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

Nan Okun1, Jo-Ann Johnson2, Stefania Ronzoni3

  • 1Department of Obstetrics and Gynecology, Sunnybrook Hospital, University of Toronto, ON.

Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|May 13, 2026
PubMed

Insights

Early aspirin can prevent preterm preeclampsia, but adherence is key. A multiple marker screening, including placental growth factor (PlGF), improves adherence and risk assessment for better pregnancy outcomes.

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.

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