Pre-eclampsia Aspirin Eligibility (NICE / USPSTF-ACOG)

This tool applies the published, guideline-endorsed categorical risk-factor approach used to decide low-dose aspirin prophylaxis for pre-eclampsia: NICE NG133 (Hypertension in pregnancy, 2019, updated 2023) offers aspirin 75-150 mg daily from 12 weeks until birth when at least one high-risk factor (previous hypertensive disease in pregnancy, chronic kidney disease, autoimmune disease such as SLE or antiphospholipid syndrome, type 1 or type 2 diabetes, or chronic hypertension) or at least two moderate-risk factors (nulliparity, age 40 or older, pregnancy interval over 10 years, BMI 35 or higher at booking, family history of pre-eclampsia, or multifetal pregnancy) are present. USPSTF (2021) and ACOG Committee Opinion 743 endorse a closely related framework, recommending 81 mg/day (ideally before 16 weeks) for one or more high-risk factors (history of pre-eclampsia, multifetal gestation, chronic hypertension, pregestational diabetes, kidney disease, autoimmune disease) or two or more moderate factors, which additionally include several sociodemographic items the US guidance treats as markers of structural inequity rather than biology (Black race, lower income) alongside obesity, family history, prior adverse pregnancy outcome, long interpregnancy interval, and IVF conception. The Fetal Medicine Foundation separately runs a validated Bayesian competing-risks model (Wright et al., AJOG 2015; O'Gorman et al., Ultrasound Obstet Gynecol 2017) that combines maternal factors with mean arterial pressure, uterine artery pulsatility index, PAPP-A and PlGF to output a patient-specific percentage risk of preterm pre-eclampsia; this was the screening test used to select women for aspirin in the ASPRE trial (Rolnik et al., NEJM 2017). That competing-risks coefficient set is proprietary to licensed FMF/Astraia software and is not reproduced here. Optional MAP, uterine artery PI, and biomarker MoM fields are shown only as qualitative context flags against commonly cited research thresholds — they do not generate a percentage risk.