Low-dose aspirin reduces the risk for preterm delivery

  • Hoffman MK & al.
  • Lancet
  • 25 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In nulliparous women with singleton pregnancies from low-income and middle-income countries, early administration of low-dose aspirin (between 6 weeks and 0 days of gestation and 13 weeks and 6 days of gestation) was associated with a reduction in the incidence of preterm births before 37 weeks and perinatal mortality.

Why this matters

  • Findings confirm the previously suggested benefit of low-dose aspirin in reducing the risk of preterm birth.

Study design

  • In modified intention-to-treat (mITT) analysis, 11,544 nulliparous women from six countries with singleton pregnancies were randomly assigned to receive low-dose aspirin (81 mg daily; n=5780) or placebo (n=5764).
  • Primary outcome: incidence of preterm birth (number of deliveries
  • Funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Key results

  • Overall, the incidences of preterm birth at
  • Women in the aspirin vs placebo group had significant reductions in:
    • perinatal mortality (264 vs 309 per 1000 births; RR, 0.86; 95%CI, 0.73-1.00; P=.048);
    • foetal loss (303 vs 353 per 1000 pregnancies; RR, 0.86; 95%CI, 0.74-1.00; P=.039);
    • early preterm delivery (
    • early preterm delivery (
  • No significant difference was seen in other maternal, foetal, and neonatal events between both groups.

Limitations

  • The optimal dose and time of initiation of aspirin remained unclear.