Cardio-oncology & otherRandomised controlled trial
Implementation of First-Trimester Screening and Prevention of Preeclampsia: A Stepped Wedge Cluster-Randomized Trial in Asia
- Stepped wedge cluster randomised trial
- multicentre
Authors' conclusion
The implementation of the screen-and-prevent strategy for preterm preeclampsia is not associated with a significant reduction in the incidence of preterm preeclampsia.
Study context
- Population
- Pregnant women at maternity/diagnostic units in 10 regions in Asia, 2019–202242,897 screened
- Participants
- 48,725 women
- Comparison
- First-trimester screen-and-prevent strategy vs routine antenatal care
- Primary endpoint
- Incidence of preterm preeclampsia
Primary result
Preterm preeclampsia
Adjusted odds ratio
1.59
95% CI 0.91–2.77
Intervention vs Non-intervention
aOR 1.59 (95% CI 0.91–2.77)
As reported in the abstract
Further findings
| Outcome | aOR (95% CI) | |
|---|---|---|
| Aspirin prophylaxis among high-risk women (intervention phase) — Aspirin prophylaxis vs Non-intervention · preterm preeclampsia; 41% reduction | 0.59 (0.37–0.92) | |
| Aspirin prophylaxis among high-risk women (intervention phase) — Aspirin prophylaxis vs Non-intervention · preeclampsia with delivery <34 weeks; 54% reduction | 0.46 (0.23–0.93) | |
| Aspirin prophylaxis among high-risk women (intervention phase) — Aspirin prophylaxis vs Non-intervention · spontaneous preterm birth <34 weeks; 55% reduction | 0.45 (0.22–0.92) | |
| Aspirin prophylaxis among high-risk women (intervention phase) — Aspirin prophylaxis vs Non-intervention · perinatal death; 64% reduction | 0.34 (0.12–0.91) | |
| 0.10.31310Adjusted odds ratio (log scale) |
Acceptance of first-trimester screening
- Women who agreed to first-trimester screening, overall (42 897 of 48 725)
- 88.04%
Aspirin uptake among high-risk women (intervention phase)
- High-risk women who received aspirin prophylaxis (2919 of 3543)
- 82.39%
Safety
Aspirin-related severe adverse events
- No significant between-group difference
Original publication
Implementation of First-Trimester Screening and Prevention of Preeclampsia: A Stepped Wedge Cluster-Randomized Trial in Asia. Circulation. Published 26 June 2024. doi:10.1161/circulationaha.124.069907
Summarised from the published abstract; every number is checked against it