Materiały źródłowe

• #1 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8236336/

  Preeclampsia is an obstetric disorder that affects 38% of pregnant women and remains a leading cause of short- and long-term neonatal and maternal morbidity and mortality. Professional societies recommend the use of low dose aspirin to prevent preeclampsia in high-risk women. […] The only current cure for preeclampsia is delivery of the placenta and fetus, however this is commonly associated with iatrogenic preterm delivery. In an effort to prevent that and improve outcomes for mothers, children and adult offspring, research efforts are currently focused not only on treatment of preeclampsia, but on ways to prevent preeclampsia from occurring. […] Aspirin is currently the only medication recommended for the prevention of preeclampsia. […] Currently, both the U.S. Preventive Services Task Force (USPSTF) and the American College of Obstetricians and Gynecologists (ACOG) recommend aspirin use for preeclampsia prevention for women at high risk for developing the disease (e.g. those with chronic hypertension, pre-gestational diabetes mellitus, multifetal gestation, renal disease, and autoimmune disease, etc), and to be started between 12 and 28 weeks gestation and continued until delivery.

• #1 Preeclampsia: Prevention – UpToDate

  https://www.uptodate.com/contents/preeclampsia-prevention

  Preeclampsia: Prevention […] Standard prenatal care, including close follow-up of high-risk patients after midgestation, increases the chance that preeclampsia will be detected early in the course of disease. […] Early diagnosis followed by appropriate management, including delivery, may prevent some of the serious sequelae of the disease, such as eclamptic seizures and multiorgan failure. […] Since there is no curative treatment other than delivery, an intervention that could prevent preeclampsia would have a significant impact on maternal and neonatal health worldwide. […] Low-dose aspirin prophylaxis is the most useful preventive pharmacologic intervention, but the magnitude of benefit is variable and depends on a number of factors. […] This topic will review several interventions that have been evaluated for prevention of preeclampsia.

• #2 Preeclampsia: Prevention – UpToDate

  https://www.uptodate.com/contents/preeclampsia-prevention

  Preeclampsia: Prevention […] Standard prenatal care, including close follow-up of high-risk patients after midgestation, increases the chance that preeclampsia will be detected early in the course of disease. […] Early diagnosis followed by appropriate management, including delivery, may prevent some of the serious sequelae of the disease, such as eclamptic seizures and multiorgan failure. […] Since there is no curative treatment other than delivery, an intervention that could prevent preeclampsia would have a significant impact on maternal and neonatal health worldwide. […] Low-dose aspirin prophylaxis is the most useful preventive pharmacologic intervention, but the magnitude of benefit is variable and depends on a number of factors. […] This topic will review several interventions that have been evaluated for prevention of preeclampsia.

• #2 Low-Dose Aspirin Use During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy

  ABSTRACT: Low-dose aspirin has been used during pregnancy, most commonly to prevent or delay the onset of preeclampsia. […] The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support the U.S. Preventive Services Task Force guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery. […] Low-dose aspirin prophylaxis should be considered for women with more than one of several moderate risk factors for preeclampsia. […] Based on the findings from the USPSTF and others, low-dose aspirin prophylaxis (81 mg/day) after 12 weeks of gestation modestly reduces the risk of preeclampsia in women at increased risk, without resulting in adverse fetal effects, increased maternal bleeding, or placental abruption.

• #3 Low-Dose Aspirin Use During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy

  The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support the USPSTF guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery. […] In the absence of high-risk factors for preeclampsia, current evidence does not support the use of prophylactic low-dose aspirin for the prevention of early pregnancy loss, fetal growth restriction, stillbirth, or preterm birth.

• #4 Low-Dose Aspirin Use for the Prevention of Preeclampsia and Related Morbidity and Mortality | ACOG

  https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/12/low-dose-aspirin-use-for-the-prevention-of-preeclampsia-and-related-morbidity-and-mortality

  Low-dose aspirin has been used during pregnancy most commonly to prevent or delay the onset of preeclampsia. The previous recommendation from the American College of Obstetricians and Gynecologists (ACOG), the Society for Maternal-Fetal Medicine (SMFM), and the U.S. Preventive Services Task Force (USPSTF) has been for low-dose aspirin (81 mg/d) prophylaxis after 12 weeks of gestation in pregnant individuals at high risk of preeclampsia and suggested low-dose aspirin prophylaxis in pregnant individuals with more than one moderate-risk factor. ACOG and SMFM also have provided more detailed information around timing, recommending that low-dose aspirin be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery. […] In September 2021, the USPSTF published updated recommendations on aspirin use to prevent preeclampsia and related morbidity and mortality. The primary USPSTF recommendation remains largely unchanged: prescribe low-dose (81 mg/d) aspirin after 12 weeks of gestation to individuals who are at high risk for preeclampsia (Grade B). However, the USPSTF provided updated guidance regarding moderate-risk factors. Specifically, the USPSTF now recommends low-dose aspirin for individuals with more than one moderate-risk factor.

