Prophylactic aspirin delays development of preterm and term preeclampsia

  • Wright D & al.
  • Am J Obstet Gynecol
  • 21 Feb 2019

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Prophylactic use of aspirin may delay development of preterm and term preeclampsia.
  • Women with risk factors for preeclampsia may experience greater benefits.

Why this matters

  • The mechanism for how aspirin prevents preeclampsia is unclear.

Key results

  • The experimental model proves aspirin prevents both preterm and term preeclampsia, but high-risk patients differed from low-risk patients.
  • In high-risk patients, the risk for preterm preeclampsia was reduced in women on aspirin (2.7% vs 7.1%).
  • In low-risk patients, the use of prophylactic aspirin reduced the risk for term preeclampsia (3.6% vs 5.7%).

Study design

  • Unplanned secondary subgroup analysis of data from the ASPRE trial, involving 13 hospitals investigating risks for and prevention of preeclampsia with aspirin.
  • A model was developed and fitted to examine the hypothesis that aspirin causes a delay in gestational age at time of diagnosis of preeclampsia.
  • Funding: Fetal Medicine Foundation and European Union 7th Framework Programme.

Limitations

  • Model needs to be validated.
  • Lack of power for preeclampsia at term.

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