Can Aspirin Reduce the Risk of Pre-eclampsia in Pregnant Women?

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Highlights

• Pre-eclampsia is a complication of pregnancy and is a leading cause of maternal and infant illness.
• Scientists have found aspirin drug to be able to reduce the risk of pre-eclampsia in pregnant women.
• The research study has found �definitive proof' of improved outcomes in high-risk pregnancies.

Pre-eclampsia is a complication of pregnancy characterized by high blood pressure and signs of damage to the organ system. It may cause premature birth, and also in extreme cases, maternal and fetal death.

Taking a low-dose of aspirin before bed may help to reduce the risk of pre-eclampsia in pregnant women, finds a trial led by Professor Kypros Nicolaides, King's College London along with Professor David Wright of the University of Exeter.

‘Aspirin has been found to produce �definitive proof� of improving the outcomes in high-risk pregnancies.’

The research study has been published in the journal New England Journal of Medicine.

Low-Dose Aspirin for Pre-Eclampsia
Administering a low-dose aspirin (150mg) can lead to a 62% reduction in the rate of early preterm pre-eclampsia that results in delivery before 37 weeks.

The drug was found to show an 82% reduction in the early pre-eclampsia, resulting in delivery before 34 weeks.

The trial was conducted on 1776 women who were at a high-risk for preterm pre-eclampsia. Aspirin was found to have a lower incidence of developing the disease in women when compared to those taking a placebo.

Preterm eclampsia was found to occur only in 13 participants of the aspirin group when compared to 35 in the placebo group.

All pregnant women were given a dose of 150mg per day between 11 to 14 weeks of pregnancy until the 36 weeks. The results found that low-dose aspirin should be prescribed to women at risk for the disease.

The study results of the trial offered a �definitive proof' of the effect of aspirin said Professor Nicolaides, Director of Harris Birthright Research Centre for Fetal Medicine at King's College London and Chairman of the Fetal Medicine Foundation.

"This extensive study is definitive proof that women can take simple measures in the first trimester of pregnancy to significantly reduce their chances of developing pre-term pre-eclampsia."

David Wright, Professor of Medical Statistics, University of Exeter Medical School, said, "Over the last ten years, we have developed new methods for assessing the risk of pre-eclampsia. We have applied these to identify women for inclusion in the ASPRE trial. The results show that aspirin can prevent pre-eclampsia in high risk pregnancies. I hope that they will alter clinical practice and improve pregnancy outcomes for mothers and their babies."

Study Findings
Aspirin therapy was found to show a 10% lower incidence of pre-eclampsia. More than 30 trials were conducted to find out the benefit of a dose of 50 to 150mg of aspirin for preventing pre-eclampsia.

Based on the participant data in the analysis, the aspirin effect may not be affected by the pregnancy stage on when it was introduced.

However, on other analysis, the aspirin drug which was started at or before 16 weeks of gestation may reduce the rates of preeclampsia by half, fetal-growth restriction and perinatal death. While, aspirin taken after 16 weeks of gestation may not show significant benefit.

The World Health Organization has already recommended low-dose aspirin for the prevention of preeclampsia in women who are at high-risk and also recommends it to be started before 20 weeks of pregnancy.

The Combined Multimarker Screening and Randomized Patient Treatment trial was conducted at 13 maternity hospitals in the United Kingdom, Spain, Italy, Belgium, Greece and Israel.

Women who had a routine prenatal visit in the hospitals, were offered screening for pre-eclampsia.

This was done by combining maternal factors, such as weight, family history and medical history that includes diabetes, mean arterial pressure, uterine-artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor.

The study results will be announced at the 16th FMF World Congress in Fetal Medicine, Slovenia.

Pre-eclampsia
Pre-eclampsia is one of the leading causes of maternal and infant illness and death globally. It may cause the blood flow through the placenta to be reduced. This might restrict the oxygen flow and nutrients to the fetus that could restrict growth.

According to the Preeclampsia Foundation, the disorders are estimated to cause 76,000 maternal and 500,000 infant deaths every year.

Pregnant women with a family history of the condition, who are obese or as a high blood pressure or kidney disease may increase the probability of developing pre-eclampsia.

Around 2% of pregnancies may be with severe preeclampsia while around 6% of them may have mild preeclampsia.

Complications may occur early on in pregnancy. This can lead to premature birth and also in extreme cases it may cause the death of both the baby and the mother.

It is usually characterized by an increase in the blood pressure and protein in the urine. This could occur after the 20th week of pregnancy and may result in pre-term birth.

Complications
Pre-eclampsia may lead to

• Convulsions
• Renal or liver failure
• Cardiac, pulmonary and other maternal health complications

Pre-eclampsia before 37 weeks may contribute to health complications for the baby. This may include growth restriction, developmental delays because of prematurity or even death.



Source: Medindia

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