title: Prediction and prevention of early-onset pre-eclampsia: impact of aspirin after first-trimester screening.
abstract: OBJECTIVE
  To examine the effect of a combination of screening and treatment with low-dose aspirin on the prevalence of early-onset pre-eclampsia (PE).
  
  
  METHODS
  This was a retrospective analysis of two consecutive cohorts of women screened for early PE. The first cohort was observed to determine whether algorithms developed to screen for PE at 11 to 13 + 6 weeks' gestation could be applied to our population. High-risk women in the second cohort were advised on their risk and offered aspirin (150 mg at night), with treatment starting immediately after screening. The prevalence of early PE and the proportion of women with PE delivering at 34-37 weeks' gestation were compared between the cohorts.
  
  
  RESULTS
  In the observational and interventional cohorts, 3066 and 2717 women, respectively, were screened. There were 12 (0.4%) cases of early PE in the observational cohort and one (0.04%) in the interventional cohort (P < 0.01). Among all women with PE delivering before 37 weeks, 25 (0.83%) were in the observational cohort and 10 (0.37%) in the interventional cohort (P = 0.03).
  
  
  CONCLUSIONS
  A strategy of first-trimester screening for early PE coupled with prescription of aspirin to the high-risk group appears to be effective in reducing the prevalence of early PE.
authors: Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.|RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: F
authors: F
authors: Park
authors: Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
authors: K
authors: K
authors: Russo
authors: Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.|Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: P
authors: P
authors: Williams
authors: RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: M
authors: M
authors: Pelosi
authors: RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: R
authors: R
authors: Puddephatt
authors: RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: M
authors: M
authors: Walter
authors: Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
authors: C
authors: C
authors: Leung
authors: RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.|Department of Obstetrics and Gynaecology, University of Malaya, Kuala Lumpur, Malaysia.
authors: R
authors: R
authors: Saaid
authors: RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: H
authors: H
authors: Rawashdeh
authors: RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: R
authors: R
authors: Ogle
authors: Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.|RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
authors: J
authors: J
authors: Hyett
mesh_terms: D000328:Adult; D001241:Aspirin / Q000008:administration & dosage*; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D012307:Risk Factors; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: PAPP-A; aspirin; first-trimester prediction; mean arterial pressure; pre-eclampsia; uterine artery Doppler