Two definitions of preterm preeclampsia—preterm-onset and preterm-delivery preeclampsia: A mini-review

Abstract

Aim: Currently, the medical term "preterm preeclampsia (PE)" is not included in the Japan Society of the Study of Hypertension in Pregnancy (JSSHP) classification of hypertensive disorders of pregnancy.

Methods: We searched PubMed for studies using the term "preterm PE" on October 1, 2024, with the following combination of keywords: "preterm preeclampsia" OR "preterm pre-eclampsia."

Results: A total of 479 articles were identified. The term "preterm PE" first appeared in 1994. From 2011 to 2023, the number of studies using the term "preterm PE" gradually increased, reaching 62 in 2023. The studies using the term "preterm PE" involved prediction of preterm PE (i.e., preterm-delivery PE). Current studies predicting preterm PE focus on competing risks models using maternal factors, biophysical markers, and biomarkers in the first trimester, and an established competing risks model for predicting preterm PE is available on the website of the Fetal Medicine Foundation (FMF). However, the term "preterm PE" has been used with different meanings (preterm-onset vs. preterm-delivery PE).

Conclusions: Both definitions of preterm PE have merits and demerits. Therefore, not only preterm-delivery PE but also preterm-onset PE should be evaluated simultaneously as primary outcomes when predicting preterm PE.