Related Experiment Video
Updated: Sep 17, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Aspirin, Birthweight, and Large-For-Gestational-Age Neonates: A Secondary Analysis of the ASPRE Trial
Daniel L Rolnik1, Liona C Poon2, Argyro Syngelaki3
1Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.
Insights
Low-dose aspirin increases birthweight in newborns without raising the rate of large-for-gestational-age (LGA) neonates. However, aspirin may increase LGA rates in mothers with pre-existing diabetes.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Pharmacology
Background:
- Low-dose aspirin is used in pregnancy to reduce the risk of preeclampsia.
- The impact of aspirin on birthweight distribution and large-for-gestational-age (LGA) neonates requires further clarification.
Purpose of the Study:
- To evaluate the effect of aspirin on birthweight distribution.
- To determine aspirin's impact on the incidence of LGA neonates.
Main Methods:
- Secondary analysis of the ASPRE trial data.
- Compared birthweight distributions and LGA rates between aspirin and placebo groups.
- Stratified analyses by pre-existing diabetes and preeclampsia; logistic regression for LGA predictors.
Main Results:
- Aspirin use shifted birthweight from <2500g to 2500-4000g and percentiles (<25th to 25th-75th).
- No significant increase in LGA neonates observed (5.5% vs. 6.2%, p=0.667).
- Significant interaction between aspirin treatment and pre-existing diabetes (p=0.034) for LGA rates.
Conclusions:
- Aspirin increases birthweight without increasing LGA rates in the general high-risk population.
- Aspirin may be associated with a higher LGA rate in women with pre-existing diabetes, meriting further study.
Objective:
To investigate the effects of aspirin on the distribution of birthweight and its impact on the rates of large-for-gestational-age (LGA) neonates.
Design:
Secondary analysis of the Combined Multimarker Screening and Randomised Patient Treatment with Aspirin for Evidence-based Preeclampsia Prevention (ASPRE) trial.
Setting:
Thirteen hospitals in England, Spain, Belgium, Greece, Italy and Israel.
Population:
Participants of the ASPRE trial at increased risk of preterm pre-eclampsia (PE) who had a live birth.
Methods:
We compared the birthweight distributions and the rates of LGA neonates between the trial groups. Analyses were stratified according to the presence of pre-existing diabetes mellitus and the development of PE, and logistic regression was used to investigate independent predictors of LGA neonates with birthweight above the 90th percentile.
Main Outcome Measures:
Birthweight distribution and rates of LGA neonates.
Results:
Among 1571 singleton, live neonates (777 from the aspirin group and 794 from the placebo group), aspirin was associated with a shift in birthweight from < 2500 to 2500-4000 g, and birthweight percentile from < 25th to 25th-75th percentiles, with no significant increase in LGA neonates (5.5% vs. 6.2%, p = 0.667). Logistic regression demonstrated a significant interaction between treatment and pre-existing diabetes (p-value 0.034), and a positive association between maternal weight and LGA neonates (adjusted odds ratio 1.040, 95% confidence interval 1.030-1.051, p < 0.001).
Conclusions:
Aspirin use is associated with increased birthweight without increasing the rate of LGA neonates. Among women with pre-existing diabetes, aspirin may be associated with a higher rate of LGA neonates, warranting further investigation.
Related Concept Videos
01:52Regression Toward the Mean
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...