Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia
Authors: Stéphanie Roberge, Suzanne Demers, Emmanuel Bujold
Journal: Annals of Internal Medicine (2014)

Letters21 October 2014Low-Dose Aspirin for Prevention of Morbidity and Mortality From PreeclampsiaStéphanie Roberge, MSc, Suzanne Demers, MD, and Emmanuel Bujold, MD, MScStéphanie Roberge, MScFrom Université Laval, Québec, Québec, Canada., Suzanne Demers, MDFrom Université Laval, Québec, Québec, Canada., and Emmanuel Bujold, MD, MScFrom Université Laval, Québec, Québec, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5020-4 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Henderson and colleagues (1) observed that low-dose aspirin reduces the risk for preterm birth, preeclampsia, and intrauterine growth restriction. However, we believe that they should have developed some important details before concluding that low-dose aspirin therapy should be started after the first trimester. Although the authors reported that 8 trials initiated low-dose aspirin treatment before 16 weeks of gestation, only 5 of them effectively randomly assigned study participants at a mean (or median) gestational age of less than 16 weeks. For example, CLASP (Collaborative Low-Dose Aspirin Study in Pregnancy) initiated randomization at 12 weeks of gestation, but ...References1. Henderson JT, Whitlock EP, O'Connor E, Senger CA, Thompson JH, Rowland MG. Low-dose aspirin for prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160:695-703. [PMID: 24711050] doi:10.7326/M13-2844 LinkGoogle Scholar2. CLASP: a randomised trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnant women. CLASP (Collaborative Low-dose Aspirin Study in Pregnancy) Collaborative Group. Lancet. 1994;343:619-29. [PMID: 7906809] CrossrefMedlineGoogle Scholar3. Roberge S, Nicolaides KH, Demers S, Villa P, Bujold E. Prevention of perinatal death and adverse perinatal outcome using low-dose aspirin: a meta-analysis. Ultrasound Obstet Gynecol. 2013;41:491-9. [PMID: 23362106] doi:10.1002/uog.12421 CrossrefMedlineGoogle Scholar4. Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116:402-14. [PMID: 20664402] doi:10.1097/AOG.0b013e3181e9322a CrossrefMedlineGoogle Scholar5. National Institute for Health and Clinical Excellence. Hypertension in Pregnancy: The Management of Hypertensive Disorders during Pregnancy. Manchester, United Kingdom: National Institute for Health and Clinical Excellence; 2010 [updated 2011]. Accessed at http://guidance.Nice.Org.Uk/cg107 on 16 April 2014. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Université Laval, Québec, Québec, Canada.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0365. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLow-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force Jillian T. Henderson , Evelyn P. Whitlock , Elizabeth O'Connor , Caitlyn A. Senger , Jamie H. Thompson , and Maya G. Rowland Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force Jillian T. Henderson , Evelyn P. Whitlock , Elizabeth O'Connor , Caitlyn A. Senger , Jamie H. Thompson , and Maya G. Rowland Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia Jillian T. Henderson , Elizabeth O'Connor , and Evelyn P. Whitlock Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia Jillian T. Henderson , Elizabeth O'Connor , and Evelyn P. Whitlock Metrics Cited ByMolecular Targets of Aspirin and Prevention of Preeclampsia and Their Potential Association with Circulating Extracellular Vesicles during PregnancyPrimary and secondary prevention of preterm birth: a review of systematic reviews and ongoing randomized controlled trialsPreeclampsia induced by STOX1 overexpression in mice induces intrauterine growth restriction, abnormal ultrasonography and BOLD MRI signaturesPreeclampsia Screening: Combining All the Right Markers to predict a Wrong Disease?A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosusInnate Immune System at the Maternal-Fetal Interface: Mechanisms of Disease and Targets of Therapy in Pregnancy SyndromesG-Protein-coupled receptors as potential drug candidates in preeclampsia: targeting the relaxin/insulin-like family peptide receptor 1 for treatment and prevention 21 October 2014Volume 161, Issue 8Page: 613KeywordsDisclosureMorbidityPreeclampsiaPregnancyPreterm birth ePublished: 21 October 2014 Issue Published: 21 October 2014 CopyrightCopyright © 2014 by American College of Physicians. 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