Can Aspirin Use During Pregnancy Reduce Preeclampsia Risk?

Daily aspirin use during pregnancy can reduce risk of preterm preeclampsia in women with a higher likelihood of developing the condition, according to a recent study.

Preterm preeclampsia is one of the most significant known causes of maternal and perinatal complications and death during pregnancy. However, less is known about the effects of aspirin use on the risk of preterm preeclampsia.
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For their double-blind, placebo-controlled trial, the researchers randomly assigned 1776 women with singleton pregnancies to receive either 150 mg of aspirin or placebo daily, from 11 to 14 weeks of gestation until 36 weeks. All participants faced a high risk of developing preterm preeclampsia, and the primary outcome was delivery with preeclampsia prior to 37 weeks of gestation.

Analysis was conducted in accordance with the intention-to-treat principle.

Results included assessment of 798 participants receiving aspirin and 822 receiving placebo. A total of 13 (1.6%) participants receiving aspirin developed preterm preeclampsia, compared with 35 (4.3%) participants receiving placebo. The researchers found that women taking aspirin daily during pregnancy had a 62% lower rate of delivery prior to 37 weeks of gestation due to preterm preeclampsia, and an 82% lower rate in delivery prior to 34 weeks, vs women receiving placebo.

Participants adhered well to treatment, with 79.9% of participants taking 85% or more of the required number of tablets, according to the researchers. Additionally, there were no significant differences between the groups in the incidence of neonatal adverse outcomes or other adverse events.

“Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a lower incidence of this diagnosis than placebo,” the researchers concluded.

—Christina Vogt

Reference:

Rolnik DL, Wright D, Poon LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia [Published online June 28, 2017]. N Eng J Med. doi:10.1056/NEJMoa1704559.