Description:
<jats:p><jats:bold>Objective </jats:bold> To investigate whether first‐trimester arterial pulse wave analysis (PWA) can predict pre‐eclampsia.</jats:p><jats:p><jats:bold>Design </jats:bold> This was a prospective screening study.</jats:p><jats:p><jats:bold>Setting </jats:bold> The Homerton University Hospital, a London teaching hospital.</jats:p><jats:p><jats:bold>Population </jats:bold> Two hundred and ten low‐risk women with a singleton pregnancy were analysed.</jats:p><jats:p><jats:bold>Methods </jats:bold> Radial artery pulse waveforms were measured between the 11<jats:sup>+0</jats:sup> and 13<jats:sup>+6</jats:sup> weeks of gestation and the aortic waveform derived by applying a generalised transfer function. Augmentation pressure (AP) and augmentation index at heart rate of 75 beats per minute (AIx‐75), measures of arterial stiffness, were calculated. The multiple of the gestation‐specific median in controls for AP and AIx‐75 were calculated. Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve.</jats:p><jats:p><jats:bold>Main outcome measures </jats:bold> Prediction of pre‐eclampsia by AIx‐75.</jats:p><jats:p><jats:bold>Results </jats:bold> Fourteen (6.7%) women developed pre‐eclampsia, and 196 remained normotensive. Eight of the 14 women developed pre‐eclampsia before 34 weeks of gestation (early‐onset pre‐eclampsia). For a false‐positive rate of 11%, AIx‐75 had a detection rate of 79% for all cases of pre‐eclampsia and 88% for early‐onset pre‐eclampsia.</jats:p><jats:p><jats:bold>Conclusion </jats:bold> First‐trimester arterial PWA can play a significant role in understanding the pathophysiology of pre‐eclampsia and may play a role in early screening.</jats:p>