Ira Bernstein, M.D.’83, professor of obstetrics, gynecology, and reproductive sciences at the Larner College of Medicine and chair of the medical advisory board of the Preeclampsia Foundation, was quoted in a Medscape article on predicting preeclampsia.
Clinicians and researchers have long dreamed of accurate screening tools for preeclampsia—tools that could lead to detection before symptoms manifest and then targeted treatment. But current methods of risk assessment and prevention fall short. The U.S. Preventive Services Task Force recommends the use of low-dose aspirin (LDA) in people who are at increased risk for preeclampsia. The problem is, most pregnant individuals fall into the high-risk and especially the moderate-risk categories. This has led to debates over possible universal LDA prophylaxis and discussion “about how to rule out who’s at such low risk they don’t need LDA,” Bernstein said.
Experts believe that as risk assessment becomes more accurate, adherence to aspirin prophylaxis recommendations will increase, as will appreciation of evidence-based nonpharmacologic interventions. But they also hope to see more data on the potentially prophylactic value of other agents, such as heparin, metformin, and statins. “Even when used in the right patient, aspirin prevents only a portion of disease,” said Bernstein.