Society for Maternal-Fetal Medicine

View all recommendations from this society

March, 10 2021

Don’t perform routine midtrimester serum biomarker risk stratification for preterm birth or preeclampsia in asymptomatic patients.

Routine midtrimester biomarker risk stratification for preterm birth (e.g., various cytokines) and preeclampsia (e.g., placental growth factor (PlGF), soluble FMS-like tyrosine kinase-1 (sFlt-1)) in asymptomatic pregnant women is not recommended due to its limited utility and poor predictive value, respectively. Importantly, employing interventions (eg, low-dose aspirin) based on screening results have not been shown to improve maternal or fetal outcomes. Furthermore, there is the potential to expose many women to unnecessary prophylactic intervention(s).


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

As a national medical specialty society, the Society for Maternal-Fetal Medicine relies on the input of any number of its committees in the development of various documents. In the case of the items included in this list, the Publications Committee reviewed the literature and evidence from SMFM’s published documents for possible topics. For SMFM’s first set of five recommendations a sub-group of the Committee initially developed a list of 10 items that the Committee then ranked for the top five with input and suggestions by the Society’s Executive Committee. For SMFM’s second set of recommendations, the sub-group of the Committee developed a list of 12 items that the Committee then ranked for the top five, again soliciting input and suggestions by the Society’s Executive Committee. For SMFM’s third set of five recommendations, the sub-group of the Publications Committee developed a list of 10 items that the Committee ranked for the top five, again soliciting input and suggestions by the Society’s Executive Committee. The final lists have been reviewed and approved by the Society’s Document Review Committee and Executive Committee.

SMFM’s disclosure and conflict of interest policy can be found at www.smfm.org

Sources

American College of Obstetrics and Gynecology. Gestational Hypertension and Preeclampsia: Practice Bulletin, Number 222. Obstet Gynecol 2020 Jun;135(6):e237-260.

Screening for spontaneous preterm birth and resultant therapies to reduce neonatal morbidity and mortality: A review. Semin Fetal Neonatal Med 2018 Apr;23(2):126-132.

Wei S, Fraser W, Luo ZC. Inflammatory cytokines and spontaneous preterm birth in asymptomatic women: A systematic review. Obstet Gynecol 2010 Aug;116(2):393-401.