Key result
First-trimester MAP >90 mmHg plus maternal factors predicts preeclampsia with an AUC of 0.73.
Why the study?
Current preeclampsia screening methods relying on multiples of the median are complex, warranting an absolute mean arterial pressure threshold for resource-limited settings.
Does a mean arterial pressure cutoff value > 90 mmHg predict the development of preeclampsia in first-trimester pregnant women?
Cohort (n=10,323)
Yes
Does a mean arterial pressure cutoff value > 90 mmHg predict the development of preeclampsia in first-trimester pregnant women?
Effect estimate: AUC 0.73 (95% CI 0.70-0.77)
A first-trimester mean arterial pressure cutoff > 90 mmHg offers a simple, cost-effective model for predicting preeclampsia in resource-limited settings.
May support simplified first-trimester preeclampsia screening with MAP >90 mmHg; leaves open external validation and prospective outcome trials.
Objective: To establish an optimal mean arterial pressure (MAP) cutoff value during the first trimester of pregnancy and evaluate the performance of a simplified screening model combining this threshold with maternal factors for preeclampsia prediction in a large Chinese cohort. Because current screening methods that rely on multiples of the median (MoM) are complex, we assessed the clinical utility and predictive accuracy of a direct, absolute MAP threshold designed for resource-limited settings. Methods: This was a prospective, multicenter cohort study conducted across multiple prenatal care centers in China from May 2021 to November 2024. A consecutive sample of 10,323 women with singleton pregnancies (11 +0 to 13 +6 gestational weeks) was enrolled. Participants were retrospectively assigned to a cutoff cohort ( n = 3613, 35%) and a validation cohort ( n = 6710, 65%) using computational partitioning. The development of preeclampsia served as the primary outcome. An optimal MAP cutoff value was identified in the first cohort, and a prediction model incorporating this threshold alongside maternal characteristics was developed and validated in the second cohort. Results: Preeclampsia occurred in 388 (3.8%) participants. The optimal first-trimester MAP cutoff value was 90 mmHg. The screening model utilizing this MAP cutoff yielded an area under the curve of 0.73 (95% confidence interval ( CI ): 0.70–0.77) for cross-validation. In internal validation, the model demonstrated a specificity of 0.71 (95% CI : 0.70–0.73) and a detection rate of 41% at a fixed false-positive rate of 10%. Conclusion: A MAP value exceeding 90 mmHg can serve as a useful predictor for preeclampsia during the first trimester among Chinese women. The proposed MAP-cutoff model offers a cost-effective and readily implementable alternative to complex MoM-based algorithms, making it particularly valuable for routine clinical practice in resource-limited settings.
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Tang et al. (2026) conducted a cohort in Preeclampsia (n=10,323). Mean arterial pressure (MAP) cutoff > 90 mmHg was evaluated on Development of preeclampsia (AUC 0.73, 95% CI 0.70-0.77). A first-trimester mean arterial pressure cutoff >90 mmHg combined with maternal factors predicted preeclampsia with an AUC of 0.73 (95% CI 0.70-0.77).
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