• #5 Preventing pre-eclampsia – Monash Women’s

  https://monashwomens.org/health-information/first-trimester-pregnancy/preventing-pre-eclampsia/

  Recent research has shown that several major pregnancy complications, including pre-eclampsia, can be lessened or prevented by treatment from the first trimester. […] Pre-eclampsia is a particularly exciting area of prevention as it is a serious condition that cannot be cured except by birth, has significant risks for both mother and baby, and is now known to be safely reduced by around 60% with a simple daily dose of aspirin (at night). […] Aspirin is started early to help the placenta grow and continue to develop optimally. This is before 16 weeks although there is a lesser degree of benefit if started later. […] In short, yes. A very large trial (ASPRE) was able to demonstrate the safety of aspirin at 150mg in pregnant women for mothers and their babies and that it successfully reduced the incidence of severe early pre-eclampsia, the kind most associated with harm to mother and baby.

• #6 Controversies and Clarifications Regarding the Role of Aspirin in Preeclampsia Prevention: A Focused Review

  https://www.mdpi.com/2077-0383/13/15/4427

  Several subsequent meta-analyses have demonstrated that LDA is highly effective in the prevention of preterm preeclampsia (occurring prior to 37 weeks) only if therapy is initiated before 16 weeks gestation, with no conferred benefit on term preeclampsia. […] Considering the positive effect of aspirin, a key issue is how to identify those at risk of developing preeclampsia. Given that the beneficial effect of aspirin is maximized when initiated before 16 weeks gestation, it is critical to perform such screening no later than the first trimester. […] The Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial, a double-blind, placebo-controlled trial, was designed to evaluate the effect of 150 mg of aspirin initiated in the first trimester on the rate of preterm preeclampsia. […] As either screening approach may be associated with difficulty in its implementation, and considering the clear beneficial effect of LDA on preterm preeclampsia rates, its low cost, and favorable safety profile, the utilization of universal LDA prophylaxis has been debated.

• #7 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3534321/

  A meta-analysis including all randomized trials evaluated the effectiveness of aspirin compared with placebo or no treatment in women with an abnormal uterine artery Doppler and clinically relevant perinatal and maternal outcomes. There was a significant benefit of aspirin in reducing preeclampsia. […] A more recent meta-analysis aimed to estimate the effect of low-dose aspirin in women at moderate or high risk for preeclampsia. The analysis included 27 studies with follow-up for the outcome of preeclampsia. Low-dose aspirin started at 16 weeks or earlier was associated with a significant reduction in PE and FGR, whereas aspirin started after 16 weeks does not produce the same results. Low-dose aspirin started at 16 weeks or earlier also was associated with a reduction in severe PE, gestational hypertension, and preterm birth.

• #8 Controversies and Clarifications Regarding the Role of Aspirin in Preeclampsia Prevention: A Focused Review

  https://www.mdpi.com/2077-0383/13/15/4427

  Several subsequent meta-analyses have demonstrated that LDA is highly effective in the prevention of preterm preeclampsia (occurring prior to 37 weeks) only if therapy is initiated before 16 weeks gestation, with no conferred benefit on term preeclampsia. […] Considering the positive effect of aspirin, a key issue is how to identify those at risk of developing preeclampsia. Given that the beneficial effect of aspirin is maximized when initiated before 16 weeks gestation, it is critical to perform such screening no later than the first trimester. […] The Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial, a double-blind, placebo-controlled trial, was designed to evaluate the effect of 150 mg of aspirin initiated in the first trimester on the rate of preterm preeclampsia. […] As either screening approach may be associated with difficulty in its implementation, and considering the clear beneficial effect of LDA on preterm preeclampsia rates, its low cost, and favorable safety profile, the utilization of universal LDA prophylaxis has been debated.

• #9 Preventing pre-eclampsia – Monash Women’s

  https://monashwomens.org/health-information/first-trimester-pregnancy/preventing-pre-eclampsia/

  There are other things you can do to reduce your chance of developing pre-eclampsia. These include maintaining a healthy BMI, keeping any chronic medical conditions well controlled and taking a calcium supplement or having a calcium rich diet. […] Interestingly, there is good data which shows that aspirin taken at night is much more effective than aspirin taken in the morning at preventing pre-eclampsia, even when all else is equivalent.

• #10 Controversies and Clarifications Regarding the Role of Aspirin in Preeclampsia Prevention: A Focused Review

  https://www.mdpi.com/2077-0383/13/15/4427

  The optimal dose of aspirin in the prevention of preeclampsia differs between guidelines and varies between 50–162 mg per day. […] The optimal timing of LDA administration during the day is suggested to be at bedtime to maximize its beneficial effects. […] Meta-analyses have demonstrated that LDA has to be given prior to 16 weeks in order to have a beneficial effect on preterm preeclampsia rates. […] LDA therapy has an important role in the prevention of preterm preeclampsia. Identification of those at risk for preeclampsia should occur early during the first trimester, while the optimal screening approach differs among professional society guidelines. LDA should be administered prior to 16 weeks, with a daily dosage of at least 100 mg given at bedtime in order to maximize its beneficial effects.

