Beyond preeclampsia: low dose aspirin as a preventative strategy for spontaneous preterm birth

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Pharmacology

Background:

• Spontaneous preterm birth (PTB) is a major global health concern with complex causes.
• Placental insufficiency is a key factor in PTB and preterm pre-eclampsia (PE).
• Low-dose aspirin (LDA) is proven to prevent preterm PE by addressing placental insufficiency.

Purpose of the Study:

• To review current evidence on LDA's effectiveness in preventing spontaneous PTB.
• To explore LDA's role in different patient subgroups, including those at risk for PE and with a history of PTB.

Main Methods:

• Narrative review of existing scientific literature and clinical studies.
• Analysis of findings related to LDA dosage, timing, and patient populations.
• Examination of factors influencing treatment adherence and effectiveness.

Main Results:

• LDA initiated before 16 weeks gestation at ≥100 mg daily prevents PTB in patients at risk for preterm PE.
• Emerging data indicates LDA may reduce PTB in nulliparous women, though confirmation is pending.
• Studies suggest a potential preventive effect of LDA in women with prior spontaneous PTB, but require larger trials.

Conclusions:

• LDA shows promise as a safe, cost-effective strategy for spontaneous PTB prevention.
• Effectiveness may vary among subgroups based on PTB etiology.
• Future research should prioritize implementation studies focusing on adherence and subgroup identification.