Utility of the US Preventive Services Task Force for Preeclampsia Risk Assessment and Aspirin Prophylaxis

What factors in the US Preventive Services Task Force (USPSTF) guidelines on preeclampsia risk assessment accurately estimate low, moderate, or high preeclampsia risk, and how is preeclampsia risk associated with aspirin prophylaxis (AP) recommendations?This cohort study of 5684 participants found that 88.8% were at increased risk (70.3% at moderate risk and 18.5% at high risk) of preeclampsia. Only 37% of those in the moderate risk category were recommended AP. High risk factors had sufficient value in estimating risk, but moderate risk factors had little value, leading to nonspecific AP recommendations.These findings suggest that USPSTF guidelines provide little utility for estimating preeclampsia risk and subsequent AP recommendation among individuals at moderate risk for preeclampsia, which constitute the majority of the population.

Corresponding Author: Thomas F. McElrath, MD, PhD, Division of Maternal-Fetal Medicine, Brigham tmcelrath@bwh.harvard.edu).

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