Key result
Non-response to acetylsalicylic acid was found in 30.7% of pregnant women and was significantly associated with a higher rate of obstetric complications (23.08% vs 7.7%; p=0.008).
Why the study?
Despite recommendations for low-dose acetylsalicylic acid (ASA) in pregnancy, clinical efficacy varies due to resistance, prompting assessment of biological response using platelet occlusion time (POT).
Cross-Sectional (n=39)
Yes
Nearly one-third of pregnant women taking low-dose acetylsalicylic acid exhibit biological non-response, which is significantly associated with a higher incidence of obstetric complications.
Answers are grounded in this paper and cite their sources.
ASA non-response by POT occurred in 31% and was associated with complications; leaves open whether monitoring improves outcomes.
Low-dose acetylsalicylic acid (ASA) has been recommended for pregnant women since 2011 by the OMS to prevent thrombotic phenomena. Despite the variability of its clinical efficacy (resistance phenomena), its non-standardized biological monitoring can be performed using platelet occlusion time (POT). The aim of this study was to assess the response to ASA using POT. A multicenter, cross-sectional, analytical study was conducted in the obstetrics and gynaecology departments of six Brazzaville hospitals over a period of 09 months and included pregnant women on ASA 100 mg daily for at least 7 days. POT was measured using the INNOVANCE® PFA®-200 system. The variables studied were clinical (age, medical and obstetrical history) and biological (blood count, POT). Non-response to ASA was defined by a POT of 150 seconds or less. Data analysis was performed using STATA 12 software. Logistic regression was used to assess the determinants associated with non-response. The incidence of obstetric complications according to ASA resistance was evaluated by the Kaplan-Meier method and the Log-Rank test. The significance threshold was p<0.005. The study involved 39 pregnant women, mean age 33.9 ± 5.4 years, treated with ASA for hypertensive disorders of pregnancy n=19 (48.7%), chronic arterial hypertension n=7 (18%), diabetes n=3(7.7%) fetal death n=3(7.7%), unexplained miscarriage n=3(7.7%), advanced age n=2 (5.1%) and twin pregnancy n=2(5.1%). The median body index was 25.5 kg/m2 [23.7;29.4] with 35.9% women of normal weight, 48.7% overweight and 15.4% obese. Non-response to ASA was found in 12 pregnant women (30.7%). No statistically significant differences were observed between non-responders and responders with regard to epidemiological, clinical and haematological determinants (p>0.05). Non-response was more observed in women with complications 23.08% versus 7.7% (p=0,008). Non-response to ASA, present in a third of hypertensive pregnant women, is associated with the occurrence of obstetrical complications in Brazzaville.
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Gokaba et al. (2024) conducted a cross-sectional in Pregnant women on acetylsalicylic acid (n=39). Non-response to acetylsalicylic acid (ASA resistance) vs. Response to acetylsalicylic acid was evaluated on obstetric complications (p=0.008). Non-response to acetylsalicylic acid was found in 30.7% of pregnant women and was significantly associated with a higher rate of obstetric complications (23.08% vs 7.7%; p=0.008).
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