Systematic Literature Review of Preeclampsia Prevention Models: Implications for Developing an Integrated Model in Indonesia

Abstract

Preeclampsia is a leading cause of maternal morbidity and mortality worldwide, including in Indonesia. Preventive strategies such as calcium supplementation, community-based interventions, and self-monitoring of blood pressure have been widely studied. However, these approaches remain fragmented and lack integration into a comprehensive management model. This study aimed to analyze existing preeclampsia prevention management models reported in international guidelines and trials and to synthesize the evidence as a basis for developing an integrated prevention model for Indonesia. A Systematic Literature Review was conducted following PRISMA guidelines. Searches in PubMed, Scopus, ScienceDirect, and Google Scholar identified 1,236 records. After screening, 12 studies were included, comprising international guidelines, Cochrane reviews on calcium. The review identified three major categories of prevention models: (1) risk screening and prediction with biomarkers; (2) education and empowerment, including self-monitoring; and (3) integrated guideline-based care emphasizing high-quality antenatal services and preventive supplementation. Evidence indicates greater effectiveness when these strategies are applied holistically. Current preeclampsia prevention models show effectiveness when integrated into a holistic management framework that combines risk screening, maternal and family education, and primary health services aligned with international guidelines. This systematic review provides an evidence-based foundation for developing an integrated preeclampsia prevention management model.