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Early initiation of low-dose aspirin for reduction in preeclampsia risk in high-risk women: a secondary analysis of the MFMU High-Risk Aspirin Study

Journal of Perinatology volume 35, pages 328–331 (2015)Cite this article

Subjects

Abstract

Objective:

Early initiation of low-dose aspirin (LDA) may reduce preeclampsia risk. We sought to determine whether LDA was beneficial when initiated <17w0d, within a trial of high-risk women enrolled <26w0d.

Study Design:

Secondary analysis of the Maternal-Fetal Medicine Units High-Risk Aspirin study, including women enrolled <17w0d, randomized to LDA (60 mg day−1) or placebo with chronic hypertension (CHTN, n=186), diabetes (n=191) or prior preeclampsia (n=146). The primary outcome was preeclampsia at any time in pregnancy, secondary outcomes were early preeclampsia (<34w0d), late preeclampsia (⩾34w), small for gestational age (SGA; neonatal birthweight <10th %) and composite (early preeclampsia or SGA). Outcomes were compared by exact Χ2-tests.

Results:

Baseline characteristics were similar between treatment groups. Aspirin was associated with a lower rate of late-onset preeclampsia ⩾34w (17.36% vs 24.42%, P=0.047), with a 41% reduction in women with CHTN (18.28% vs 31.18%, P=0.041). There were no other significant differences in the outcome.

Conclusion:

Aspirin initiated <17w0d reduced the risk for late-onset preeclampsia by 29% supporting the practice of early initiation of aspirin in high-risk women.

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Acknowledgements

The authors thank Dr Ronald Gibbs MD and Dr K. Joseph Hurt MD for their editorial support. Dr Gibbs and Dr Hurt are employed by the University of Colorado and have no disclosures to report. The authors appreciate the assistance of the National Institute of Child Health and Human Development (NICHD) and the MFMUs Network in making the database from the MFMU High-Risk Aspirin trial available for secondary analysis. The contents of this report represent the views of the authors and do not represent the views of the Eunice Kennedy Shriver NICHD MFMUs Network or the National Institutes of Health. This analysis was supported by the University of Colorado Department of Obstetrics and Gynecology. The original study on which the present article is based was funded by the National Institute of Child Health and Human Development. The findings were presented as a poster at the 34rd annual meeting of the Society for Maternal-Fetal Medicine, 3 to 8 February, 2014, New Orleans, LA, USA.

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Authors and Affiliations

  1. University of Colorado Department of Obstetrics and Gynecology, Aurora, CO, USA

    G S Moore, A L Post, H L Galan & K D Heyborne

  2. Colorado School of Public Health, Aurora, CO, USA

    A A Allshouse

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  1. G S Moore
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  2. A A Allshouse
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  3. A L Post
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Correspondence to G S Moore.

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Moore, G., Allshouse, A., Post, A. et al. Early initiation of low-dose aspirin for reduction in preeclampsia risk in high-risk women: a secondary analysis of the MFMU High-Risk Aspirin Study. J Perinatol 35, 328–331 (2015). https://doi.org/10.1038/jp.2014.214

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