TOPLINE:

The Fetal Medicine Foundation (FMF) method for early risk assessment and aspirin prophylaxis showed no significant reduction in preterm preeclampsia in a Swedish population-based study of 61,840 deliveries, with a tendency toward increased term preeclampsia rates noted.

METHODOLOGY:

• A population-based, retrospective cohort study included 61,840 deliveries from five obstetric hospitals in southeast Sweden between 2012 and 2022.
• Participants aged ≥ 18 years received care at hospitals in Linköping, Norrköping, Jönköping, Eksjö, and Värnamo, with exclusion criteria including multiple gestation and absence of early pregnancy antenatal care records.
• The FMF cohort comprised deliveries between December 2016 and August 2022, with a 7-month washout period after implementation at each site.
• Risk assessment was conducted between weeks 11+0 and 13+6 of pregnancy, with high-risk individuals (> 1:100) receiving 150 mg daily aspirin until gestational week 36+0.

TAKEAWAY:

• Implementation of the FMF method showed no significant reduction in preterm preeclampsia (odds ratio [OR], 1.13; 95% CI, 0.9-1.5).
• Researchers observed a tendency toward increased term preeclampsia rates (OR, 1.14; 95% CI, 1.00-1.30).
• The Fetal Medicine Foundation method achieved successful implementation in more than 85% of the pregnant population.
• No significant differences were found in other obstetrical or neonatal outcomes between the cohorts.

IN PRACTICE:

“A tailored allocation of resources by allowing less intensive monitoring for those identified as low risk for pPE [preterm preeclampsia] supports a more individualized and potentially more efficient model of prenatal care. Further population-based studies using a per protocol approach are needed to evaluate the efficacy of aspirin prophylaxis among individuals identified as high risk according to the FMF method,” the authors of the study wrote.

SOURCE:

The study was led by Nuria Mans-Gallart, Department of Biomedical and Clinical Sciences, Linköping University in Linköping, Sweden. It was published online in American Journal of Obstetrics & Gynecology.

LIMITATIONS:

According to the researchers, the retrospective design limited their ability to account for unknown changes in population characteristics and clinical practices. The study was underpowered due to low prevalence of preterm preeclampsia, with sufficient statistical power only to detect differences greater than 25% between groups. The authors noted that even smaller effects could have important clinical implications for both short-term and long-term consequences of extreme premature birth. Additionally, the researchers acknowledged that potential underdiagnosis of preeclampsia cases in the pre-Fetal Medicine Foundation cohort may have influenced the findings.

DISCLOSURES:

The study received funding through grants from Medical Research Council of Southeast Sweden and Futurum - the Academy for Health and Care, Jönköping, Sweden. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.