Delivery of the baby and the placenta is still the only definitive management for preeclampsia, and planned delivery is recommended for all women with preeclampsia who are 37 weeks pregnant or more. However, for women who are 34-36 weeks pregnant with preeclampsia, immediate delivery is not recommended due to the risks it may present to the baby. Healthcare providers will typically follow “expectant management” for these women, monitoring them closely until delivery is necessary because of possible risks for the baby from early preterm birth. Several smaller studies have explored this recommendation for expectant management, asking whether planned delivery among women with preeclampsia between 34-36 weeks of pregnancy is more beneficial for mother and baby compared to expectant management. In this study, researchers combined the data from several of these studies (1,790 participants across six different research studies) in a meta-analysis to ask if planned delivery between 34-36 weeks of pregnancy in women with preeclampsia can reduce complications for the mother and her baby. Researchers created a composite outcome to answer their question, a combination of several possible clinical complications related to preeclampsia and early delivery.
The results showed that planned delivery (compared to “expectant management”) at 34 weeks or later reduced risk for complications in the mother as well as the decreased the likelihood the baby would be small for their gestational age. However, planned early delivery was found to increase the risk for short-term respiratory complications in the baby.
Take home message: This meta-analysis showed that planned delivery in women 34-36 weeks pregnant with preeclampsia has both benefits and risks. These risks and benefits should be consider by clinicians caring for women with preeclampsia and discussed with patients when presenting management options for her pregnancy.
Link: https://www.ajog.org/article/S0002-9378(22)00315-5/fulltext
Citation: Beardmore-Gray A, Seed PT, Fleminger J, Zwertbroek E, Bernardes T, Mol BW, Battersby C, Koopmans C, Broekhuijsen K, Boers K, Owens MY, Thornton J, Green M, Shennan AH, Groen H, Chappell LC. Planned delivery or expectant management in preeclampsia: an individual participant data meta-analysis. Am J Obstet Gynecol. 2022 Apr 26:S0002-9378(22)00315-5. doi: 10.1016/j.ajog.2022.04.034. Epub ahead of print. PMID: 35487323.
Each quarter, our team of researchers reviews the most current studies related to hypertensive disorders of pregnancy and selects those studies they feel will be of greatest interest to our community to summarize.
Special thanks to our volunteer research team, who under the leadership of Dr. Elizabeth Sutton, make Research Roundup possible: Alisse Hauspurg, MD Felicia LeMoine, and MD Jenny Sones, PhD, DVM.
Frequently asked questions about the Preeclampsia Registry, a patient-driven registry and biobank.
The Preeclampsia Foundation offers research funding, study recruitment, and other patient engagement services to researchers.
We provide research grant funding to advance progress towards detection, prevention, or treatment of preeclampsia, HELLP syndrome, and other hypertensive disorders of pregnancy.
Article Titles: Association of Birth Year of Pregnant Individuals With Trends in Hypertensive Disorders of Pregnancy in the United States, 1995-2019 Trends in Hypertensive Disorders of Pregnancy i...
HMOX1 Genetic Polymorphisms Display Ancestral Diversity and May Be Linked to Hypertensive Disorders in Pregnancy “Racial disparity” means that a condition may happen more often in a speci...
First trimester serum biomarker discovery study for early onset, preterm onset and preeclampsia at term More and more tests are being developed to help predict if somebody will go on to develop preec...
Gut Dysbiosis Promotes Preeclampsia by Regulating Macrophages and Trophoblasts Over the last few decades, research has exploded on the “gut microbiome,” meaning what types of (and how man...
Thanks to everyone who commented and shared on social media about this recent Research Roundup article. Our organization recognizes that talking about certain factors in the cause of preeclampsia, lik...