Main findings
This study shows a higher prevalence of risk factors for PE during the first trimester in women with COVID-19 as compared with the reference population. In the COVID-19 group the proportion of high BMI and chronic hypertension was higher, whereas the proportion of smokers was lower, which are also risk factors for developing PE. Regarding biochemical and biophysical markers, no differences were found in PlGF levels. However, in the COVID-19 group there was a slight increase, although statistically significant, in UtAPI (1.08 MoM versus 1.00 MoM).
When we examined the COVID-19 group according to severity (mild or severe), no differences were observed in PlGF and UtAPI. However, women with severe COVID-19 had significantly higher BMI and MAP at the first-trimester screening.
The findings of this study support the hypothesis that women with COVID-19 are at a higher risk for PE than the general population; however, it seems that this was due mainly to shared maternal risk factors (obesity and hypertension), as there was no significant difference in PlGF levels, and the small difference in UtAPI is probably not correlated with abnormal trophoblastic invasion, as first-trimester multiple of the median (MoM) UtAPI values in our population ranges from 1.12 to 1.67 in women that subsequently develop PE, whereas MoM UtAPI values are 1.03 in women without PE14.