What question did this study set out to answer?

To evaluate the effect of daily low-dose aspirin on maternal hypertensive complications, pregnancy outcomes, and prostacyclin-thromboxane balance in high-risk pregnant women.

September 1, 1993BJOG An International Journal of Obstetrics & Gynaecology

Low dose aspirin in hypertensive pregnant women: effect on pregnancy outcome and prostacyclin‐thromboxane balance in mother and newborn

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Why the study?

Does low-dose aspirin (50 mg/day) prevent hypertensive complications and improve fetal outcomes in pregnant women with pre-existing hypertension or prior severe preeclampsia?

Population

208 pregnant women with pre-existing hypertension or a history of severe preeclampsia in their previous…

Comparison

Aspirin 50 mg/day from a mean of 15 weeks… vs Placebo from a mean of 15 weeks gestational age…

Design

RCT, Randomised (method not specified), Placebo controlled

Follow-up

From mean 15 weeks gestational age to delivery

Authors

LVLasse ViinikkaResearch Council of Finland AHAnna‐Liisa Hartikainen‐SorriUniversity of Oulu RLRiitta LummeHelsinki Metropolia University of Applied Sciences

Discussion

Member takes

Implication

Does not prevent maternal hypertensive complications; challenges routine use for this indication while extending neonatal outcome data.

Key Points

To evaluate the effect of daily low-dose aspirin on maternal hypertensive complications, pregnancy outcomes, and prostacyclin-thromboxane balance in high-risk pregnant women.
Multicenter randomized placebo-controlled trial in Finland enrolling 208 pregnant women with chronic hypertension or a history of severe preeclampsia.
Participants received aspirin (50 mg/day, n=103) or placebo (n=105) from a mean gestational age of 15 weeks until delivery.
Primary endpoints included worsening hypertension, proteinuria, fetal growth, Doppler-assessed fetal hemodynamics, and prostanoid metabolite excretion in mothers and newborns (subgroup n=18).
Aspirin did not significantly reduce the rise of blood pressure without proteinuria (12/97 vs 14/100) or with proteinuria (9/97 vs 11/100).
Fetal hemodynamic disturbances (1/44 vs 6/45, P = 0.05) and neonatal intensive care unit admissions (10/97 vs 21/100, P = 0.04) were significantly lower in the aspirin group.
Aspirin inhibited over 90% of platelet thromboxane A2 production and decreased urinary thromboxane excretion by 65% to 80% without reducing prostacyclin metabolites.

Structured PICO

Does low-dose aspirin (50 mg/day) prevent hypertensive complications and improve fetal outcomes in pregnant women with pre-existing hypertension or prior severe preeclampsia?

Population

208 pregnant women with pre-existing hypertension or a history of severe preeclampsia in their previous pregnancy

Intervention

Aspirin 50 mg/day from a mean of 15 weeks gestational age to delivery

Comparator

Placebo from a mean of 15 weeks gestational age to delivery

Outcome

Exacerbation of pre-existing hypertension or the appearance of hypertension in previously normotensive women, the appearance of proteinuria, and fetal growthhard clinical

Low-dose aspirin (50 mg/day) in high-risk pregnant women did not prevent the rise of maternal hypertension but improved fetal haemodynamic performance and reduced the need for intensive neonatal care.

Cite This Study

Viinikka et al. (1993) studied this question.

synapsesocial.com/papers/6a7c5effe7cf49620a26bcc5 https://doi.org/10.1111/j.1471-0528.1993.tb14304.x

Topics

Hypertension management

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Low dose aspirin in hypertensive pregnant women: effect on pregnancy outcome and prostacyclin‐thromboxane balance in mother and newborn

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Low dose aspirin in hypertensive pregnant women: effect on pregnancy outcome and prostacyclin‐thromboxane balance in mother and newborn

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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