• #11 Low-Dose Aspirin Use for the Prevention of Preeclampsia and Related Morbidity and Mortality | ACOG

  https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/12/low-dose-aspirin-use-for-the-prevention-of-preeclampsia-and-related-morbidity-and-mortality

  Based on the updated USPSTF guidance and its supporting evidence, ACOG and SMFM are revising their recommendation regarding low-dose aspirin prophylaxis for the prevention of preeclampsia. Low-dose aspirin (81 mg/d) prophylaxis is recommended for pregnant individuals at high risk of preeclampsia with one or more of the following risk factors: History of preeclampsia, especially when accompanied by an adverse outcome; Multifetal gestation; Chronic hypertension; Pregestational type 1 or 2 diabetes; Kidney disease; Autoimmune disease (ie, systemic lupus erythematous, antiphospholipid syndrome); Combinations of multiple moderate-risk factors. […] These risk factors are consistently associated with the greatest risk for preeclampsia. Preeclampsia incidence would likely be at least 8% in a population of pregnant individuals having one of these risk factors. Pregnant individuals with more than one of several moderate risk factors: Nulliparity; Obesity (ie, body mass index 30); Family history of preeclampsia (ie, mother or sister); Black race (as a proxy for underlying racism); Lower income; Age 35 years or older; Personal history factors (eg, low birth weight or small for gestational age, previous adverse pregnancy outcome, 10-year pregnancy interval); In vitro fertilization. […] When recommended, low-dose aspirin should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery.

• #12 Recommendation: Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: Preventive Medication | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/low-dose-aspirin-use-for-the-prevention-of-morbidity-and-mortality-from-preeclampsia-preventive-medication

  Evidence demonstrates that aspirin use reduces the risk of preeclampsia in high-risk populations. […] Low-dose aspirin use should be initiated after 12 weeks of gestation. […] Pregnant persons with 1 or more high-risk factors should receive low-dose aspirin. Pregnant persons with moderate-risk factors may also benefit from low-dose aspirin. […] The USPSTF has also issued recommendations for numerous conditions in pregnant persons, including screening for preeclampsia and folic acid supplementation to prevent neural tube defects. […] The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine recommend low-dose aspirin (81 mg/d) prophylaxis for persons at high risk of preeclampsia; the regimen should be initiated between 12 and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery.

• #13 Low-Dose Aspirin Use for the Prevention of Preeclampsia and Related Morbidity and Mortality | ACOG

  https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/12/low-dose-aspirin-use-for-the-prevention-of-preeclampsia-and-related-morbidity-and-mortality

  Based on the updated USPSTF guidance and its supporting evidence, ACOG and SMFM are revising their recommendation regarding low-dose aspirin prophylaxis for the prevention of preeclampsia. Low-dose aspirin (81 mg/d) prophylaxis is recommended for pregnant individuals at high risk of preeclampsia with one or more of the following risk factors: History of preeclampsia, especially when accompanied by an adverse outcome; Multifetal gestation; Chronic hypertension; Pregestational type 1 or 2 diabetes; Kidney disease; Autoimmune disease (ie, systemic lupus erythematous, antiphospholipid syndrome); Combinations of multiple moderate-risk factors. […] These risk factors are consistently associated with the greatest risk for preeclampsia. Preeclampsia incidence would likely be at least 8% in a population of pregnant individuals having one of these risk factors. Pregnant individuals with more than one of several moderate risk factors: Nulliparity; Obesity (ie, body mass index 30); Family history of preeclampsia (ie, mother or sister); Black race (as a proxy for underlying racism); Lower income; Age 35 years or older; Personal history factors (eg, low birth weight or small for gestational age, previous adverse pregnancy outcome, 10-year pregnancy interval); In vitro fertilization. […] When recommended, low-dose aspirin should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery.

• #14 Aspirin Use to Prevent Preeclampsia: USPSTF Recommendation

  https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2021/09/28/19/45/Aspirin-Use-to-Prevent-Preeclampsia

  High-risk factors for preeclampsia include: history of preeclampsia (especially when accompanied by an adverse outcome), multifetal gestation, chronic hypertension, pregestational type 1 or 2 diabetes, kidney disease, and autoimmune disease (i.e., systemic lupus erythematosus, antiphospholipid syndrome). If one or more of these high-risk factors are present, the USPSTF recommends low-dose aspirin. […] Moderate-risk factors for preeclampsia include: nulliparity, obesity (i.e., body mass index 30 kg/m2), family history of preeclampsia (i.e., mother or sister), Black persons (due to social, rather than biological, factors), lower income, age 35 years or older, personal history factors (e.g., low birth weight or small for gestational age, previous adverse pregnancy outcome, 10-year pregnancy interval), or in vitro conception. If two or more of these moderate-risk factors are present, the USPSTF recommends low-dose aspirin (may consider low-dose aspirin if one of these risk factors is present).

• #15 Low-Dose Aspirin Use During Pregnancy | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/07/low-dose-aspirin-use-during-pregnancy

  ABSTRACT: Low-dose aspirin has been used during pregnancy, most commonly to prevent or delay the onset of preeclampsia. […] The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine support the U.S. Preventive Services Task Force guideline criteria for prevention of preeclampsia. Low-dose aspirin (81 mg/day) prophylaxis is recommended in women at high risk of preeclampsia and should be initiated between 12 weeks and 28 weeks of gestation (optimally before 16 weeks) and continued daily until delivery. […] Low-dose aspirin prophylaxis should be considered for women with more than one of several moderate risk factors for preeclampsia. […] Based on the findings from the USPSTF and others, low-dose aspirin prophylaxis (81 mg/day) after 12 weeks of gestation modestly reduces the risk of preeclampsia in women at increased risk, without resulting in adverse fetal effects, increased maternal bleeding, or placental abruption.

