iMATERNA RESEARCH

We know that research is the best investment to improve the health of pregnant women, fetuses and newborns.

In this section we will make visible the different projects in which we collaborate, and that will allow the society to continue advancing in the knowledge of the diseases that affect this complex and fascinating moment in life

Prediction and prevention of preterm preeclampsia.

Spanish multicentre study: H.U Torrejón, Madrid; H.U Virgen de la Arrixaca, Murcia; H.U Fundación Alcorcón, Madrid; H. Materno-infantil A Coruña; H. Quirón Pozuelo, Madrid; H.U Vall d´Hebron, Barcelona

Principal Investigator: Dr. María del Mar Gil

Early pre-eclampsia is one of the leading causes of maternal and perinatal death and is estimated to affect almost 1% of our pregnant women.

The objectives of the DECREASE Project are: to know the incidence of this serious disease in our country, select the best screening method adjusted to our population, estimate the effect of the implementation of the screening method on maternal-fetal health and develop recommendations for the implementation of a possible screening in the Spanish population.

The DECREASE study aims to achieve the clinical implementation of a screening program for pre-eclampsia (PE) in Spain, ensuring that all the requirements within the Documento Marco de Cribado Poblacional (2010) from the Public Health Commission are met.

PE is a major cause of maternal and perinatal mortality, morbidity and long-term sequelae, especially in those cases that, due to their severity, require delivery before term (preterm-PE). Focused in external validation methods (something most of clinical studies lack off) tries to continue the research started by the ASPRE study, which has recently demonstrated that aspirin can reduce the rate of preterm-PE in more than 60% when it is early administered in high-risk pregnancies.

Objectives of the study:

  1. To determine the incidence of the disease (preterm-PE) in Spain.
  2. To select the best method of screening from all the currently proposed (NICE and ACOG recommendations, The Fetal Medicine Foundation or the Spanish group of Medicina Fetal Barcelona) adjusted to the characteristics of the Spanish population.
  3. To estimate the effect of the clinical implementation of such screening and preventive program in maternal/fetal health.
  4. To develop recommendations for population screening for preterm-PE in Spain.

Methods: This is a two-phase prospective cohort study involving six maternity units in Cataluña, Galicia, Madrid and Murcia, in which the incidence of preterm-PE in two consecutive cohorts will be compared. During the first phase, 10,000 pregnancies will be prospectively screened for preterm-PE but no treatment will be given based on risk assessment. The second phase will involve other 10,000 pregnancies and low-dose aspirin will be given to screened positive women as prophylactic treatment. Outcomes of both cohorts will be compared.

 Impact: We expect the results to facilitate the implementation of a national screening program for preterm-PE and the consequent improvement of perinatal outcomes, promoting therefore maternal and fetal/neonatal health.