Spontaneous Preterm Birth: Is Prevention with Aspirin Possible?

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Pharmacology

Background:

• Preterm birth rates in Germany (8.6%) are high, contributing to significant perinatal morbidity and mortality.
• Spontaneous preterm birth (labor or premature rupture of membranes) accounts for about two-thirds of cases.
• Optimizing prevention strategies is crucial, with recent interest in low-dose aspirin's potential impact.

Purpose of the Study:

• To review current knowledge on low-dose aspirin's efficacy in preventing spontaneous preterm births.
• To evaluate aspirin's role beyond preventing iatrogenic preterm births.

Main Methods:

• Selective literature search in PubMed up to April 2020.
• Keywords included: "randomized trial", "randomized study", "spontaneous preterm birth", and "aspirin".

Main Results:

• Secondary analyses of randomized studies indicate low-dose aspirin significantly reduces spontaneous preterm births in high- and low-risk populations.
• The ASPIRIN trial showed 81mg daily aspirin before 14 weeks gestation lowered preterm birth by 11% in nulliparous women (11.6% vs 13.1%).

Conclusions:

• Further research is urgently needed to confirm these findings.
• Widespread aspirin prophylaxis (from 12 weeks gestation) may be considered if results are validated.