Preeclampsia Risk: Aspirin Gaps & New Study Findings
New Study Questions USPSTF Guidelines for Preeclampsia Risk, Highlights Need for Personalized Prediction
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Boston, MA – A recent study published in JAMA Network Open is raising critical questions about the effectiveness of current guidelines for identifying pregnant individuals at risk for preeclampsia, a potentially life-threatening condition. The findings suggest that the U.S. Preventive Services Task Force (USPSTF) guidelines, while well-intentioned, may be over-identifying moderate-risk pregnancies, leading to overwhelmed care teams and potentially reduced patient compliance with preventive measures like low-dose aspirin.
USPSTF Guidelines Under Scrutiny for Preeclampsia Risk Assessment
The study,led by Dr. Thomas McElrath, vice president of clinical development at Mirvie and a maternal-fetal medicine physician at Mass General Brigham, analyzed the utility of the USPSTF guidelines in predicting preeclampsia. The guidelines recommend low-dose aspirin for pregnant individuals at high risk for developing preeclampsia, typically starting at 12 weeks of gestation. Though, the research indicates that a meaningful majority of pregnant women fall into the “moderate risk” category, a classification that appears to lack strong predictive power.
“Identifying 9 out of 10 women as at risk is not helping and overburdens care teams and pregnant patients, too,” stated dr. McElrath. “physicians might potentially be reluctant to prescribe aspirin when the majority of their patients fall into the moderate risk category. This is compounded by less than 25% compliance with aspirin use by patients in the moderate risk category.”
The study found that 70.3% of pregnant women in their cohort were classified as moderate risk according to USPSTF guidelines. Crucially,having one or more moderate risk factors without any high-risk factors did not reliably predict preeclampsia. Even among those with two or more moderate risk factors but no high-risk factors, only nulliparity (first pregnancy) showed a modest association with increased preeclampsia risk (Relative Risk [RR], 1.48; 95% CI, 1.35-1.62; P < .001). Factors like obesity (RR, 1.11; 95% CI, 1.01-1.22; P = .048), Black race (RR, 0.95; 95% CI, 0.80-1.14; P = .63), and advanced maternal age (RR, 0.79; 95% CI, 0.65-0.96; P = .02) showed little to no association with increased risk in this specific subgroup.
The Rising Tide of Preeclampsia and the Need for innovation
The findings come at a critical time, as rates of preeclampsia in the U.S. have doubled over the past 15 years, with no signs of slowing.Kara Boeldt, a preeclampsia survivor and Founder and Executive Director of EndPreeclampsia.org, expressed concern that the 2021 USPSTF guidelines have not curbed this alarming trend.
“The introduction of the USPSTF guidelines in 2021 didn’t do anything to reverse course on the rise of preeclampsia,” Boeldt commented. “This vital and eye-opening study highlights that we need new approaches that can predict who’s truly at risk for preeclampsia, which can be so hazardous for moms and their babies. This is why I am incredibly encouraged and excited by the innovation being led by companies like Mirvie, which can finally offer some pregnant women and their care teams a clear, personalized prediction of their preeclampsia risk with a simple blood test during pregnancy.”
A Call for Clearer, Objective Risk Prediction
The study underscores a growing consensus that more precise and objective methods are needed to identify individuals who will benefit most from preventive interventions.
“the findings of this critically important study confirm the need for clear, objective measures of preeclampsia risk prediction, to motivate preventive care,” said Maneesh Jain, CEO and Co-Founder of Mirvie.
Mirvie’s innovative approach, exemplified by their Encompass™ platform, aims to provide this much-needed clarity. By leveraging advanced technology, companies like Mirvie are working to deliver personalized risk predictions, enabling healthcare providers to intervene earlier and more effectively.
“With innovation like Encompass™, we can now deliver preventive care to the right patients at the right time and impact rates