Aspirin for evidence-based preeclampsia prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history.
Journal article
Poon, L.C., Wright, D., Rolnik, D.L., Syngelaki, A., Delgado, J.L., Tsokaki, T., Leipold, G., Akolekar, R., Shearing, S., De Stefani, L., Jani, J.C., Plasencia, W., Evangelinakis, N., Gonzalez-Vanegas, O., Persico, N., Nicolaides, K.H. and Allen, A. 2017. Aspirin for evidence-based preeclampsia prevention trial: effect of aspirin in prevention of preterm preeclampsia in subgroups of women according to their characteristics and medical and obstetrical history. American Journal of Obstetrics & Gynecology. 217 (5), pp. 585.e1- 5.. https://doi.org/10.1016/j.ajog.2017.07.038
Authors | Poon, L.C., Wright, D., Rolnik, D.L., Syngelaki, A., Delgado, J.L., Tsokaki, T., Leipold, G., Akolekar, R., Shearing, S., De Stefani, L., Jani, J.C., Plasencia, W., Evangelinakis, N., Gonzalez-Vanegas, O., Persico, N., Nicolaides, K.H. and Allen, A. |
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Abstract | Objective: To examine whether there are differences in the effect of aspirin on the incidence of preterm-PE in the ASPRE trial in subgroups defined according to maternal characteristics and medical and obstetrical history. Study design: This was a secondary analysis of data from the ASPRE trial. In ASPRE women with singleton pregnancies had screening by means of an algorithm that combines maternal factors and biomarkers at 11-13 weeks’ gestation. Those with an estimated risk for preterm-PE of >1 in 100 were invited to Results: There was no evidence of heterogeneity in the aspirin effect in subgroups defined according to maternal characteristics and obstetrical history. In participants with chronic hypertension preterm-PE occurred in 10.2% (5/49) in the aspirin group and in 8.2% (5/61) in the placebo group (adjusted odds ratio 1.29, 95% confidence interval, 0.33 to 5.12); the respective values in those without chronic hypertension were 1.1% (8/749) in the aspirin group and 3.9% (30/761) in the placebo group (adjusted odds ratio 0.27, 95% confidence interval, 0.12 to 0.60). In all participants with adherence of >90% the adjusted odds ratio in the aspirin group was 0.24 (95% CI 0.09 to 0.65), in the subgroup with chronic hypertension it was 2.06 (95% CI 0.40 to 10.71) and in those without chronic hypertension it was 0.05 (95% CI 0.01 to 0.41). For the complete data set the test of interaction was not significant at the 5% level (p=0.055), but in those with adherence >90%, after adjustment for multiple comparisons, the interaction was significant at the 5% level (p=0.0019). Conclusions: The beneficial effect of aspirin in the prevention of preterm preeclampsia may not apply in pregnancies with chronic hypertension. There was no evidence of heterogeneity in the aspirin effect in subgroups defined according to maternal characteristics and obstetrical history. |
Keywords | First trimester screening; Aspirin; ASPRE trial; Preeclampsia; Chronic hypertension; Uterine artery Doppler; Mean arterial blood pressure; Placental growth factor; Pregnancy associated plasma protein-A |
Year | 2017 |
Journal | American Journal of Obstetrics & Gynecology |
Journal citation | 217 (5), pp. 585.e1- 5. |
Publisher | Elsevier |
ISSN | 00029378 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.ajog.2017.07.038 |
Official URL | https://doi.org/10.1016/j.ajog.2017.07.038 |
Publication dates | |
Online | 04 Aug 2017 |
Nov 2017 | |
Publication process dates | |
Accepted | 31 Jul 2017 |
Deposited | 15 Jun 2020 |
Accepted author manuscript | |
Output status | Published |
References | 1. Rolnik DL, Wright D, Poon LC, et al. Aspirin |
Additional information | Erratum dated 2018-04-01 |
https://repository.canterbury.ac.uk/item/8v96y/aspirin-for-evidence-based-preeclampsia-prevention-trial-effect-of-aspirin-in-prevention-of-preterm-preeclampsia-in-subgroups-of-women-according-to-their-characteristics-and-medical-and-obstetrical
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