Treatment with low-dose aspirin may lower the risk of preterm preeclampsia among pregnant women at high risk for the condition, new study findings suggest.
In a study, the odds of preeclampsia developing before 37 weeks of gestation were 62% lower among women who took 150 mg of aspirin daily during pregnancy compared with women who took placebo, Daniel L. Rolnik, MD, of Homerton University Hospital in London, and colleagues reported in the New England Journal of Medicine (2017;377:613-622).
The investigators enrolled 1776 women with singleton pregnancies determined to be at high risk for preeclampsia by means of first trimester screening. The researchers randomly assigned patients to receive aspirin at a dose of 150 mg per day or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation. After 152 patients withdrew consent during the trial and the loss of 4 patients to follow up, 798 women in the aspirin group and 822 in the placebo group remained in the trial.
Preterm preeclampsia developed in 13 women (1.6%) in the aspirin group versus 35 (4.3%) in the placebo group, a statistically significant difference in incidence. The aspirin and placebo groups were similar with respect to the incidence of neonatal adverse outcomes or other adverse events.
“Unlike previous trials of strategies to reduce the risk of preeclampsia among high-risk women, we identified women at high risk for preterm preeclampsia by means of combined screening with maternal demographic characteristics and historical factors and biomarkers — a strategy that has been shown to be superior to other currently used methods,” Dr Rolnik’s group wrote.
Rolnik DL, Wright D, Poon LC, et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med 2017;377:613-622). doi: 10.1056/NEJMoa1704559