Abstract
Background: The role of aspirin in preventing preeclampsia is a topic of debate since long time. Till now its recommended only for high risk cases with wide range of variations in protocol from country to country.
Methods: We conducted a double-blind, randomized, placebo-controlled trial in four groups of pregnant women at high risk for preeclampsia, including 471 women with pregestational insulin-treated diabetes mellitus, 774 women with chronic hypertension, 688 women with multifetal gestations, and 606 women who had had preeclampsia during a previous pregnancy. The women were enrolled between gestational weeks 13 and 26 and received either 75 mg of aspirin or placebo daily.
Results: Outcome data were obtained on all but 36 of the 2600 women who entered the study. The incidence of preeclampsia was similar in the 1300 women in the aspirin group and the 1300 women in the placebo group (aspirin, 18 percent; placebo, 20 percent; P = 0.23). The incidences in the aspirin and placebo groups for each of the four high-risk categories were also similar: for women with pregestational diabetes mellitus, the incidence was 20 percent in the aspirin group and 21 percent in the placebo group (P = 0.38); for women with chronic hypertension, 24 percent and 26 percent (P = 0.66); for those with multifetal gestations, 15 percent and 17 percent (P = 0.10); and for those with preeclampsia during a previous pregnancy, 18 percent and 18 percent (P = 0.47). In addition, the incidences of perinatal death, preterm birth, and infants small for gestational age were similar in the aspirin and placebo groups.
Conclusions: In our study, low-dose aspirin did not reduce the incidence of preeclampsia significantly or improve perinatal outcomes in pregnant women at high risk for preeclampsia.
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Corresponding Author
Varnica Psyche
DMCH Darbhanga
DOI: https://dx.doi.org/10.18535/jmscr/v6i1.11
