{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T06:26:00Z","timestamp":1787379960130,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the effect of aspirin on gestational age at delivery due to preterm pre\u2010eclampsia (PE) in women with chronic hypertension (CH), to assess the predictive performance of the Fetal Medicine Foundation (FMF) first\u2010trimester competing\u2010risks model for preterm PE in this high\u2010risk group and to evaluate how parity, previous PE and biomarker values influence individualized risk estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from two multicenter first\u2010trimester PE screening studies: the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence\u2010based Preeclampsia Prevention trial and the Screening Program for Preeclampsia trial. The effect of aspirin on gestational age at delivery due to PE was assessed using Bayesian inference. The screening performance of the FMF model was evaluated by discrimination, calibration and decision\u2010curve analysis. The influence of parity, previous PE and biomarkers (mean arterial pressure (MAP), uterine artery pulsatility index (UtA\u2010PI) and placental growth factor (PlGF)) on risk classification was explored using empirical data and Monte Carlo simulations with generalized additive models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The combined dataset included 51\u2009024 women with a singleton pregnancy, of whom 556 (1.1%) had CH. Among the women with CH, 58 (10.4%) developed preterm PE. Bayesian analysis indicated that aspirin delayed delivery due to PE by a mean of 3.6 (95% credible interval, 0.2\u20136.6)\u2009weeks, with a 98% posterior probability of benefit. The FMF model demonstrated good discrimination (area under the receiver\u2010operating\u2010characteristics curve, 0.819 (95%\u2009CI, 0.763\u20130.874)), adequate calibration and higher net benefit compared with a treat\u2010all approach. Overall, 21.8% of women with CH were classified as low risk (&lt;\u20091 in 100) for preterm PE, consisting mostly of nulliparous women and parous women without previous PE. Predicted risks for preterm PE were strongly influenced by MAP and PlGF, with UtA\u2010PI contributing to a lesser extent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In women with CH, aspirin can delay delivery due to preterm PE, and first\u2010trimester risk assessment using the FMF competing\u2010risks model reliably identifies low\u2010 and high\u2010risk individuals. The predicted risk is driven primarily by MAP and PlGF, supporting risk stratification and individualized management in early pregnancy. \u00a9 2026 The Author(s).\n                      <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic>\n                      published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70212","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T20:00:04Z","timestamp":1774728004000},"page":"613-622","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["First\u2010trimester prediction and prevention of preterm pre\u2010eclampsia in women with chronic hypertension"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-3592","authenticated-orcid":false,"given":"D. L.","family":"Rolnik","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2725-971X","authenticated-orcid":false,"given":"S.","family":"Gil\u2010Pugliese","sequence":"additional","affiliation":[{"name":"Department of Perinatology University Institute of Biomedical Sciences of C\u00f3rdoba  C\u00f3rdoba Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-6072","authenticated-orcid":false,"given":"A.","family":"Syngelaki","sequence":"additional","affiliation":[{"name":"Fetal Medicine Research Institute, King's College Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6936-4369","authenticated-orcid":false,"given":"E.","family":"Bujold","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Research Center, Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire de Qu\u00e9bec Universit\u00e9 Laval  Quebec City QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4800-3190","authenticated-orcid":false,"given":"D.","family":"Wright","sequence":"additional","affiliation":[{"name":"Department of Clinical and Biomedical Science University of Exeter  Exeter UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3944-4130","authenticated-orcid":false,"given":"L. 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