Low-dose aspirin for the prevention of pre-eclampsia in wome
Low-dose aspirin has been the most widely studied preventive drug for pre-eclampsia.

The low-dose Aspirin in the Prevention of Pre-Eclampsia in China (APPEC) study was designed to evaluate the effect of 100mg aspirin in preventing pre-eclampsia among high-risk pregnant women screened with maternal risk factors in China, where pre-eclampsia is highly prevalent, and the status of low-dose aspirin supply is commonly suboptimal.

Women were randomly assigned to the aspirin or control group in a 1:1 allocation ratio. Statistical analyses were performed according to an intention-to-treat basis. The primary outcome was the incidence of pre-eclampsia, diagnosed with systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg developing after 20 weeks of gestation with previously normal blood pressure (SBP < 140 mmHg and DBP < 90 mmHg), and complicated by proteinuria. The secondary outcomes included maternal and neonatal outcomes.

One thousand eligible women were recruited, of which the final 898 patients were analyzed on an intention-to-treat basis.

- Pre-eclampsia incidence did not show a significant difference between the aspirin group and the control group.

- Likewise, adverse maternal and neonatal outcomes did not differ significantly between the two groups.

- Meanwhile, the incidence of postpartum hemorrhage between the two groups was similar. They did not find any significant differences in pre-eclampsia incidence between the two groups in the subgroup analysis of the different risk factors.

A dose of 100mg of aspirin per day, initiated from 12 to 20 gestational weeks until 34 weeks of gestation, did not reduce the incidence of pre-eclampsia in pregnant women with high-risk factors in China.

American Journal of Obstetrics & Gynecology
Source: https://doi.org/10.1016/j.ajog.2021.08.004
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