USPSTF Guidelines of Little Value for Estimating Preeclampsia Risk in Those at Moderate Risk

WEDNESDAY, July 23, 2025 (HealthDay News) — Moderate U.S. Preventive Services Task Force (USPSTF) preeclampsia risk factors have little value for estimating the risk for preeclampsia, according to a study published online July 17 in JAMA Network Open.

Thomas F. McElrath, M.D., Ph.D., from Brigham & Women”s Hospital in Boston, and colleagues examined which characteristics in the USPSTF guidelines on preeclampsia risk assessment accurately estimate preeclampsia risk status and the association of preeclampsia risk with aspirin prophylaxis (AP) in an observational cohort study involving pregnant participants aged 18 years or older with a singleton pregnancy less than 22 weeks” gestation.

Overall, 88.8 percent of 5,684 participants had an increased risk for preeclampsia (70.3 percent at moderate risk; 18.5 percent at high risk). The researchers found that 43.1 percent of participants received an AP recommendation. The overall rate of preeclampsia was 12.1 percent; rates were 3.0, 10.5, and 23.5 percent for those at low, moderate, and high risk, respectively, according to USPSTF categories. Nulliparity was associated with an increased risk for preeclampsia, and advanced maternal age was associated with a reduced risk among those with two or more moderate risk factors, but no high risk factors (relative risks, 1.48 and 0.79, respectively); no associations were seen for obesity or Black race. Overall, 82.0 percent of participants with any high risk factors were recommended AP, while 85.9 percent of those at low risk were not recommended AP. In contrast, 23.8 and 50.4 percent of those with one and two or more moderate risk factors, respectively, were recommended AP.

“Moderate risk factors, in the absence of high risk factors, had no or low value for estimating the risk of developing preeclampsia, leading to nonspecific recommendation of AP in the moderate-risk category,” the authors write.

Several authors disclosed ties to the pharmaceutical and medical technology industries.

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