Expanding First-Trimester Preterm Preeclampsia Screening With Placental Growth Factor Testing.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Clinical Chemistry

Background:

• Preterm preeclampsia affects 0.5% to 1% of pregnancies.
• Aspirin initiated before 16 weeks can prevent preterm preeclampsia, but effectiveness hinges on patient adherence.
• Current clinical factor-based screening for preterm preeclampsia has a high number needed to treat (NNT>100) and poor adherence.

Purpose of the Study:

• To evaluate the effectiveness of a multiple marker screening algorithm for preterm preeclampsia.
• To compare the NNT and treatment adherence of clinical factor-based screening versus a multiple marker algorithm.
• To determine if a combined approach can improve first-trimester risk assessment for preeclampsia.

Main Methods:

• Review of current evidence on preterm preeclampsia screening methods.
• Analysis of a multiple marker algorithm incorporating placental growth factor (PlGF) and standardized blood pressure measurement.
• Comparison of NNT and treatment adherence rates between different screening strategies.

Main Results:

• A multiple marker algorithm including PlGF is associated with a lower NNT (<30) compared to clinical factors alone.
• This algorithm demonstrates improved treatment adherence and facilitates personalized follow-up care.
• The combined approach offers a more comprehensive first-trimester risk assessment for preeclampsia.

Conclusions:

• A multiple marker screening algorithm, including PlGF, significantly enhances preterm preeclampsia risk assessment.
• Improved adherence and personalized care are key benefits of this advanced screening method.
• Offering this combined approach universally could optimize early detection and prevention strategies for preeclampsia.