Use of Low Dos Aspirin in Women with Increased Risk of Preeclampsia

Abstract

Introduction: The role of aspirin in the primary or secondary prevention of preeclampsia has been the subject of numerous studies and great controversy. Our aim reports on LDA usage rates by women with an increased PE risk, as well as on determinants and reasons given for use and non‐use.

Material and Method: In this multicenter, double-blind, placebo-controlled trial, the current study randomly assigned 2100 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation. The analysis was performed according to the intention-to-treat principle.

Results: Preterm preeclampsia occurred in 13 participants (1.6%) in the aspirin group, as compared with 35 (4.3%) in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74; P=0.004). Results were materially unchanged in a sensitivity analysis that took into account participants who had withdrawn or were lost to follow-up.

Conclusion: This randomized trial showed that among women with singleton pregnancies who were identified using first-trimester screening as being at high risk for preterm preeclampsia, the administration of aspirin at a dose of 150 mg per day from 11 to 14 weeks of gestation until 36 weeks of gestation resulted in a significantly lower incidence of preterm preeclampsia than that with placebo.