Evaluation of Risk Factor Screening Using the Ministry of Health’s Scoring System for the Incidence of Early-Onset Preeclampsia in Primary Health Service

Wilis Dwi Pangesti,1 Elsa Pudji Setiawati Sasongko,2 Adhi Pribadi,3 Dany Hilmanto4 1Doctoral Program in Medical Sciences, Padjadjaran University, Bandung, Indonesia; 2Department of Public Health Sciences, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia; 3Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Padjadjaran University and Hasan Sadikin Hospital Bandung, Bandung, Indonesia; 4Department of Pediatrics, Hasan Sadikin Hospital and Faculty of Medicine, Padjadjaran University, Bandung, IndonesiaCorrespondence: Elsa Pudji Setiawati Sasongko, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Ir. Soekarno KM. 21, Jatinangor, Sumedang, 45363, Indonesia, Tel +628122320872, Email [email protected]: Early onset preeclampsia (E) causes severe complications that lead to morbidity and mortality in women. Various screening methods have been implemented, including the Ministry of Health’s scoring system and eoPEE prevention programs implemented in primary health care in Indonesia.Purpose: The objectives of this study were: 1) To determine the results of screening for eoPE risk factors using the Ministry of Health’s scoring system, 2) To evaluate the accuracy of the Ministry of Health’s scoring system in predicting the occurrence of eoPE.Patients and Methods: This prospective cohort design study was conducted from October 2021 to September 2022 in 38 primary health centers in Banyumas Regency, Central Java Province, Indonesia. A purposive sampling technique was utilized. The pregnant women with a gestational age of < 20 weeks who were screened for eoPE risk factors using the Ministry of Health’s scoring system at the first pregnancy visit were included as research participants. Data were processed using SPSS version 29, and a 95% confidence interval was used to determine the significance level.Results: The results revealed that 563 (13.9%) were classified as high risk for developing eoPE. The incidence of eoPE among those pregnancy screened was 2.5%. The most common maternal risk factors associated with eoPE were mean arterial pressure (24.8%), age ≥ 35 years (18.6%), and pre-pregnancy obesity (7.5%). The sensitivity, specificity, positive predictive value, and negative predictive value of the scoring system for eoPE were 52%, 87.1%, 9.6%, and 98.6%, respectively.Conclusion: It is concluded that the scoring performance test requires modification or other approaches to increase its sensitivity and positive predictive value. Modification of this system requires an approach that is easy, inexpensive, and feasible to be carried out in developing countries.Keywords: early-onset preeclampsia, risk factors, scoring system, screening