Medical Director Pomelo Care Fresh Meadows, NY, United States
Introduction: Preeclampsia is a leading contributor to maternal morbidity and mortality; low-dose aspirin prophylaxis can reduce relative risk by 25% or more in high-risk women (Henderson et al, 2014). Despite this, aspirin prophylaxis use in high-risk pregnancies remains suboptimal at below 25% (Ray et al, 2022). This retrospective study explored the impact of Pomelo Care’s 24/7 virtual maternity care program on aspirin prophylaxis utilization among pregnant women at elevated risk of preeclampsia. Methods: Patients (Nf89) were included if they: (A) enrolled in Pomelo Care's virtual maternity program before week 29 of pregnancy, (B) were postpartum or more than 12 weeks gestation as of 9/15/2023, (C) engaged with Pomelo's services at least once 30 days before 9/15/2023, and (D) were at high preeclampsia risk per clinical or algorithmic determination. Patients were counseled to begin low-dose aspirin, per ACOG practice bulletin 222. The primary outcome was aspirin initiation and use during pregnancy. IRB waiver of informed consent was obtained. Results: Aspirin was utilized by 65% (58/89) of patients, representing a 160% increase relative to reported rates in literature. The rate remained above twice the average even when criterion C was relaxed to include patients engaged with Pomelo at any point in time (58%, 62/106). Conclusion/Implications: The results suggest that engagement in Pomelo Care’s virtual maternity program is associated with an increase in aspirin use among pregnant women at elevated risk for preeclampsia. This highlights the potential for virtual care interventions to promote evidence-based practice and improve maternal health outcomes.
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