Pre-Eclampsia: Revisiting Risk Factors and Challenging Current Approaches to Screening in All Settings

The United Nations set a goal to reduce maternal mortality by three quarters between 1990 and 2015 in their Millennium Development Goals, which were not met. Most of these deaths are preventable, and one quarter of maternal deaths are due to pre-eclampsia and eclampsia. Prenatal screening is important for improving maternal health outcomes in general and is essential for the detection and management of pre-eclampsia. However, pre-eclampsia screening is solely based on maternal risk factors and has low (<5% in the U.S.) detection rates.

To address this global problem, risk factors should be analyzed at a more personalized level and studies should be performed in more low- and middle-income countries, non-European populations and at a community level. Additionally, access to technological screening tools must be more widespread.

This review describes the latest theories in pre-eclampsia etiology, the scientific basis behind established pre-eclampsia risk factors, biomarkers that have been identified as significant for pre-eclampsia, and technologies that aid in advancing pre-eclampsia screening worldwide. Researchers are challenged to think critically when performing and analyzing results of pre-eclampsia-related studies, especially when mistreating race as a risk factor, to encourage the development of improved alternatives to pre-eclampsia screening.