Efficacy of Aspirin 162 mg per day Prophylaxis for Preeclampsia Prevention in High -Risk Pregnant women
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Abstract
BACKGROUND: Preeclampsia is one of the most serious health issues that affect pregnant Women. It contributes to both maternal and infant morbidity and mortality. Prophylaxis with low-dose aspirin (60-150 mg per day) has been recommended to prevent preeclampsia in pregnant women with high risk. Numerous studies have compared aspirin at a dose greater than the current recommended 81 mg per day, associated with the highest reduction in preterm preeclampsia.
OBJECTIVE: This study aimed to examine the efficacy of aspirin 162 mg versus 81 mg per day for preeclampsia prevention in high-risk pregnant women
METHODS: A Retrospective Cohort study was performed. We collected data on high-risk
pregnant women from the database at Chiangrai Prachanukroh Hospital between 1 January 2016 to 31 May 2023. The sample was divided into 2 groups, the aspirin 162 mg per day group and the aspirin 81 mg per day group. Chi-square test and T-test were used to compare the data in both groups and risk regression analysis to compare the incidence of preeclampsia, maternal& fetal outcomes,95%CI, p value< 0.05.
RESULTS: A total of 372 pregnant women met high-risk criteria. A total of 182 pregnant women received aspirin 162 mg and 190 pregnant women received aspirin 81 mg. The incidence of all gestational age preeclampsia was not significantly different in both groups. But in multivariate data analysis, we found that the aspirin 162 mg experienced a significant 98% reduction in risk preterm preeclampsia before 34 weeks gestation (RR= 0.02, 95%CI;0.00-0.21, p=0.001 ) and a significant 84% reduction in risk preterm delivery 34 weeks gestation(RR= 0.16, 95%CI;0.03-0.78, p=0.024 )
CONCLUSIONS AND RECOMMENDATIONS: In this study demonstrates that aspirin162 mg per day should be recommended for preeclampsia prophylaxis in high-risk pregnant women. Aspirin 162 mg per day was effective in reducing preterm preeclampsia before 34 weeks gestation and reduction for indicated preterm birth, without increased risk for maternal & fetal complications.
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References
Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA. 2002;287(24):3183-6.
Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130-7.
Steegers EA, Von DP, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet 2010;376(9741):631-44.
ACOG practice bulletin no. 202 Summary: gestational hypertension and preeclampsia. Obstet Gynecol 2019;133(1):1.
National Collaborating Centre for Women's and Children's Health (UK). Hypertension in
Pregnancy : the management of hypertensive disorders during pregnancy. RCOG 2010.
Mol BW, Roberts CT, Thangaratinam S, Magee LA, de Groot CJ, Hofmeyr GJ. Pre-eclampsia. Lancet 2016;387(10022):999-1011.
Faculty of Medicine Chiang Mai University, Department of Obstetrics and Gynecology [Internet]. Chiang Mai: Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University; 2020. Guideline for Preeclampsia; n.d. [cited 2021 May 5]. Available from: https://w1.med.cmu.ac.th/obgyn/lessons/guideline-for-preeclampsia/
National Institute for Health and Care Excellence. [Internet]. London: NICE; 2019. Hypertension in pregnancy: diagnosis and management NICE guideline [NG133]; 2023 [cited 2021 May 5]. Available from: https://www.nice.org.uk/guidance/ng133
Henderson JT, Whitlock EP, O’Connor E, Senger CA, Thompson JH, Rowland MG. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160(10):695–703.
ACOG committee opinion no. 743: low-dose aspirin use during pregnancy. Obstetrics & Gynecology. 2018;132(1): 44-52.
ACOG Practice Bulletin No. 202: gestational hypertension and preeclampsia. Obstetrics & Gynecology. 2019. 133(1):1.
Charoenbun C. Low dose aspirin for prevention of preeclampsiaamomg woman at hight risk. Chiangrai Medical Journal. 2021;13(1):153-62.
Tapp S, Guerby P, Girard M, Roberge S, Côté S, Ferreira E, et al. A pilot randomized trial comparing the effects of 80 versus 160 mg of aspirin on midtrimester uterine artery pulsatility index in women with a history ofpPreeclampsia. J Obstet Gynaecol Can. 2020;42(12):1498-504.
Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. Am J Obstet Gynecol. 2017;216(2):110–20. e6.
Van Doorn R, Mukhtarova N, Flyke IP, Lasarev M, Kim K, Hennekens CH, et al. Dose of aspirin to prevent preterm preeclampsia in women with moderate or high-risk factors: a systematic review and meta-analysis. PLoS One. 2021;16(3):e0247782.
