Indication-based administration of low dose aspirin for the prevention of preeclampsia: A retrospective study in Northern Greece

Introduction: Preeclampsia is a multisystem progressive disorder characterized by vascular abnormalities and coagulation disorders. The administration of low-dose aspirin is recommended before 16 weeks to delay or even avoid the onset of preeclampsia, based on screening tests. This study aimed to investigate the targeted or non-targeted administration of low-dose aspirin in pregnancies, according to the indications for its administration. Material and methods: This was a retrospective cohort study from the medical records of the Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, including pregnant women that were screened for preeclampsia. The parametric or non-parametric distribution of the data was examined using the Shapiro-Wilk test. The association between the intake and the indication for aspirin intake was examined by the x2 independence test for each medical society’s guidelines. The sensitivity, specificity, and positive and negative predictive values of the different criteria were calculated and compared by applying One-Way ANOVA. All results with a p-value < 0.05 were considered statistically significant. Results: In total, 2,716 women were included in the study; a statistically significant relationship between patients’ aspirin-taking behavior and the indication for aspirin according to the FMF, ACOG and NICE criteria was found. Sensitivity was the highest based on NICE criteria (78.6%), while specificity and positive predictive value (PPV) were the highest based on FMF criteria (89.9% and 61.1%, respectively). Conclusion: Applying the FMF criteria for the use of aspirin results in its more targeted administration achieved high sensitivity, specificity and PPV. Examining the number of patients receiving low-dose aspirin in pregnancy without indication could have clinical implications, highlighting the need for better targeting of the population to which it is administered.