Peri-conception use of low-dose aspirin and gestational age at delivery

Objective To determine whether low-dose aspirin (LDA) affects the time of onset of preeclampsia and the time of delivery in high-risk women. Study Design Secondary analysis of a multicenter randomized controlled trial of LDA (60 mg) in high-risk women. Quantile regression was used to identify the median gestational age at preeclampsia diagnosis and median gestational age at delivery, whereas logistic regression was used to determine the likelihood of preeclampsia-indicated delivery within 7 days. Results Total of 2,479 women were randomized and 461 developed preeclampsia. The mean gestational age at enrollment was 20 ± 4 weeks. On multivariate analysis, LDA did not affect the time of preeclampsia diagnosis (coefficient −0.4 weeks, 95% CI: −1.1 to 0.2; p = 0.2), time of delivery (coefficient 0 weeks, 95% CI: −0.3 to 0.3; p = 1), or likelihood of preeclampsia-indicated delivery within 7 days (OR = 0.8; 95% CI: 0.5–1.2; p = 0.2). In multifetal gestations, preeclampsia was diagnosed at least 1 week earlier than women with diabetes or previous preeclampsia (p < 0.05), and delivery occurred at least 2 weeks prior (p < 0.001). Conclusion LDA prophylaxis did not significantly affect time of diagnosis of preeclampsia, time of delivery, or likelihood of preeclampsia-indicated delivery within 7 days. LDA prophylaxis did not significantly affect time of diagnosis of preeclampsia, time of delivery, or likelihood of preeclampsia-indicated delivery within 7 days.

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AB0372 PREGNANCY OUTCOME IN WOMEN WITH SJÖGREN SYNDROME IS OFTEN COMPLICATED BY PLACENTA INSUFFICIENCY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5725 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1486.2-1486

Author(s):

I. Troester ◽

F. Kollert ◽

A. Zbinden ◽

L. Raio ◽

F. Foerger

Keyword(s):

Pregnancy Outcome ◽

Preterm Delivery ◽

Gestational Age ◽

Small For Gestational Age ◽

Low Dose ◽

Sjögren Syndrome ◽

Sjogren Syndrome ◽

Live Births ◽

Dose Aspirin ◽

Low Dose Aspirin

Background:Chronic inflammatory rheumatic diseases are often associated with a negative effect on pregnancy outcome. Most obstetrical complications are placenta-mediated such as preterm delivery and growths restrictions. In women with Sjögren syndrome, data on placenta- mediated complications are scarce and conflicting (1,2).Objectives:To analyse neonatal outcome in women with Sjögren syndrome with focus on preterm delivery and growth restriction.Methods:We retrospectively analysed 23 pregnancies of 16 patients with Sjögren syndrome that were followed at our centre with regard to pregnancy outcome, medication and disease characteristics. Small for gestational age was defined as birthweight percentile <10th. Preterm delivery was defined as delivery before 37, early term as delivery between 37-39 and term as delivery between 39-42 weeks of gestation.Results:Of 23 pregnancies, one ended in a miscarriage and 22 resulted in live births including one set of twins. Treatment used during pregnancy was hydroxychloroquine (20 pregnancies), prednisone (8), azathioprine (5) and cyclosporine (2). Concomitant treatment with low-dose aspirin was used in 9 pregnancies.Of the 22 live births, 17 were born at early term and 5 at term. There were no preterm deliveries. Median birth weight was 2820g (range 2095-3845g). Nine newborns (40.9%) were small for gestational age (SGA). Maternal treatment during these pregnancies was hydroxychloroquine in all cases and additional low-dose aspirin in three cases. Elevated CRP levels during pregnancy were found in 57% of the cases with SGA outcome. Only one woman with an SGA infant had positive anti-phospholipid antibodies.Regarding delivery mode, most patients had caesarean sections.Conclusion:In our cohort of women with Sjögren syndrome the prevalence of small for gestational age infants was high despite maternal treatment with hydroxychloroquine. Inflammatory markers could help to identify the patients at risk for placental insufficiency, yet prospective studies of larger cohorts are needed.References:[1]Gupta S et al; Sjögren Syndrome and Pregnancy: A literature review. Perm J 2017; 21:16-047[2]De Carolis S et al; The impact of primary Sjögren’s syndrome on pregnancy outcome: Our series and review of the literature. Autoimmun Rev 2014; 13(2):103-7Disclosure of Interests:Isabella Troester: None declared, Florian Kollert Employee of: Novartis, Astrid Zbinden: None declared, Luigi Raio: None declared, Frauke Foerger Grant/research support from: unrestricted grant from UCB, Consultant of: UCB, GSK, Roche, Speakers bureau: UCB, GSK

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Low-Dose Aspirin in Early Gestation for Prevention of Preeclampsia and Small-for-Gestational-Age Neonates: Meta-analysis of Large Randomized Trials

American Journal of Perinatology ◽

10.1055/s-0036-1572495 ◽

2016 ◽

Vol 33 (08) ◽

pp. 781-785 ◽

Cited By ~ 21

Author(s):

Stéphanie Roberge ◽

Baha Sibai ◽

Affette McCaw-Binns ◽

Emmanuel Bujold

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Randomized Trials ◽

Low Dose ◽

Meta Analysis ◽

Early Gestation ◽

Dose Aspirin ◽

Low Dose Aspirin

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Effect of low dose aspirin on fetal outcome in women at risk for developing pregnancy induced hypertension

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20201145 ◽

2020 ◽

Vol 7 (4) ◽

pp. 865

Author(s):

Madhusmita Pradhan ◽

Jyotiranjan Champatiray ◽

Kishore V. S.

