Key result
Following the introduction of a national guideline, the percentage of Dutch gynecologists prescribing aspirin for a history of preeclampsia at term increased from 15% in 2016 to 97% in 2021.
Why the study?
To evaluate the implementation of low-dose aspirin in pregnancy for preventing utero-placental complications among gynecologists in the Netherlands following the introduction of a national guideline.
Did the introduction of a national guideline improve the prescription of aspirin in pregnancy among Dutch gynecologists?
Cross-Sectional (n=364)
Yes
Did the introduction of a national guideline improve the prescription of aspirin in pregnancy among Dutch gynecologists?
The implementation of a national guideline significantly increased the self-reported prescription of low-dose aspirin for the prevention of utero-placental complications among Dutch gynecologists.
Guideline implementation was associated with higher aspirin prescribing; leaves open whether this improves real-world preeclampsia outcomes.
OBJECTIVE: To evaluate the implementation of low-dose aspirin in pregnancy for the prevention of utero-placental complications among gynecologists in the Netherlands between 2016 and 2021. In this timeframe, a national guideline about aspirin in pregnancy was introduced by the Dutch Society of Obstetrics and Gynecology. MATERIALS AND METHODS: A national online survey among Dutch gynecologists and residents was performed. An online questionnaire was distributed among the members of the Dutch Society of Obstetrics and Gynecology in April 2016 and April 2021. Main outcome measure was the proportion of gynecologists indicating prescription of aspirin in pregnancy for high and moderate risk indications. RESULTS: In 2016, 133 respondents completed the survey, and in 2021 231. For all indications mentioned in the guideline there was an increase in prescribing aspirin in 2021 in comparison to 2016. More specifically, the percentage of gynecologists prescribing aspirin for a history of preeclampsia before 34 weeks, between 34 and 37 weeks and at term increased from respectively 94% to 100%, 39% to 98%, and 15% to 97%. Consultant obstetricians and respondents working in an university hospital did not more often indicate the prescription of aspirin for tertiary care indications in 2021. Future use of a prediction model was suggested in the narrative comments. CONCLUSION: Implementation of aspirin in pregnancy among Dutch gynecologists substantially improved after a five year timeframe in which the national guideline on aspirin during pregnancy was introduced and trials confirming the effect of aspirin were published.
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Weg et al. (2022) conducted a cross-sectional in Pregnancy / Utero-placental complications (n=364). Survey year 2021 (post-guideline) vs. Survey year 2016 (pre-guideline) was evaluated on Proportion of gynecologists indicating prescription of aspirin in pregnancy for high and moderate risk indications. Following the introduction of a national guideline, the percentage of Dutch gynecologists prescribing aspirin for a history of preeclampsia at term increased from 15% in 2016 to 97% in 2021.
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