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The Impact of Universalizing Aspirin Prophylaxis on Treatment Provision for High-Risk Pregnant Patients

Adina R Kern-Goldberger1,2, Kirat Sandhu1, Cara D Dolin1

  • 1Division of Maternal-Fetal Medicine, Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

American Journal of Perinatology
|March 25, 2025
PubMed

Insights

A universal low-dose aspirin policy significantly increased prescription rates for preeclampsia prevention. This policy improved aspirin use broadly and specifically among high-risk patients with hypertension and diabetes.

Area of Science:

  • Obstetrics and Gynecology
  • Pharmacology
  • Public Health

Background:

  • Low-dose aspirin is recommended for preeclampsia prevention in high-risk pregnancies.
  • Preeclampsia poses significant risks to both mother and fetus.
  • Consistent aspirin use is crucial for its preventive efficacy.

Purpose of the Study:

  • To evaluate the impact of a universal low-dose aspirin policy on prescription rates.
  • To assess changes in aspirin utilization before and after policy implementation.
  • To determine if the policy improved aspirin use in high-risk populations.

Main Methods:

  • Prospective observational study in a multihospital health system.
  • Interrupted time series analysis of aspirin prescriptions.
  • Inclusion of 11,382 patients, analyzing data up to 16 weeks gestation.

Main Results:

  • Statistically significant increase in aspirin prescription rates across the entire cohort (IRR: 2.93).
  • Significant increase in aspirin prescription rates for a high-risk subcohort (IRR: 1.48).
  • High-risk subcohort included patients with chronic hypertension, pregestational diabetes, and/or multiple gestation.

Conclusions:

  • A universal low-dose aspirin policy significantly increased its utilization during pregnancy.
  • The policy demonstrated improved aspirin use among high-risk patients.
  • Universal aspirin policies may enhance broader risk reduction and optimize care for high-risk individuals.

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