Imidazo[1,2‑a]pyridines as Privileged Scaffolds: Synthetic Advances, Biological Activities, and Translational Challenges.

Preeclampsia affects up to 8% of all pregnancies and is a major cause of morbidity and mortality []. Low‐dose aspirin (LDA, e.g., 81 mg) for participants at moderate or high risk is associated with a 10%–20% reduction in the development of preeclampsia [, ]. The American College of Obstetricians and Gynecologists recommends initiation of LDA among eligible individuals between 12 and 28 weeks’ gestation, including in participants of low socioeconomic status (SES) or self‐reported Black race, as a proxy for discrimination and marginalization, as these participants are at particular risk [, , ]. LDA use is reported in under half of participants with high‐risk factors and less than 25% of those with more than 1 moderate risk factor []. The Society for Maternal‐Fetal Medicine (SMFM) in 2023 identified initiation and adherence to LDA as an area necessitating quality improvement activities []. While prescription of aspirin is an important first step to aspirin use, barriers to adherence are significant [, , ]. This is especially important in the context of prior research, which found that in order to improve outcomes, adherence to LDA should be greater than 90% []. SMFM recommends evaluation of current practices to inform interventions, specifically around communication and patient education to decrease barriers to adherence []. Given the clinical significance of LDA, a multi‐method study was undertaken to examine the implementation of a universal LDA initiative in a prenatal clinic serving participants of low SES. Implementation science uses rigorous scientific frameworks and theories to bridge the gap from evidence‐based intervention to real‐world use, an essential task in optimizing prenatal care and improving maternal outcomes []. A central tenet of implementation science is understanding barriers and facilitators to evidence‐based medicine to employ effective intervention strategies. In the pre‐implementation phase of our trial, we utilized a qualitative approach to understand barriers and facilitators to aspirin adherence.