• #16

  https://www.who.int/publications/i/item/9789240081130

  In women identified as being at increased risk of developing pre-eclampsia, prophylaxis with daily low-dose aspirin can reduce the risk of pre-eclampsia by 10-20%. […] For women living in areas with low calcium intake, high-dose calcium supplementation can reduce the risk of developing pre-eclampsia by more than 50%. […] The purpose of this target product profile (TPP) is to provide guidance to product developers and funders about key characteristics and desired attributes of preventive agents that should be administered to pregnant women identified as being at increased risk of developing pre-eclampsia, accompanied by monitoring for the development of pre-eclampsia. […] This TPP outlines both minimal and preferred characteristics of a medicine that should: prevent the development of pre-eclampsia; have a good safety profile during pregnancy; be commenced early in pregnancy (before 20 weeks gestation) and continued throughout pregnancy and postpartum as required; be suitable for administration in any health care setting where pregnant women receive antenatal care, including in low- and middle-income countries.

• #17 Preeclampsia Prevention

  https://mobile.fpnotebook.com/CV/OB/PrclmpsPrvntn.htm

  Preeclampsia Prevention, Preeclampsia Prophylaxis, PIH Prophylaxis, HELLP Prevention, Pregnancy Induced Hypertension Prophylaxis […] Aspirin 81 mg/day […] ACOG and USPTF Indications (to start in first trimester) […] One Preeclampsia high risk factor or two moderate risk factors (sere above) […] This replaces the older, more limited criteria focused on prior Preeclampsia in pregnancy […] Protocol […] Aspirin 81 mg orally daily […] Start at 12 to 28 weeks (preferably by 16 weeks gestation) […] Continue Aspirin until delivery […] Efficacy: Benefits […] Prevents Pregnancy Induced Hypertension […] Prevents Intrauterine Growth Retardation […] Efficacy: Number Needed to Treat (NNT) to prevent one case of Preeclampsia […] NNT: 69 (overall) […] NNT: 18 (if highest risk factors present)

• #18 Preeclampsia Prevention

  https://fpnotebook.com/CV/OB/PrclmpsPrvntn.htm

  Aka: Preeclampsia Prevention, Preeclampsia Prophylaxis, PIH Prophylaxis, HELLP Prevention, Pregnancy Induced Hypertension Prophylaxis […] Management: Aspirin 81 mg/day […] Efficacy: Benefits […] Prevents Pregnancy Induced Hypertension […] Prevents Intrauterine Growth Retardation […] Efficacy: Number Needed to Treat (NNT) to prevent one case of Preeclampsia […] NNT: 69 (overall) […] NNT: 18 (if highest risk factors present) […] Management: Calcium Supplementation […] Efficacy: Benefits (based on weak evidence) […] Lowers Preeclampsia risk […] Management: Other Measures […] Consistent Exercise initiated in early pregnancy reduces the risk of developing Gestational Hypertension and Preeclampsia […] Start aerobic Exercise early in pregnancy, for 30 minutes each on 3-4 days per week.

• #19 Low-dose aspirin (LDA) during pregnancy to prevent preeclampsia – Norton Healthcare Provider Louisville, Ky.

  https://nortonhealthcareprovider.com/news/low-dose-aspirin-lda-pregnancy/

  Patients already receiving medically-indicated low-dose aspirin for other established conditions prior to 12 to 28 weeks can continue their low-dose aspirin treatment. […] Administering LDA therapy earlier in pregnancy (prior to 11 weeks) does not decrease the risk of preeclampsia or other hypertensive disorders among high-risk women, according to a study. […] Patients with a history of aspirin allergy, hypersensitivity to other salicylates/nonsteroidal anti-inflammatory drugs (NSAIDs), nasal polyps or asthma with aspirin-induced acute bronchospasm should not receive LDA therapy in pregnancy.

• #20 SciELO Brazil – Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review

  https://www.scielo.br/j/rbgo/a/grvQDQfNQ8Vd5rhXwkp7hKy/?lang=en

  The second most frequent procedure in the selected studies was the prescription of calcium, although administered alone it obtained low certainty. […] Calcium is also used for the prevention of PE because there is epidemiological, clinical and laboratory evidence that indicates the association of dietary calcium deficiency with hypertensive disorders of pregnancy. […] One systematic review highlighted calcium supplementation (1 g to 2 g/day) for the prevention of PE, and found that calcium supplementation significantly reduces the risk (between 55% and 64%) in women with low dietary calcium intake. […] The use of statins in the treatment of PE has taken a leading role in recent years. […] The oral treatment with 3 g per day of L-arginine has a significant effect on the prevention of PE in high-risk patients, as well as on the ability to avoid more severe outcomes. […] Based on the studies included in the present review, the administration of aspirin is considered the best procedure for the prevention of PE in high-risk women, which corroborates the results of several studies published in recent years.

• #21 Dietary supplements and prevention of preeclampsia | Hypertension Research

  https://www.nature.com/articles/s41440-025-02144-9

  Calcium plays an important role in the regulation of vascular smooth muscle and vascular endothelial function and contributes to normal blood pressure regulation. […] Since 2011, the World Health Organization (WHO) has recommended calcium supplementation to prevent PE in pregnant women with low calcium intake. […] A recent meta-analysis in 2022 showed that calcium supplementation significantly reduced the risk of developing PE (RR: 0.49, 0.390.61) (30 studies, n=20,445). […] Therefore, calcium supplementation is expected to be effective in preventing PE in Japan, one of the countries with low calcium intake. […] Although vitamin D is gaining attention as a potential candidate for PE prevention, the accumulated evidence is not sufficient to recommend routine vitamin D supplementation. […] Therefore, well-designed, adequately powered studies are needed to obtain additional supporting evidence.

