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Published on: June 29, 2013
Low dose aspirin for the treatment of fetal growth restriction: a randomized controlled trial
J P Newnham1, M Godfrey, B J Walters
1University Department of Obstetrics and Gynaecology, King Edward Memorial Hospital for Women, Perth, Western Australia.
Insights
Low-dose aspirin did not improve birth outcomes for pregnancies with fetal growth restriction. This daily treatment did not significantly alter birth weight or neonatal size measures in affected pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Pharmacology
Background:
- Fetal growth restriction (FGR) and umbilical-placental insufficiency are significant complications in pregnancy.
- Effective treatments to improve neonatal outcomes in these high-risk pregnancies are crucial.
Purpose of the Study:
- To investigate if daily maternal aspirin (100mg) improves birth weight and neonatal size in FGR pregnancies.
- To assess aspirin's effect on umbilical-placental insufficiency indicators.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 51 pregnant women.
- Inclusion criteria: Fetal abdominal circumference <10th percentile and umbilical artery Doppler S/D ratio >95th percentile (28-36 weeks gestation).
- Aspirin compliance assessed via maternal serum thromboxane B2 levels.
Main Results:
- No significant differences observed between aspirin and placebo groups in gestational age at birth, birth weight, neonatal size measurements, or neonatal morbidity.
- Low-dose aspirin did not alter umbilical artery Doppler systolic/diastolic ratios.
- Aspirin significantly reduced thromboxane B2 levels, but 10.5% of women lacked biochemical confirmation of ingestion.
Conclusions:
- Daily low-dose aspirin therapy (100mg) offers no benefit for pregnancies complicated by FGR and umbilical-placental insufficiency between 28-36 weeks gestation.
- Further research may be needed to explore alternative interventions for these conditions.
Abstract:
The purpose of this study was to investigate the hypothesis that maternal administration of 100mg aspirin each day will improve birth-weight and other measures of neonatal size when given as a treatment to pregnancies complicated by fetal growth restriction and umbilical-placental insufficiency. A randomized, double-blind, placebo controlled study design was employed; 51 pregnant women were enrolled. The entry criteria were a fetal abdominal circumference < 10th per centile together with an umbilical artery Doppler systolic/diastolic ratio > 95th per centile between 28 and 36 weeks' gestation. Compliance was assessed by serial measurement of maternal serum thromboxane B2 levels. The mean gestational age at enrolment was 32 weeks and at delivery was 36 weeks. There were no differences between the 2 groups in gestational age at birth; birth-weight or birth-weight ratio; circumferences of the head, chest or abdomen; skin fold thicknesses; or neonatal morbidity. Low dose aspirin therapy did not alter Doppler systolic/diastolic ratios. After 14 days therapy, mean thromboxane B2 levels fell more than 80% from baseline values; 10.5% of women did not demonstrate biochemical confirmation of aspirin ingestion, despite verbal confirmation of compliance. We conclude that low dose aspirin therapy is not of benefit in the treatment of pregnancies complicated by fetal growth restriction and umbilical-placental insufficiency between 28 and 36 weeks' gestation.
