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Low-dose aspirin for pre-eclampsia prevention in twins with elevated human chorionic gonadotropin

Journal of Perinatology volume 36, pages 601–605 (2016)Cite this article

Subjects

Abstract

Objective:

The objective of the study is to evaluate low-dose aspirin (LDA) for pre-eclampsia prevention in twin gestations with elevated maternal serum human chorionic gonadotropin (hCG).

Study Design:

Secondary analysis of the Maternal-Fetal Medicine Units High-Risk Aspirin trial for pre-eclampsia prevention. A threshold hCG level for predicting pre-eclampsia was identified in placebo-randomized patients. Pre-eclampsia incidence and time of onset were compared between treatment groups, overall and by hCG threshold category.

Results:

Pre-eclampsia incidence was lower with LDA than with placebo (6% vs 16%, OR 0.32, 95% CI 0.12 to 0.82). An hCG threshold of 29.96 IU ml−1 best predicted pre-eclampsia. In patients with hCG <29.96 IU ml−1, the differences in pre-eclampsia incidence or time of onset were not significant. In patients with hCG >29.96 IU ml−1, LDA was associated with lower pre-eclampsia incidence than placebo (6% vs 23%, OR 0.21, 95% CI 0.06 to 0.79) and delayed onset.

Conclusion:

Twin gestations with elevated hCG levels may benefit from LDA for pre-eclampsia prevention.

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Acknowledgements

We appreciate the assistance of the National Institute of Child Health and Human Development (NICHD) and the Maternal-Fetal Medicine Units 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 National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network or the National Institutes of Health.

Author information

Authors and Affiliations

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

    A G Euser, T D Metz & K D Heyborne

  2. Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO, USA,

    T D Metz & K D Heyborne

  3. University of Colorado School of Public Health, Aurora, CO, USA

    A A Allshouse

Authors
  1. A G Euser
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  2. T D Metz
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  3. A A Allshouse
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  4. K D Heyborne
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Corresponding author

Correspondence to A G Euser.

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Competing interests

These findings of this study were presented at the 62nd Annual Scientific Meeting of the Society for Reproductive Investigation, 25 to 28 March 2015, in San Francisco, CA.

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Euser, A., Metz, T., Allshouse, A. et al. Low-dose aspirin for pre-eclampsia prevention in twins with elevated human chorionic gonadotropin. J Perinatol 36, 601–605 (2016). https://doi.org/10.1038/jp.2016.55

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