Pre-eclampsia is when high blood pressure develops after 20 weeks of pregnancy and when one or more of the following are found: protein in the urine, maternal organ damage (kidneys, liver, blood, nervous system), or evidence of problems with the uterus and placenta. Risk factors for pre-eclampsia include long-term high blood pressure or kidney disease before pregnancy, having high blood pressure or pre-eclampsia in a previous pregnancy, obesity, age, in vitro fertilization, a multiple pregnancy (e.g., twins), certain ethnic backgrounds, a first pregnancy, and a family history of pre-eclampsia.

The most effective treatment for pre-eclampsia is delivery of the baby. Clinical guidelines recommend taking a low dose of acetylsalicylic acid (ASA [Aspirin]) as a preventive measure in those with heightened risk. Clinicians might assess a pregnant person for characteristics associated with pre-eclampsia to find out if they are high-risk. A new technique developed by the Fetal Medicine Foundation (“the FMF algorithm”) uses the pregnant person’s characteristics and other indicators to better identify people at high risk for pre-eclampsia. Once a person has been identified as high-risk, their doctor can start treating them with ASA.

This health technology assessment looked at the safety, effectiveness, and cost-effectiveness of a population-wide first-trimester screening program for pre-eclampsia risk that uses the FMF algorithm (“the population-wide FMF-based screening program”) in reducing the risk of pre-eclampsia. It also looked at the accuracy of the FMF algorithm in predicting the risk of pre-eclampsia. Last, it looked at the budget impact of publicly funding the population-wide FMF-based screening program and at the experiences, preferences, and values of people who have had pre-eclampsia.