• #22 SciELO Brazil – Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review

  https://www.scielo.br/j/rbgo/a/grvQDQfNQ8Vd5rhXwkp7hKy/?lang=en

  The second most frequent procedure in the selected studies was the prescription of calcium, although administered alone it obtained low certainty. […] Calcium is also used for the prevention of PE because there is epidemiological, clinical and laboratory evidence that indicates the association of dietary calcium deficiency with hypertensive disorders of pregnancy. […] One systematic review highlighted calcium supplementation (1 g to 2 g/day) for the prevention of PE, and found that calcium supplementation significantly reduces the risk (between 55% and 64%) in women with low dietary calcium intake. […] The use of statins in the treatment of PE has taken a leading role in recent years. […] The oral treatment with 3 g per day of L-arginine has a significant effect on the prevention of PE in high-risk patients, as well as on the ability to avoid more severe outcomes. […] Based on the studies included in the present review, the administration of aspirin is considered the best procedure for the prevention of PE in high-risk women, which corroborates the results of several studies published in recent years.

• #23 Dietary supplements and prevention of preeclampsia | Hypertension Research

  https://www.nature.com/articles/s41440-025-02144-9

  Calcium plays an important role in the regulation of vascular smooth muscle and vascular endothelial function and contributes to normal blood pressure regulation. […] Since 2011, the World Health Organization (WHO) has recommended calcium supplementation to prevent PE in pregnant women with low calcium intake. […] A recent meta-analysis in 2022 showed that calcium supplementation significantly reduced the risk of developing PE (RR: 0.49, 0.390.61) (30 studies, n=20,445). […] Therefore, calcium supplementation is expected to be effective in preventing PE in Japan, one of the countries with low calcium intake. […] Although vitamin D is gaining attention as a potential candidate for PE prevention, the accumulated evidence is not sufficient to recommend routine vitamin D supplementation. […] Therefore, well-designed, adequately powered studies are needed to obtain additional supporting evidence.

• #24 Preeclampsia and preterm birth risk may be reduced by calcium dose lower than current WHO standard | Harvard T.H. Chan School of Public Health

  https://hsph.harvard.edu/news/preeclampsia-and-preterm-birth-risk-may-be-reduced-by-calcium-dose-lower-than-current-who-standard/

  To help prevent preeclampsia and preterm birthcommon complications in pregnancy that can be fatal to women and newbornslow-dose calcium supplementation (equivalent to one 500-milligram pill per day) may be as effective as the World Health Organization (WHO)s recommended high-dose calcium supplementation (equivalent to three 500-milligram pills taken throughout each day), according to a new study led by Harvard T.H. Chan School of Public Health and collaborators in India and Tanzania. […] While calcium supplementation is a known intervention to help prevent preeclampsia and preterm birthit is estimated to halve a pregnant womans risk of developing preeclampsia and reduce an infants risk of being born preterm by 25%the study is the first to evaluate the efficacy of a low-dose regimen versus a high-dose regimen.

• #25 Preeclampsia and preterm birth risk may be reduced by calcium dose lower than current WHO standard | Harvard T.H. Chan School of Public Health

  https://hsph.harvard.edu/news/preeclampsia-and-preterm-birth-risk-may-be-reduced-by-calcium-dose-lower-than-current-who-standard/

  The study found that low-dose calcium supplementation was as effective as high-dose calcium supplementation in preventing the risk of preeclampsia. […] Overall, our findings show that a single pill per day can be as effective as three, said joint first author Christopher Sudfeld, associate professor of global health and nutrition. With a reduced pill burden for women and lower costs for governments and programs that buy calcium pills, calcium supplementation should be considered widely implementable in the places its needed mostand should start saving thousands of maternal and newborn lives.

• #26 Improving access to lifesaving tools for prevention, diagnosis, and management of pre-eclampsia and maternal anemia – Unitaid

  https://unitaid.org/call-for-proposal/improving-access-to-lifesaving-tools-for-prevention-diagnosis-and-management-of-pre-eclampsia-and-maternal-anemia/

  There are developments that could offer opportunities for progress in prevention but these innovations have access issues of their own. For PE, new evidence on calcium supplements has shown that a lower-dose (500mg) regimen is just as effective as the recommended higher-dose approach (1500mg). Lower doses have potential to overcome affordability barriers and improve adherence. For anemia prevention, there is potential for multiple micronutrient supplements to replace IFA. These supplements are conditionally recommended for use by WHO and are generally considered more acceptable than IFA, potentially helping to address adherence challenges. […] To address these challenges, catalytic action is needed to drive adoption of a comprehensive range of effective, adapted PE and anemia tools within ANC platforms. This will require targeted action to resolve product-specific access barriers but also support to adopt effective models of care for ANC delivery.

