Narrative review suggests precision interventions for preeclampsia phenotypes

This narrative review explores the clinical efficacy of various prevention strategies for preeclampsia in pregnant women. The authors highlight that the clinical efficacy of standard low-dose aspirin exhibits significant heterogeneity across diverse patient populations. They do not report specific sample sizes or adverse events for these findings.

Regarding multiple pregnancies, the authors state that high-dose aspirin (≥150 mg/d) may be required to neutralize the supraphysiological load of placenta-derived extracellular vesicles. For pregnant women with chronic hypertension, a combination of low-dose aspirin and low molecular weight heparin is noted to exert synergistic protection of endothelial glycocalyx integrity, achieving dual benefits of antithrombosis and endothelial protection.

In metabolic high-risk populations, statins are described as demonstrating superior therapeutic potential compared to metformin in restoring angiogenic balance. This potential is attributed to activating the heme oxygenase 1/carbon monoxide pathway and inhibiting the adipokine chemerin. The review does not provide absolute numbers or p-values for these comparisons.

The authors recommend that future prevention strategies should shift from empirical uniform regimens to individualized precision interventions based on molecular endotypes. Safety data, including adverse events and tolerability, were not reported in this review.