First-trimester preterm preeclampsia prediction model for prevention with low-dose aspirin

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Prediction Modeling

Background:

• Preeclampsia (PE) poses significant maternal and fetal risks.
• Existing risk-scoring methods often lack precision.
• The Fetal Medicine Foundation (FMF) developed a first-trimester PE screening model.

Purpose of the Study:

• To evaluate the efficacy of the FMF first-trimester PE screening model.
• To assess the role of low-dose aspirin in PE prevention based on screening results.
• To improve early detection and management of preeclampsia.

Main Methods:

• The FMF model integrates maternal characteristics, medical history, blood pressure, serum biomarkers, and uterine Doppler pulsatility index.
• Bayes' theorem is utilized to calculate posterior risk.
• Low-dose aspirin (150 mg nightly) initiated before 16 weeks of gestation is a key intervention.

Main Results:

• Clinical trials, such as ASPRE, demonstrate that initiating aspirin based on FMF screening significantly reduces preterm PE.
• This strategy also lowers associated maternal and fetal complications.
• The antiplatelet and anti-inflammatory properties of aspirin are consistent with PE pathophysiology.

Conclusions:

• Integrating FMF's first-trimester PE screening with low-dose aspirin is a highly effective strategy for PE prevention.
• Early intervention before 16 weeks is critical for optimal outcomes.
• Ongoing research explores novel predictors and AI to further enhance prediction accuracy.