Preterm preeclampsia screening and prevention: a comprehensive approach to implementation in a real-world setting

Area of Science:

• Maternal-Fetal Medicine
• Obstetrics
• Perinatal Health

Background:

• Preeclampsia poses significant risks to maternal and perinatal health.
• Early screening and primary prevention with low-dose aspirin are crucial for high-risk populations.
• This study evaluated integrating preterm preeclampsia screening and prevention into existing aneuploidy screening workflows.

Purpose of the Study:

• To assess the feasibility of implementing preterm preeclampsia screening and prevention.
• To leverage existing aneuploidy screening programs for preeclampsia risk assessment.
• To evaluate the impact of integrated screening on clinical workflows and patient outcomes.

Main Methods:

• Prospective cohort study involving 974 pregnant individuals undergoing nuchal translucency scans.
• Risk assessment using the Fetal Medicine Foundation algorithm, incorporating maternal factors, Doppler, MAP, and serum markers (PlGF, PAPP-A).
• High-risk patients were offered low-dose aspirin; feasibility outcomes included recruitment, adherence, and screening performance.

Main Results:

• 15.6% of participants were high-risk for preterm preeclampsia.
• High recruitment (82.1%) and adherence (95.4% prescribed aspirin) were achieved.
• Screening demonstrated a detection rate of 88.9-90% for preterm preeclampsia with minimal impact on aneuploidy screening time.

Conclusions:

• Integration of comprehensive preeclampsia screening into clinical practice is feasible, even with geographically separated sites.
• Broader adoption and enhanced infrastructure are needed to optimize patient care and outcomes.
• The study highlights the potential for improved maternal-fetal health through integrated screening and prevention strategies.