USPSTF releases recommendations for preeclampsia prevention

Sept. 30, 2021

The U.S Preventive Services Task Force (USPSTF) recommends the use of low-dose aspirin (81 mg/day) as a preventive medication after 12 weeks of gestation in people who are at high risk for preeclampsia.

The recommendation is consistent with the 2014 USPSTF recommendation.

The number of preeclampsia cases is on the rise in the United States, and it is a leading cause of mortality in pregnant women, Liza Kunz, MD, OB-GYN Maternal-Fetal Disease Area Network Lead at Roche and a preeclampsia expert, explained in an interview. The disease can lead to other severe outcomes, such as hemorrhage, liver ruptures, renal failure, and seizures, she added.

Preeclampsia can occur not only during pregnancy but also after delivery.

However, the presentation of preeclampsia can be mild, with symptoms that mirror those that occur during pregnancy for other reasons, such as swollen ankles, making it challenging for clinicians to recognize preeclampsia early, Kunz said.

The USPSTF said pregnant people are at high risk for preeclampsia if they have one or more of the following risk factors:

  • History of preeclampsia
  • Multifetal gestation
  • Chronic hypertension
  •  Pregestational type 1 or 2 diabetes
  • Renal disease
  • Autoimmune disease

The USPSTF also said that combinations of multiple moderate-risk factors may be also be used to determine risk, such as having never given birth, obesity, family history of preeclampsia, maternal age of 35 years old or older, personal history factors (e.g., low birth weight or small for gestational age, previous adverse pregnancy outcome, >10-year pregnancy interval), in vitro fertilization conception, and lower income. Black people are associated with increased risk due to environmental, social, and historical inequities shaping health exposures, access to health care, and the unequal distribution of resources, not biological propensities.

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