• #27 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8236336/

  Statins are competitive inhibitors of the enzyme 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which converts HMG-CoA to mevalonic acid. Recently, there is growing interest in the role of statins to prevent preeclampsia due to increasing number of studies demonstrating strong biological plausibility to reverse or ameliorate several pathophysiological pathways associated with preeclampsia. […] Studies into the use of statins for preeclampsia have evaluated it using a therapeutic approach for patients who develop preeclampsia, and a prophylactic approach for women at high-risk for developing the disease. […] Metformin, or dimethyl-biguanide hydrochloride, is a biguanide used mainly as an anti-diabetic agent. […] However, clinical data on the effectiveness of metformin as a prophylactic agent for preeclampsia prevention are varied.

• #28 SciELO Brazil – Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review

  https://www.scielo.br/j/rbgo/a/grvQDQfNQ8Vd5rhXwkp7hKy/?lang=en

  The second most frequent procedure in the selected studies was the prescription of calcium, although administered alone it obtained low certainty. […] Calcium is also used for the prevention of PE because there is epidemiological, clinical and laboratory evidence that indicates the association of dietary calcium deficiency with hypertensive disorders of pregnancy. […] One systematic review highlighted calcium supplementation (1 g to 2 g/day) for the prevention of PE, and found that calcium supplementation significantly reduces the risk (between 55% and 64%) in women with low dietary calcium intake. […] The use of statins in the treatment of PE has taken a leading role in recent years. […] The oral treatment with 3 g per day of L-arginine has a significant effect on the prevention of PE in high-risk patients, as well as on the ability to avoid more severe outcomes. […] Based on the studies included in the present review, the administration of aspirin is considered the best procedure for the prevention of PE in high-risk women, which corroborates the results of several studies published in recent years.

• #29 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8236336/

  Statins are competitive inhibitors of the enzyme 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which converts HMG-CoA to mevalonic acid. Recently, there is growing interest in the role of statins to prevent preeclampsia due to increasing number of studies demonstrating strong biological plausibility to reverse or ameliorate several pathophysiological pathways associated with preeclampsia. […] Studies into the use of statins for preeclampsia have evaluated it using a therapeutic approach for patients who develop preeclampsia, and a prophylactic approach for women at high-risk for developing the disease. […] Metformin, or dimethyl-biguanide hydrochloride, is a biguanide used mainly as an anti-diabetic agent. […] However, clinical data on the effectiveness of metformin as a prophylactic agent for preeclampsia prevention are varied.

• #30 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8236336/

  Statins are competitive inhibitors of the enzyme 5-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, which converts HMG-CoA to mevalonic acid. Recently, there is growing interest in the role of statins to prevent preeclampsia due to increasing number of studies demonstrating strong biological plausibility to reverse or ameliorate several pathophysiological pathways associated with preeclampsia. […] Studies into the use of statins for preeclampsia have evaluated it using a therapeutic approach for patients who develop preeclampsia, and a prophylactic approach for women at high-risk for developing the disease. […] Metformin, or dimethyl-biguanide hydrochloride, is a biguanide used mainly as an anti-diabetic agent. […] However, clinical data on the effectiveness of metformin as a prophylactic agent for preeclampsia prevention are varied.

• #31 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8236336/

  The use of proton pump inhibitors including esomeprazole is safe in pregnancy, and has not been found to be associated with fetal teratogenicity, miscarriage or preterm birth. […] Contemporary research into prophylactic and therapeutic interventions for preeclampsia are providing novel and promising modalities.

• #32 SciELO Brazil – Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review Clinical Procedures for the Prevention of Preeclampsia in Pregnant Women: A Systematic Review

  https://www.scielo.br/j/rbgo/a/grvQDQfNQ8Vd5rhXwkp7hKy/?lang=en

  The second most frequent procedure in the selected studies was the prescription of calcium, although administered alone it obtained low certainty. […] Calcium is also used for the prevention of PE because there is epidemiological, clinical and laboratory evidence that indicates the association of dietary calcium deficiency with hypertensive disorders of pregnancy. […] One systematic review highlighted calcium supplementation (1 g to 2 g/day) for the prevention of PE, and found that calcium supplementation significantly reduces the risk (between 55% and 64%) in women with low dietary calcium intake. […] The use of statins in the treatment of PE has taken a leading role in recent years. […] The oral treatment with 3 g per day of L-arginine has a significant effect on the prevention of PE in high-risk patients, as well as on the ability to avoid more severe outcomes. […] Based on the studies included in the present review, the administration of aspirin is considered the best procedure for the prevention of PE in high-risk women, which corroborates the results of several studies published in recent years.

• #33 Preeclampsia Prevention

  https://mobile.fpnotebook.com/CV/OB/PrclmpsPrvntn.htm

  Calcium Supplementation […] Calcium 1-2 g orally daily […] Dietary Calcium 600 mg/day […] Efficacy: Benefits (based on weak evidence) […] Lowers Preeclampsia risk […] Lowers Blood Pressure […] Systolic lowered 5.4 mmHg […] Diastolic lowered 3.4 mmhg […] Consistent Exercise initiated in early pregnancy reduces the risk of developing Gestational Hypertension and Preeclampsia […] Start aerobic Exercise early in pregnancy, for 30 minutes each on 3-4 days per week […] Avoid routine Magnesium Supplementation […] Avoid routine Omega-3 Fatty Acid Supplementation […] Avoid antioxidant Vitamin Supplementation.

