The Impact of Different Definitions of Pre-eclampsia on Diagnosis, Management, and Outcomes

Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality worldwide. Despite its significance, multiple definitions of pre-eclampsia exist across international guidelines, including those from the World Health Organization (WHO), the American College of Obstetricians and Gynecologists (ACOG), and the International Society for the Study of Hypertension in Pregnancy (ISSHP). These variations in diagnostic criteria have implications for case identification, clinical management, and maternal and neonatal outcomes. This PhD project aims to systematically examine the impact of different definitions of pre-eclampsia on diagnosis, management strategies, and health outcomes across diverse populations and healthcare settings. Specifically, the research will: 1. Compare Diagnostic Agreement: Assess the concordance and discordance between commonly used definitions of pre-eclampsia in clinical practice and research settings. 2. Evaluate Clinical Management Differences: Investigate how varying definitions influence treatment decisions, including antihypertensive use, timing of delivery, and monitoring protocols. 3. Analyze Maternal and Neonatal Outcomes: Determine whether different definitions are associated with variations in maternal complications (e.g., eclampsia, stroke, HELLP syndrome) and neonatal outcomes (e.g., preterm birth, low birth weight, perinatal mortality). 4. Explore Health System Implications: Examine the impact of differing definitions on resource allocation, clinical workload, and data comparability in maternal health research and policy. Using a combination of primary data analysis, mixed methods research and systematic review methodologies, this project will provide critical insights into whether harmonizing diagnostic criteria could improve maternal and neonatal health outcomes. Findings from this research have the potential to inform international guidelines, optimize clinical care, and enhance the comparability of maternal health data globally. Impact: By addressing the inconsistencies in pre-eclampsia diagnosis, this PhD project will contribute to more standardized, evidence-based care, ultimately improving outcomes for mothers and babies worldwide.