure and organ function, and delivery of the baby is often necessary to resolve the condition.

Frequently Asked Questions About Preeclampsia

What are the symptoms of preeclampsia?
Symptoms of preeclampsia can include high blood pressure,protein in the urine,severe headaches,vision changes,abdominal pain,and swelling in the hands and face. Some women with preeclampsia may not experience any noticeable symptoms.
How is preeclampsia diagnosed?
Preeclampsia is typically diagnosed based on blood pressure measurements and urine tests. Additional tests might potentially be performed to assess organ function and fetal well-being.
What are the risk factors for preeclampsia?
Risk factors for preeclampsia include first pregnancy, multiple gestation, pre-existing hypertension, diabetes, kidney disease, autoimmune disorders, obesity, and a family history of preeclampsia.
How is preeclampsia treated?
The primary treatment for preeclampsia is delivery of the baby. In certain specific cases, medication might potentially be used to control blood pressure and prevent seizures until delivery is absolutely possible.
Can preeclampsia be prevented?
There is no guaranteed way to prevent preeclampsia, but certain measures may reduce the risk, such as maintaining a healthy weight, controlling blood pressure and blood sugar, and taking low-dose aspirin as recommended by a healthcare provider.

Disclaimer: This article provides general information and should not be considered medical advice. Consult with a healthcare professional for personalized guidance and treatment.

Share this article to raise awareness about preeclampsia and its potential risk factors. What other questions do you have about pregnancy health?

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