Background: Women who develop preeclampsia (PE) are at increased risk of cardiovascular disease and stroke in the subsequent decades. In individuals with cardiovascular disorders there is increased central aortic systolic blood pressure (SBP_Ao) and arterial stiffness, assessed by pulse wave velocity (PWV) and augmentation index (AIx). The aim of this screening study was to examine the potential value of assessment of SBP_Ao, PWV and AIx at 11–13 weeks’ gestation in identifying women who subsequently develop PE.

Methods: This was a screening study for PE in singleton pregnancies at 11⁺⁰ – 13⁺⁶ weeks’ gestation. Maternal history and characteristics were recorded and PWV, AIx and SBP_Ao were measured by the Arteriograph. We compared these parameters in those that developed PE (n=146) with unaffected controls (n=4,436) and examined their performance in screening for PE.

Results: In the PE group, compared to unaffected controls, there was an increase in PWV (1.12 vs 1.00 MoM, p<0.0001), AIx-75 (1.06 vs 1.00 MoM, p<0.0001) and SBP_Ao (1.10 vs. 1.00 MoM, p<0.0001). In screening for PE by a combination of maternal variables and log₁₀ AIx-75 MoM, log₁₀ PWV MoM and log₁₀ SBP_Ao, the estimated detection rate was 61.6 (95% CI 51.8–70.5), at a false-positive rate of 10%.

Conclusion: A high proportion of women who develop PE have increased SBP_Ao and arterial stiffness that is apparent from the first-trimester of pregnancy.