The Safety of Low-Dose Aspirin on the Mode of Delivery: Secondary Analysis of the Effect of Aspirin in Gestation and Reproduction Randomized Controlled Trial

2020 ◽  
Author(s):  
Allison A. Eubanks ◽  
Carrie J. Nobles ◽  
Sunni L. Mumford ◽  
Keewan Kim ◽  
Micah J. Hill ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Live Birth ◽  
Low Dose ◽  
Controlled Trial ◽  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Clinical Effects ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Intent To Treat

Objective This study aimed to examine whether prenatal low-dose aspirin (LDA) therapy affects risk of cesarean versus vaginal delivery. Study Design This study is a secondary analysis of the randomized clinical effects of aspirin in gestation and reproduction (EAGeR) trial. Women received 81-mg daily aspirin or placebo from preconception to 36 weeks of gestation. Mode of delivery and obstetric complications were abstracted from records. Log-binomial regression models estimated relative risk (RR) of cesarean versus vaginal delivery. Data were analyzed among the total preconception cohort, as well as restricted to women who had a live birth. Results Among 1,228 women, 597 had a live birth. In the intent-to-treat analysis, preconception-initiated LDA was not associated with risk of cesarean (RR = 1.02; 95% confidence interval [CI]: 0.98–1.07) compared with placebo. Findings were similar in just women with a live birth and when accounting prior cesarean delivery and parity. Conclusion Preconception-initiated daily LDA was not associated with mode of delivery among women with one to two prior losses. Key Points

Effect of Low-Dose Aspirin on the Time of Onset of Preeclampsia and Time of Delivery

2017 ◽  
Vol 34 (12) ◽  
pp. 1219-1226 ◽  
Author(s):  
Caroline Marrs ◽  
Maged Costantine ◽  
Luis Pacheco ◽  
George Saade ◽  
Giuseppe Chiossi ◽  
...  
Keyword(s):  
High Risk ◽  
Gestational Age ◽  
Low Dose ◽  
Controlled Trial ◽  
Secondary Analysis ◽  
High Risk Women ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Multicenter Randomized Controlled Trial ◽  
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.

scholarly journals The impact of low dose aspirin on the mode of delivery: secondary analysis of the effect of aspirin in gestation and reproduction (eager) trial

2018 ◽  
Vol 110 (4) ◽  
pp. e79
Author(s):  
A. Eubanks ◽  
C.J. Nobles ◽  
S. Mumford ◽  
M.J. Hill ◽  
A.H. DeCherney ◽  
...  
Keyword(s):  
Low Dose ◽  
Mode Of Delivery ◽  
Secondary Analysis ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
The Impact

scholarly journals Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial

2017 ◽  
Vol 102 (5) ◽  
pp. 1495-1504 ◽  
Author(s):  
Lindsey A. Sjaarda ◽  
Rose G. Radin ◽  
Robert M. Silver ◽  
Emily Mitchell ◽  
Sunni L. Mumford ◽  
...  
Keyword(s):  
Live Birth ◽  
Pregnancy Loss ◽  
Low Dose ◽  
Secondary Analysis ◽  
Low Grade ◽  
Birth Rates ◽  
Live Birth Rates ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Low Grade Inflammation

Abstract Context: Inflammation is linked to causes of infertility. Low-dose aspirin (LDA) may improve reproductive success in women with chronic, low-grade inflammation. Objective: To investigate the effect of preconception-initiated LDA on pregnancy rate, pregnancy loss, live birth rate, and inflammation during pregnancy. Design: Stratified secondary analysis of a multicenter, block-randomized, double-blind, placebo-controlled trial. Setting: Four US academic medical centers, 2007 to 2012. Participants: Healthy women aged 18 to 40 years (N = 1228) with one to two prior pregnancy losses actively attempting to conceive. Intervention: Preconception-initiated, daily LDA (81 mg) or matching placebo taken up to six menstrual cycles attempting pregnancy and through 36 weeks’ gestation in women who conceived. Main Outcome Measures: Confirmed pregnancy, live birth, and pregnancy loss were compared between LDA and placebo, stratified by tertile of preconception, preintervention serum high-sensitivity C-reactive protein (hsCRP) (low, &lt;0.70 mg/L; middle, 0.70 to &lt;1.95 mg/L; high, ≥1.95 mg/L). Results: Live birth occurred in 55% of women overall. The lowest pregnancy and live birth rates occurred among the highest hsCRP tertile receiving placebo (44% live birth). LDA increased live birth among high-hsCRP women to 59% (relative risk, 1.35; 95% confidence interval, 1.08 to 1.67), similar to rates in the lower and mid-CRP tertiles. LDA did not affect clinical pregnancy or live birth in the low (live birth: 59% LDA, 54% placebo) or midlevel hsCRP tertiles (live birth: 59% LDA, 59% placebo). Conclusions: In women attempting conception with elevated hsCRP and prior pregnancy loss, LDA may increase clinical pregnancy and live birth rates compared with women without inflammation and reduce hsCRP elevation during pregnancy.

scholarly journals Effect of preconception low dose aspirin on pregnancy and live birth according to socioeconomic status: A secondary analysis of a randomized clinical trial

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0200533 ◽  
Author(s):  
Shilpi Agrawala ◽  
Lindsey A. Sjaarda ◽  
Ukpebo R. Omosigho ◽  
Neil J. Perkins ◽  
Robert M. Silver ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Socioeconomic Status ◽  
Randomized Clinical Trial ◽  
Live Birth ◽  
Low Dose ◽  
Secondary Analysis ◽  
Dose Aspirin ◽  
Low Dose Aspirin
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