Keyword(s):

Birth Weight ◽

High Risk ◽

Low Birth Weight ◽

Pregnant Women ◽

Gestational Age ◽

Low Dose ◽

Pregnancy Induced Hypertension ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Induced Hypertension

Background: Though pregnancy induced hypertension is a worldwide problem, it is more prevalent in developing countries particularly south east Asian and African countries. It contributes to 20% of perinatal death and 40-50% of low birth weight babies in India. Fetal salvage is also an important consideration in providing quality care. Low dose aspirin given between 12 weeks to 28 weeks of gestational age in high-risk women at Developing Pregnancy Induced Hypertension (PIH) is anticipated to prevent the development of PIH and complications that arises especially those regarding maternal and fetal mortality due to PIH.Methods: This prospective randomized controlled trial was conducted in the dept of O and G, SCB MC and Hospital, Cuttack during November 2018 to October 2019. Pregnant women between the gestational age of 13 to 28 week were screened for risk factors and included in this study. Low dose aspirin of 60 mg daily till delivery was given to pregnant women who consented to be a part of study randomly with the other group taking placebo.Results: Incidence of IUGR babies in low dose aspirin treated mothers was as low as 1%. Incidence of LBW babies is lower in low dose aspirin treated mothers than with those who were not treated. Mean birth weight in cases was 2780 gm±352 gm vs control 2592 gm±483 gm. There is increased incidence of still birth in high risk group not treated with aspirin. No significant difference in reducing incidence premature deliveries between case and control.Conclusions: Low dose aspirin has a definite role in the prevention of PIH in high risk pregnancy and its complication like IUGR and low birth weight. Low dose aspirin reduces the incidence of PIH. Low dose aspirin can be considered a safe drug without any deleterious side effect for mother and the fetus. Benefits of prevention of PIH, justifies its administration in women at high risk.

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Administration of low-dose aspirin to mothers with small for gestational age fetuses and abnormal umbilical Doppler studies to increase birthweight: a randomised double-blind controlled trial

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2000.tb13319.x ◽

2000 ◽

Vol 107 (5) ◽

pp. 703-703

Author(s):

Brian Trudinger

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Low Dose ◽

Controlled Trial ◽

Doppler Studies ◽

Double Blind ◽

Dose Aspirin ◽

Low Dose Aspirin

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Low dose aspirin for preventing fetal growth restriction: a randomised trial

Journal of Perinatal Medicine ◽

10.1515/jpm-2017-0184 ◽

2018 ◽

Vol 46 (7) ◽

pp. 776-779 ◽

Cited By ~ 6

Author(s):

Anca-Daniela Stanescu ◽

Roxana Banica ◽

Romina-Marina Sima ◽

Liana Ples

Keyword(s):

Fetal Growth ◽

Gestational Age ◽

Fetal Growth Restriction ◽

Low Dose ◽

Growth Restriction ◽

Controlled Study ◽

Dose Aspirin ◽

Low Dose Aspirin ◽

Group A ◽

Group B

AbstractThe purpose of this study was to investigate when in pregnancy to stop the administration of low dose aspirin (150 mg/daily) so as to prevent fetal growth restriction (FGR) A randomised, placebo-controlled study was designed. The patients were all screened positive using the Fetal Medicine Foundation (FMF) early pregnancy screening test for preeclampsia (PE) and FGR prediction. One hundred and fifty patients were enrolled and divided equally into three groups: A – the controls who received placebo treatment; B – those who received aspirin till 32 weeks of gestation and C – those who received aspirin till 36 weeks of gestation. The mean gestational age at enrollment was similar for all the groups (12.4 weeks). The growth curves, fetal and maternal Doppler measurements and amniotic fluid index (AFI) were monitored every 4 weeks. Also, the outcome of the pregnancy was noted and all the results were compared between the groups. FGR was defined as a fetal weight below the 10thcentile for gestational age. In group C, there were less cases of FGR compared with the other groups: 6% vs. 10% in group B vs. 24% in controls. Also, there was a significant birth weight improvement in this group with a median of 3180 g compared with 2950 g in group B and 2760 g in group A (P=0.01). The gestational age at delivery was similar in all the groups (39 weeks in group C/39.2 weeks in group B/38.6 weeks in group A). In conclusion, low dose aspirin improves the outcome in the selected population and should be offered for prevention of FGR from 12 to 36 weeks.

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