Low daily doses of aspirin during the third trimester significantly reduced the incidence of pregnancy-induced hypertension compared to placebo (11.8% vs 35.5%; P=0.024).
RCT (n=65)
double-blind
randomized
Does low-dose aspirin prevent pregnancy-induced hypertension and pre-eclamptic toxemia in high-risk pregnant women?
Low daily doses of aspirin (100 mg) during the third trimester significantly reduce the incidence of pregnancy-induced hypertension and preeclampsia in high-risk women.
Absolute Event Rate: 11.8% vs 35.5%
p-value: p=0.024
We carried out a prospective, randomized, double-blind, placebo-controlled study to investigate the capacity of aspirin to prevent pregnancy-induced hypertension and to alter prostaglandin metabolism. A total of 791 pregnant women with various risk factors for pre-eclamptic toxemia were screened with use of the rollover test (a comparison of blood pressure before and after the woman rolls from her left side to her back) during week 28 or 29 of gestation. Of 69 women with abnormal results (an increase in blood pressure during the rollover test), 65 entered the study and were treated with a daily dose of either aspirin (100 mg; 34 women) or placebo (31 women) during the third trimester of pregnancy. The number of women in whom pregnancy-induced hypertension developed was significantly lower among the aspirin-treated than among the placebo-treated women (4 11.8 percent vs. 11 35.5 percent; P = 0.024); the same was true for the incidence of preeclamptic toxemia (1 2.9 percent vs 7 22.6 percent; P = 0.019). The mean ratio of serum levels of thromboxane A2 to serum levels of prostacyclin metabolites after three weeks of treatment decreased by 34.7 percent in the aspirin-treated group but increased by 51.2 percent in the placebo-treated group. No serious maternal or neonatal side effects of treatment occurred in either group. We conclude that low daily doses of aspirin taken during the third trimester of pregnancy significantly reduce the incidence of pregnancy-induced hypertension and pre-eclamptic toxemia in women at high risk for these disorders, possibly through the correction of an imbalance between levels of thromboxane and prostacyclin.
Schiff et al. (Thu,) conducted a rct in Pregnancy-induced hypertension and pre-eclamptic toxemia risk (n=65). Aspirin vs. Placebo was evaluated on Pregnancy-induced hypertension (p=0.024). Low daily doses of aspirin during the third trimester significantly reduced the incidence of pregnancy-induced hypertension compared to placebo (11.8% vs 35.5%; P=0.024).