Related Experiment Video
Updated: Jan 10, 2026
Comprehensive Evaluation of the Effectiveness and Safety of Placenta-Targeted Drug Delivery Using Three Complementary Methods
Published on: September 10, 2018
Effect of Targeted Aspirin Administration Based on First Trimester Combined Screening for Preeclampsia on Preterm
Monica Minopoli1, Alicia Martínez-Varea2, Claire Pegorie1
1Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK.
Insights
An aspirin intervention program did not significantly reduce preterm birth (PTB) rates in high-risk pregnancies. While some outcomes improved, further interventions are needed for substantial PTB reduction.
Area of Science:
- Maternal-fetal medicine
- Obstetrics
- Public health
Background:
- First-trimester screening identifies high-risk pregnancies for preterm preeclampsia and preterm birth (PTB).
- Aspirin prophylaxis is used to mitigate risks in these high-risk pregnancies.
Purpose of the Study:
- To evaluate the impact of an aspirin intervention program on PTB rates.
- To assess the program's effect on spontaneous preterm birth (sPTB) and iatrogenic preterm birth (iPTB) in high-risk women.
Main Methods:
- Retrospective study utilizing interrupted time series analysis (ITSA) with an ARIMA model.
- Analysis of 31,534 pregnancies between 2016 and 2022 at St George's University Hospital.
- Inclusion of women followed from the first trimester.
Main Results:
- No significant impact of the aspirin intervention program on overall PTB rates was found.
- A nonsignificant decreasing trend in total PTB and iatrogenic PTB (iPTB) was observed.
- Similar trends were noted for early PTB (<34 weeks).
Conclusions:
- First-trimester screening effectively identifies women at high risk for PTB.
- Aspirin prophylaxis and serial assessments did not significantly reduce spontaneous or iatrogenic PTB rates.
- Additional interventions are necessary to substantially decrease PTB in high-risk populations.
Objectives:
To assess the effect of an aspirin intervention program on preterm birth (PTB) rates in women identified as high-risk for preterm preeclampsia in the first-trimester screening.
Design:
This is a retrospective study evaluating the impact of the intervention program on preterm birth using interrupted time series analysis (ITSA) with an ARIMA model that accounts for seasonality and autocorrelation.
Setting:
St George's University Hospital, data collected on pregnancies between 2016 and 2022.
Population:
Pregnant women followed from the first trimester of pregnancy.
Methods:
An ITSA was conducted on the studied population to assess whether the introduction of an aspirin intervention program, based on first-trimester screening, influenced preterm birth rates.
Main Outcome Measures:
Primary outcomes included overall PTB rates, while secondary outcomes included iatrogenic preterm birth (iPTB) and spontaneous preterm birth (sPTB).
Results:
Among 31 534 births, there were 1435 PTBs: 734 spontaneous and 701 iatrogenic. ITSA analysis revealed no significant impact of the screening program on PTB rates. There was a nonsignificant decrease in total PTB and iPTB over time, with similar trends observed for early PTB (< 34 weeks).
Conclusions:
First-trimester screening for preterm preeclampsia identifies women at higher risk for both preterm preeclampsia and PTB. While aspirin prophylaxis and serial assessments improve some perinatal outcomes, they do not significantly reduce spontaneous or iatrogenic PTB rates. Additional interventions will be needed to achieve a substantial reduction in PTB rates in a high-risk population.
Related Concept Videos
01:07Teratogenicity
01:52Regression Toward the Mean
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
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,...