"Efektivitas Model FMF dalam Skrining Preeklampsia Trimester Pertama: Tinjauan Sistematis dan Implikasinya di Indonesia"

Abstract

Background Preeclampsia remains one of the leading causes of maternal and perinatal morbidity and mortality worldwide, particularly in low- and middle-income countries. Early detection through first-trimester screening is essential to identify high-risk pregnancies and prevent severe complications. This study aimed to review the effectiveness and development of first-trimester preeclampsia screening models based on global evidence and their applicability to the Indonesian healthcare context. Methods This study was a Systematic Literature Review of 40 international articles published between 2020 and 2025, retrieved from Scopus, PubMed, and ScienceDirect databases. Inclusion criteria consisted of cohort studies and meta-analyses evaluating the performance of the Fetal Medicine Foundation (FMF) screening model and its derivatives. Data were extracted using a standardized form and analyzed thematically and descriptively based on model components, AUC values, and aspirin intervention outcomes. Results The FMF model combining maternal factors, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and biomarkers PlGF and PAPP-A showed high predictive accuracy (AUC 0.90–0.96; FPR <10%). Low-dose aspirin administered before 16 weeks reduced preterm preeclampsia risk by 55–65%. A simplified three-parameter model remained effective for middle-income populations. Conclusion The FMF model and its adaptations are effective for early preeclampsia screening and can be integrated into Indonesia’s antenatal care system through the 2024 Maternal and Child Health Book and digital KIA programs.