Comparison of Early Screening Methods for Preeclampsia in the First Trimester: A Systematic Review
DOI:
https://doi.org/10.59890/ijist.v4i7.24Keywords:
Preeclampsia, First Trimester, ScreeningAbstract
Preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality worldwide. Early identification during the first trimester of pregnancy allows timely preventive interventions, including low-dose aspirin prophylaxis. Although numerous screening methods have been developed, a comprehensive comparison of their diagnostic accuracy is lacking. Objective: To synthesize and compare the effectiveness of first-trimester preeclampsia screening methods based on recent scientific evidence. Methods: A PRISMA-based systematic review was conducted by searching PubMed, Cochrane Library, Scopus, and CINAHL databases for the period 2015-2025. Inclusion criteria encompassed RCTs, prospective cohort studies, and systematic reviews reporting diagnostic accuracy of first-trimester preeclampsia screening methods. Results: A total of 1,247 articles were identified; after PRISMA screening, 10 studies met the inclusion criteria (total n = 459,890 pregnancies). The Fetal Medicine Foundation (FMF) algorithm combining maternal factors, MAP, UtA-PI, PlGF, and PAPP-A demonstrated the highest performance (sensitivity 76-90% for preterm PE, FPR 10%). Single biomarkers (PlGF, PAPP-A) showed limited accuracy (AUC 0.66-0.76), whereas multiparameter combinations were consistently superior. Conclusion: FMF algorithm-based multiparameter screening is the best approach for identifying preterm preeclampsia risk in the first trimester. Clinical implementation should consider resource availability, local population validation, and integration with antenatal care programs.
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