Society for Maternal-Fetal Medicine Special Statement: Prophylactic low-dose aspirin for preeclampsia prevention—quality metric and opportunities for quality improvement

Prophylactic low-dose aspirin reduces the rates of preeclampsia, preterm birth, fetal growth restriction, and perinatal death in patients with risk factors for preeclampsia. Despite recommendations from the US Preventive Services Task Force, the American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine, low-dose aspirin use is reported in <50% of patients with high-risk factors and <25% of patients with > 1 moderate-risk factor. These low utilization rates represent an important "quality gap" and demonstrate the need for quality improvement activities. In this paper, we outline the specifications for a process metric to standardize the measurement of the rate of aspirin use. We also outline an approach to conducting a quality improvement project to increase the utilization of aspirin by patients with risk factors for preeclampsia.