• #34 Preeclampsia Prevention

  https://fpnotebook.com/CV/OB/PrclmpsPrvntn.htm

  Aka: Preeclampsia Prevention, Preeclampsia Prophylaxis, PIH Prophylaxis, HELLP Prevention, Pregnancy Induced Hypertension Prophylaxis […] Management: Aspirin 81 mg/day […] Efficacy: Benefits […] Prevents Pregnancy Induced Hypertension […] Prevents Intrauterine Growth Retardation […] Efficacy: Number Needed to Treat (NNT) to prevent one case of Preeclampsia […] NNT: 69 (overall) […] NNT: 18 (if highest risk factors present) […] Management: Calcium Supplementation […] Efficacy: Benefits (based on weak evidence) […] Lowers Preeclampsia risk […] Management: Other Measures […] Consistent Exercise initiated in early pregnancy reduces the risk of developing Gestational Hypertension and Preeclampsia […] Start aerobic Exercise early in pregnancy, for 30 minutes each on 3-4 days per week.

• #35 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  A Mediterranean diet during pregnancy is linked to a reduced risk of preeclampsia, according to a study published in a 2022 issue of the Journal of the American Heart Association. […] Attend all your OB-GYN appointments during pregnancy. All these appointments are necessary to ensure you and your baby are in good health. They also screen you for conditions like gestational diabetes and preeclampsia.

• #36 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  If you can, try to lose as much excess weight as possible before pregnancy to avoid preeclampsia. […] Women aged 35 and older are at higher risk for developing preeclampsia. […] Exercise offers countless benefits for pregnancy and is one of the most effective ways you may be able to avoid preeclampsia. […] Quality sleep is essential during pregnancy. Not only can it reduce your risk for preeclampsia, but it can help you feel more energized, given how tiring pregnancy can be. […] Many recent studies show a link between caffeine and preeclampsia. […] High amounts of salt and sodium can raise your blood pressure and increase your preeclampsia risk. […] Certain foods are loaded with nutrients and antioxidants that can naturally regulate your blood pressure and clean your blood and body of toxins.

• #37 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  Preeclampsia cannot always be avoided, but there are plenty of healthy steps women can take to reduce their risk. […] Here are steps you can take to reduce your risk for preeclampsia and how to contact Lompoc Valley Medical Center to increase your chances of having a healthy pregnancy and delivery. […] High blood pressure is the top risk factor for developing preeclampsia. If you plan on becoming pregnant, work on lowering your blood pressure if it’s high. If you’re already pregnant, take steps to manage and control your blood pressure as best as possible throughout pregnancy. […] If you have diabetes, work closely with your doctor to control your blood sugar levels during pregnancy. […] Take good care of your kidneys by maintaining a healthy weight, not smoking, and following the directions on all over-the-counter medicines.

• #38 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  If you can, try to lose as much excess weight as possible before pregnancy to avoid preeclampsia. […] Women aged 35 and older are at higher risk for developing preeclampsia. […] Exercise offers countless benefits for pregnancy and is one of the most effective ways you may be able to avoid preeclampsia. […] Quality sleep is essential during pregnancy. Not only can it reduce your risk for preeclampsia, but it can help you feel more energized, given how tiring pregnancy can be. […] Many recent studies show a link between caffeine and preeclampsia. […] High amounts of salt and sodium can raise your blood pressure and increase your preeclampsia risk. […] Certain foods are loaded with nutrients and antioxidants that can naturally regulate your blood pressure and clean your blood and body of toxins.

• #39 Preeclampsia During Pregnancy | American Pregnancy Association

  https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/preeclampsia/

  Use little or no added salt in your meals. Drink 6-8 glasses of water a day. Avoid fried foods and junk food. Get enough rest. Exercise regularly. Elevate your feet several times during the day. Avoid drinking alcohol. Avoid beverages containing caffeine. Your doctor may suggest you take the prescribed medicine and additional supplements.

• #40 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  If you can, try to lose as much excess weight as possible before pregnancy to avoid preeclampsia. […] Women aged 35 and older are at higher risk for developing preeclampsia. […] Exercise offers countless benefits for pregnancy and is one of the most effective ways you may be able to avoid preeclampsia. […] Quality sleep is essential during pregnancy. Not only can it reduce your risk for preeclampsia, but it can help you feel more energized, given how tiring pregnancy can be. […] Many recent studies show a link between caffeine and preeclampsia. […] High amounts of salt and sodium can raise your blood pressure and increase your preeclampsia risk. […] Certain foods are loaded with nutrients and antioxidants that can naturally regulate your blood pressure and clean your blood and body of toxins.

• #41 Prevention of Preeclampsia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3534321/

  Prevention of preeclampsia is more likely to be successful by identifying women at high risk and scheduling them to proper antenatal care. Efforts should be made to find earlier PE predictors in order to institute interventions before 16 weeks. […] Interventions such as rest, exercise, reduced salt intake, garlic, marine oil, antioxidants, progesterone, diuretics, and nitric oxide showed insufficient evidence to be recommended as preventive measurements for PE. On the other hand, low-dose aspirin especially when initiated before 16 weeks in high-risk groups, and calcium especially in low-intake populations show promise in the prevention of PE.

