Friday, April 24, 2020

Low-Dose Aspirin Cuts Preterm Delivery in Nulliparous Women

In continuation of my update on aspirin 

Among nulliparous women with singleton pregnancies from low-income and middle-income countries, the incidence of preterm delivery before 37 weeks is reduced for those receiving low-dose aspirin versus placebo, according to a study published in the Jan. 25 issue of The Lancet.

Matthew K. Hoffman, M.D., from Christiana Care in Newark, Delaware, and colleagues conducted a randomized trial of low-dose aspirin initiated between 6 weeks 0 days of pregnancy and 13 weeks 6 days of pregnancy in nulliparous women from seven community sites in six countries (India, the Democratic Republic of the Congo, Guatemala, Kenya, Pakistan, and Zambia). A total of 11,976 women aged 14 to 40 years were randomly assigned to receive either low-dose aspirin (5,990 women) or placebo (5,786 women); 5,780 and 5,764 women, respectively, were included in the primary outcome analysis.
The researchers found that preterm birth before 37 weeks occurred in 11.6 and 13.1 percent of the women who took aspirin and placebo, respectively (relative risk, 0.89; 95 percent confidence interval, 0.81 to 0.98). Women who took aspirin had significant reductions in perinatal mortality, fetal loss (infant death after 16 weeks of gestation and before seven days postpartum), early preterm delivery (<34 weeks), and incidence of delivery before 34 weeks with hypertensive disorders of pregnancy (relative risk [95 percent confidence interval], 0.86 [0.73 to 1.00], 0.86 [0.74 to 1.00], 0.75 [0.61 to 0.93], and 0.38 [0.17 to 0.85], respectively).
"Our results suggest that low-dose aspirin therapy in early pregnancy could provide an inexpensive way to lower the preterm birth rate in first-time mothers," a coauthor said in a statement.

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