There is international consensus that screening for pre-eclampsia risk should occur in early pregnancy, to evaluate whether there is an indication for evidence-based preventative measures (e.g. low-dose aspirin). While clinical practice guidelines are intended to advise clinicians on high-quality, evidence-based practice, quality of the documents vary, as do the screening recommendations.

“This study highlights the important differences between the evidence and clinical guidelines, especially regarding body mass index. By reviewing guidelines in this way, we can ensure that prophylactic measures can be put in place for women at risk of developing pre-eclampsia. Thus, better outcomes for mothers and babies.” Terteel Elawad co-first author on the study

In this analysis, we show that pre-eclampsia risk factors advocated by clinical practice guidelines were poorly aligned with evidence, consisting primarily of umbrella and other high-quality systematic reviews.

“ Pre-eclampsia risk factors in practice guidelines are poorly aligned with evidence, especially for obesity – this is clearly an important message and has been further highlighted by an interesting mini commentary in support within the same issue of BJOG” Professor Laura Magee, Senior author on the study.

With the availability of multivariable prediction models in early and later pregnancy, digital health technologies for data processing and awareness that pre-eclampsia risk may evolve as pregnancy progresses, we are well-placed to refresh our strategy to identify throughout pregnancy, the women at increased risk of pre-eclampsia, and modify their likelihood of disease and complication.

Here is the link to the paper: Risk factors for pre-eclampsia in clinical practice guidelines: comparison with the evidence