Discontinuing aspirin at 24 to 28 weeks gestation feasible for preeclampsia prevention while reducing bleeding risk: JAMA
Spain: In pregnant women with high preeclampsia risk, aspirin discontinuation at gestation weeks 24 to 28 to prevent preterm preeclampsia maintains efficacy while potentially reducing bleeding risk, findings from a randomized, phase 3 trial have shown. The results appeared in the Journal of the American Medical Association (JAMA) on February 21, 2023.
Previous studies have shown that aspirin causes a reduction in the incidence of preeclampsia by 62% in pregnant individuals at high preeclampsia risk. However, aspirin might be tied to an increased risk of peripartum bleeding, which could be mitigated by aspirin discontinuation before term, i.e. 37 weeks of pregnancy and by accurately selecting individuals at high preeclampsia risk in the pregnancy's first trimester.
Against the above background, Manel Mendoza and colleagues from Spain aimed to determine whether aspirin discontinuation in pregnant women with normal soluble fms-like tyrosine kinase–1 to placental growth factor (sFlt-1:PlGF) ratio between gestation weeks 24 and 28 weeks of gestation was noninferior to aspirin continuation for the prevention of preterm preeclampsia.
They addressed the question, "can aspirin be discontinued at 24 to 28 weeks of gestation among pregnant women taking aspirin to prevent preterm preeclampsia when the sFlt-1:PlGF ratio is normal?"
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