• #42

  https://www.bornontario.ca/en/news/preeclampsia-prevention-in-ontario-can-we-do-better.aspx

  Multi-factor early-pregnancy screening for preeclampsia can identify most women and birthing individuals at risk, particularly of early-onset, severe disease. […] Taking low-dose aspirin can prevent 80%-94% of early-onset, severe preeclampsia. […] Consideration should be given to multifactorial early-pregnancy screening for preeclampsia, as well as a timely initiation of low-dose aspirin in people who are identified to be at risk.

• #43 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  A Mediterranean diet during pregnancy is linked to a reduced risk of preeclampsia, according to a study published in a 2022 issue of the Journal of the American Heart Association. […] Attend all your OB-GYN appointments during pregnancy. All these appointments are necessary to ensure you and your baby are in good health. They also screen you for conditions like gestational diabetes and preeclampsia.

• #44 Preeclampsia: Prevention – UpToDate

  https://www.uptodate.com/contents/preeclampsia-prevention

  Preeclampsia: Prevention […] Standard prenatal care, including close follow-up of high-risk patients after midgestation, increases the chance that preeclampsia will be detected early in the course of disease. […] Early diagnosis followed by appropriate management, including delivery, may prevent some of the serious sequelae of the disease, such as eclamptic seizures and multiorgan failure. […] Since there is no curative treatment other than delivery, an intervention that could prevent preeclampsia would have a significant impact on maternal and neonatal health worldwide. […] Low-dose aspirin prophylaxis is the most useful preventive pharmacologic intervention, but the magnitude of benefit is variable and depends on a number of factors. […] This topic will review several interventions that have been evaluated for prevention of preeclampsia.

• #45 Preeclampsia, Genomics and Public Health | Blogs | CDC

  https://blogs.cdc.gov/genomics/2022/10/25/preeclampsia/

  We wonder if Erica would have had the same pregnancy complications from preeclampsia if a universal screening test for predicting preeclampsia in early stages of pregnancy existed. […] If you are already pregnant, get early and regular prenatal care; talk with your doctor about any medicines you take and which ones are safe; keep track of your blood pressure at home with a home blood pressure monitor; and learn the early (urgent) warning signs for preeclampsia.

• #46 Can Women Reduce Their Risk For Preeclampsia? – Lompoc Valley Medical Center

  https://www.lompocvmc.com/blogs/2022/august/can-women-reduce-their-risk-for-preeclampsia-/

  Preeclampsia cannot always be avoided, but there are plenty of healthy steps women can take to reduce their risk. […] Here are steps you can take to reduce your risk for preeclampsia and how to contact Lompoc Valley Medical Center to increase your chances of having a healthy pregnancy and delivery. […] High blood pressure is the top risk factor for developing preeclampsia. If you plan on becoming pregnant, work on lowering your blood pressure if it’s high. If you’re already pregnant, take steps to manage and control your blood pressure as best as possible throughout pregnancy. […] If you have diabetes, work closely with your doctor to control your blood sugar levels during pregnancy. […] Take good care of your kidneys by maintaining a healthy weight, not smoking, and following the directions on all over-the-counter medicines.

• #47 Missed opportunities in aspirin prescribing for preeclampsia prevention | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-06039-w

  Hypertensive disorders of pregnancy, including preeclampsia, are a leading cause of perinatal morbidity and mortality in the United States, particularly among low-income and historically marginalized populations. Evidence suggests low-dose aspirin prophylaxis may help prevent preeclampsia in individuals at increased risk of developing the disease. […] Low-dose aspirin is currently the only intervention recommended by the United States Preventive Services Task Force (USPSTF) and American College of Obstetricians (ACOG) for primary prevention of preeclampsia in individuals at increased risk of developing the disease. […] Despite the documented benefits of aspirin prescribing and support from professional societies, there are still many missed opportunities for aspirin prophylaxis to prevent preeclampsia. Future interventions should focus on identifying patients who qualify for aspirin prophylaxis on the basis of having multiple moderate-risk factors without comorbid high-risk factors.

• #48 Missed opportunities in aspirin prescribing for preeclampsia prevention | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-06039-w

  Studies reporting similarly low rates of aspirin prescribing in high-risk populations suggest that despite the established benefits of aspirin and clear recommendations from professional societies, there are still many missed opportunities for aspirin prophylaxis to prevent preeclampsia. Interventions need to focus on identifying patients who qualify for aspirin prophylaxis on the basis of having multiple moderate-risk factors without comorbid high-risk factors.

• #49 Missed opportunities in aspirin prescribing for preeclampsia prevention | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-023-06039-w

  Studies reporting similarly low rates of aspirin prescribing in high-risk populations suggest that despite the established benefits of aspirin and clear recommendations from professional societies, there are still many missed opportunities for aspirin prophylaxis to prevent preeclampsia. Interventions need to focus on identifying patients who qualify for aspirin prophylaxis on the basis of having multiple moderate-risk factors without comorbid high-risk factors.

• #50 Discussing low-dose aspirin use for preeclampsia prevention

  https://www.contemporaryobgyn.net/view/discussing-low-dose-aspirin-use-for-preeclampsia-prevention

  A major focus of initiatives is to amplify awareness among clinicians about the benefits of low-dose aspirin. Khan believes many patients and providers are unaware about this option, indicating a need to spread awareness. […] Khan recommended clinicians listen to their patients, even when they are not told about their patients medical histories in a way that they are expecting. According to Khan, every pregnant patient should know about the risk of preeclampsia, not just those who are deemed high risk.

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