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Evaluation of impacts of aspirin therapy versus placebo on preeclampsia: An observational study
Liping Zhou1, Zhenzhen Wang1, Li Wang1
1Department of Obstetrics, Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, Henan, China, 450003.
Insights
Low-dose aspirin effectively prevents gestational hypertension and pre-eclampsia in high-risk pregnancies. This treatment significantly reduces the incidence of these conditions with minimal adverse effects, improving maternal and neonatal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Maternal-Fetal Medicine
Background:
- Gestational hypertension and pre-eclampsia are significant contributors to maternal and neonatal mortality.
- These conditions often arise after the 20th week of pregnancy, linked to factors like malnutrition or obesity.
- Early intervention with low-dose aspirin, initiated between 11 and 28 weeks, is a potential preventive strategy.
Purpose of the Study:
- To evaluate the efficacy of aspirin in preventing pre-eclampsia among high-risk pregnancies.
- To assess the safety profile of aspirin treatment, including any adverse reactions.
Main Methods:
- An observational study involving 600 high-risk pregnant women.
- Participants were randomized into two groups: 301 received 150 mg aspirin, and 299 received a placebo.
- Treatment was administered between 11 and 36 weeks of gestation, with assessments at 25, 36, and 37 weeks.
Main Results:
- Aspirin therapy significantly reduced the incidence of gestational hypertension at all assessed time points (<25, <36, and >37 weeks) compared to placebo.
- Preeclampsia rates were substantially lower in the aspirin group across all gestational age assessments.
- The odds ratios for developing gestational hypertension and pre-eclampsia were consistently lower for women receiving aspirin.
Conclusions:
- Low-dose aspirin is highly effective in preventing gestational hypertension and pre-eclampsia in women at high risk.
- The treatment demonstrates a favorable safety profile with minimal adverse effects.
- Aspirin represents a valuable therapeutic option for improving pregnancy outcomes in at-risk populations.
Background:
Gestational hypertension and pre-eclampsia often increase maternal and neonatal mortality. The illness usually appears after the 20th week of pregnancy due to malnutrition or obesity. Untreated, it can lead to neonatal and maternal mortality. Low-dose Aspirin can prevent preeclampsia if started between 11 and 28 weeks. Several studies support this technique, although others have shown limited effectiveness and negative side effects.
Objective:
This study aims to assess the effectiveness of aspirin treatment for the prevention of preeclampsia, taking into account any possible adverse reactions.
Methods:
This observational research comprised 600 singleton pregnant women at high risk of pregnancy-induced hypertension. The aspirin group had 301 individuals and the placebo group 299. From 11 to 36 weeks of pregnancy, they received 150 mg of aspirin and 150 mg of placebo. Gestational hypertension was assessed at 25 weeks, 36 weeks, and 37 weeks. If any, aspirin and placebo-related adverse pregnancy and neonatal outcomes were reported.
Results:
With aspirin therapy, 4 females and 14 females with placebo developed gestational hypertension before 25 weeks of pregnancy with an odds ratio of 0.283 (0.092-0.87); before 36 weeks, 5 females and 15 females with placebo developed GHD with an odds ratio of 0.331 (0.118-0.922); and after 37 weeks, 17 females and 35 females with placebo developed GHD. Preeclampsia occurred in 5 females in the aspirin group and 17 in the placebo group at <25 weeks (odds ratio 0.292 (0.106-0.802), 7 females in the aspirin arm and 25 females in the placebo arm at <36 weeks (odds ratio 0.278 (0.118-0.652), and 21 females in the aspirin arm and 39 females in the placebo arm at >37 weeks (odds ratio 0.5349 (0.307-0.930).
Conclusion:
In pregnant women at high risk of prenatal hypertension and preeclampsia, aspirin therapy is very effective with minimal side effects.
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