Low-Dose Aspirin in High-Risk Pregnancy?

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Abstract
Objectives: To determine the value of low-dose aspirin (100 mg/day) therapy in high-risk pregnancies, and to assess improvement in maternal abnormalities in response to this therapy, we conducted a prospective, randomized, double-blind, placebo-controlled therapeutic study. Methods: One hundred and eight pregnant women with preexisting hypertension (n = 60) or renal disease (n = 28), or a history of early severe preeclampsia (n = 20) in a previous pregnancy, took either aspirin (n = 58) or placebo (n = 50) from 17 to 19 weeks amenorrhea till approximately 37 weeks amenorrhea. The main outcome measures were duration of pregnancy, birth weight, maximum antenatal blood pressure, and maximum antenatal serum uric acid level. Outcome: Median values for the maximum antenatal blood pressure were higher and for birth weight lower in placebo-treated than in aspirin-treated women. Noncompliance with treatment, as assessed by platelet aggregation studies, was high in both groups. Conclusion: There was a small but potentially beneficial effect of aspirin on the development of hypertension and on fetal growth but no effect on overall pregnancy outcome. Noncompliance in both treatment groups may contribute to failure to demonstrate a clearer difference between them, and may partially explain conflicting results of aspirin therapy in the literature.