Poster Presentation Society of Obstetric Medicine of Australia and New Zealand and Australasian Diabetes in Pregnancy Society Joint Scientific Meeting 2017

Effect of early use of low-dose aspirin therapy on late-onset pre-eclampsia (#144)

Patrick G Lan 1 2 , Adrian G Gillin 1 2 , Marilena Pelosi 3 , Jane Tooher 3 , Puk Sandager 4 , Jonathan Hyett 3 5
  1. Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  2. Sydney Medical School, University of Medicine, Sydney, NSW, Australia
  3. Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  4. Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark
  5. Central Clinical School, University of Sydney, Sydney, NSW, Australia

Introduction: Low-dose aspirin is commonly used as a therapeutic tool for preventing the development of pre-eclampsia. However, this appears to be most effective at reducing the development of early-onset pre-eclampsia (delivery before 34 weeks' gestation) compared to late-onset disease (delivery after 34 weeks' gestation), especially in women considered as being at high-risk of developing pre-eclampsia. Despite having no apparent effect on the prevalence of late-onset disease, the effect of low-dose aspirin on the clinical profile of late-onset pre-eclampsia is not known.

Objective: To determine if low-dose aspirin therapy from early in pregnancy modifies the clinical severity of late-onset pre-eclampsia.

Methods: A retrospective analysis of all women screened for risk of developing early-onset pre-eclampsia at 11 to 13+6 weeks’ gestation between April 2012 to October 2014 and who subsequently developed late-onset pre-eclampsia.

Results: Women found to be at high risk of developing pre-eclampsia at 11 to 13+6 weeks’ were prescribed low-dose aspirin for the duration of their pregnancy. Women in this cohort who developed late-onset pre-eclampsia were compared to those who developed late-onset pre-eclampsia and had not been prescribed low-dose aspirin. The use of low-dose aspirin was associated with earlier delivery at 38.0 (37.5-38.5) weeks’ gestation vs 39.0 (38.7-39.4) weeks’ gestation for the non-aspirin group (p<0.01). Aspirin use was also associated with lower absolute birth weight 2851 (2646-3055)-grams vs. 3215 (3068-3362)-grams in the non-aspirin group (p<0.01). No other significant difference was noted including the use of intravenous antihypertensive therapy, magnesium sulfate, presence of symptoms at time of presentation, length of hospitalisation and serum laboratory parameters between the two cohorts. In addition, aspirin use was not found to be associated with significant adverse clinical outcomes.

Conclusion: The use of low-dose aspirin from early in pregnancy did not have a clinical impact on the severity of late-onset pre-eclampsia.