HCA Healthcare and March of Dimes have teamed up to address clinical practice gaps in preeclampsia prevention during high-risk pregnancies.
The organizations launched a clinical initiative and implementation toolkit to help maternal care teams reduce preeclampsia rates. The resource centers are helping clinicians identify high-risk pregnancies and incorporating low-dose aspirin into routine prenatal care.
Preeclampsia remains a serious threat to pregnant patients and their babies. Although clinical guidelines recommend low-dose aspirin to reduce the risk in eligible patients, treatment remains underused. Only 11% to 14% of pregnant patients at risk for preeclampsia had a prescription or clinical recommendation for low-dose aspirin.
March of Dimes collaboration aims to close that gap by helping clinicians put existing evidence into practice through resources designed for obstetrician-gynecologists, midwives, family physicians and other maternal care professionals.
The Low Dose, Big Benefits Preeclampsia Campaign
March of Dime’s Low Dose, Big Benefits campaign combines clinician education with patient and community awareness for preeclampsia prevention. Preeclampsia is a pregnancy complication involving new-onset high blood pressure, typically occurring after 20 weeks of gestation. It can lead to severe complications, including organ damage, stroke, preterm delivery and fetal growth restrictions.
The campaign’s initial rollout targeted Federally Qualified Health Centers in Houston and Miami. In Texas and Florida, Black and Latina women face a higher risk of developing preeclampsia. Federally Qualified Health Centers serve a larger share of these populations, positioning the program to reach patients at greater risk. According to the maternal health group, the campaign helps clinicians within this clinic identify patients at risk for preeclampsia. Their resources and programming focus on increasing preventative use of low-dose aspirin.
March of Dime developed the campaign resources through a $1.5 million grant from the HCA Healthcare Foundation. The tools were built in collaboration with medical experts and organizations such as the American Medical Association.
Improving Maternal Health Outcomes Through Aspirin
The maternal health campaign is based on maternal health guidelines. Evidence-based guidelines recommend low-dose aspirin as a cost-effective way to reduce preeclampsia risk in pregnant patients meeting clinical criteria. When used appropriately, aspirin can reduce the risk of developing preeclampsia by 10% to 20%.
Since preeclampsia can affect fetal development, early risk assessment is a central strategy. Resources focus on training clinicians on identifying eligible patients to initiate treatment. The U.S. Preventive Services Task Force recommends 81 milligrams of aspirin daily after 12 weeks of gestation for pregnant patients at high risk of preeclampsia. The American College of Obstetricians and Gynecologists recommends starting low-dose aspirin between 12 and 28 weeks, ideally before 16 weeks.
Guidelines also recommend daily low-dose aspirin after 12 weeks of pregnancy for patients with two or more moderate risk factors. These include Black race, first pregnancy, age 35 or older, and a body mass index above 30.
Bridging The Gap In Clinical Practice
Despite the cost-effectiveness and guideline recommendation, low dose aspirin is underutilized in clinical practice. Joint research by March of Dimes and Komodo Health found that provider screening contributed to low use. Clinicians frequently failed to screen for risk factors or formally recommend low-dose aspirin during early prenatal visits and overlooked moderate risk factors.
March of Dimes’ clinician training and education is focused on closing the gap between clinical guidelines and treatment plans. The group is also focused on helping clinics use technology to better integrate guideline recommendations to clinic workflows. One of the behavior change the campaign is addressing is formal prescribing. Rather, the group is training clinicians to prioritize prescriptions in lieu of informal over-the-counter recommendations.
Community health centers serving at-risk populations in Florida and Texas will receive resources to help integrate evidence-based recommendations into clinical practice. The resources will also support patient interactions, train care teams to incorporate prenatal risk assessments, and improve electronic workflows for identifying patients who could benefit from low-dose aspirin.
Although the campaign rollout focuses on Texas and Florida, doctors nationwide can access the resources through the March of Dimes Preeclampsia Prevention program page.
Inside The Toolkits
The campaign provides clinical toolkits, patient resources and clinician resource hub. Resources also include clinician-focused instructions on screening habits during the prenatal visits. The campaign provides medical professionals with specialized education. OB-GYNs, midwives and pharmacists will have access to customizable visual slide decks to use when training regional staff and peers. They also include a video series and clinician modules sharing the clinical evidence behind daily 81mg low-dose aspirin use.
March of Dimes’ resources also include patient materials to improve awareness and encourage patients to advocate for their care. The materials are available in multiple languages, including English, Spanish, Portuguese, Haitian Creole and Chinese. Patients can use visual, interactive doctor discussion guides to share relevant risk information with their providers. Other resources include infographics and digital kits.
Doctors can request these resources to be distributed to patients. Patients will also be able to access these resources through March of Dimes channels.
