Pregnant women taking low-dose aspirin at lower risk of preterm delivery: Lancet
Delhi: Women who take daily low-dose aspirin were 11% less likely to have premature babies than women given a placebo, according to a recent study published in The Lancet journal.
According to the study, among the first-time mothers, the intake of daily low-dose aspirin, from as early as the sixth week of pregnancy through the 36th week lowes the risk of preterm birth --the birth of a baby before the 37th week of pregnancy.
Preterm birth remains a common cause of neonatal mortality, with a disproportionately high burden in low-income and middle-income countries. Matthew K Hoffman, Department of Obstetrics and Gynecology, Christiana Care, Newark, USA, and colleagues conducted this ASPIRIN trial -- a randomized, multicountry, double-masked, placebo-controlled trial of low-dose aspirin (81 mg daily) initiated between 6 weeks and 0 days of pregnancy, and 13 weeks and 6 days of pregnancy, in nulliparous women with an ultrasound confirming gestational age and a singleton viable pregnancy.
According to the authors, low-dose aspirin therapy in early pregnancy could provide an inexpensive way to lower the preterm birth rate in first-time mothers.
For the study, the researchers enrolled 11,976 women with a first-time pregnancy from seven sites in India, Pakistan, Zambia, Democratic Republic of the Congo, Guatemala and Kenya. Roughly half were assigned at random to receive 81 milligrams of aspirin daily; the other group received a daily placebo. Women were included in the study only if they maintained a pregnancy for more than 20 weeks.
Key findings of the study include:
- From March 23, 2016 to June 30, 2018, 14 361 women were screened for inclusion and 11 976 women aged 14–40 years were randomly assigned to receive low-dose aspirin (5990 women) or placebo (5986 women).
- 5780 women in the aspirin group and 5764 in the placebo group were evaluable for the primary outcome.
- Preterm birth before 37 weeks occurred in 668 (11·6%) of the women who took aspirin and 754 (13·1%) of those who took placebo (RR 0·89).
- In women taking aspirin, there was a significant reduction in perinatal mortality (0·86), fetal loss (infant death after 16 weeks' gestation and before 7 days postpartum; 0·86), early preterm delivery (<34 weeks; 0·75), and the incidence of women who delivered before 34 weeks with hypertensive disorders of pregnancy (0·38).
- Other adverse maternal and neonatal events were similar between the two groups.
The authors note that the low cost and safety of low-dose aspirin therapy suggest that it could be easily adapted for widescale use.
"In populations of nulliparous women with singleton pregnancies from low-income and middle-income countries, low-dose aspirin initiated between 6 weeks and 0 days of gestation and 13 weeks and 6 days of gestation resulted in a reduced incidence of preterm delivery before 37 weeks, and reduced perinatal mortality," they concluded.
The study, "Low-dose aspirin for the prevention of preterm delivery in nulliparous women with a singleton pregnancy (ASPIRIN): a randomised, double-blind, placebo-controlled trial," is published in The Lancet.