Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia
Authors: Jillian T. Henderson, Elizabeth O'Connor, Evelyn P. Whitlock
Journal: Annals of Internal Medicine (2014)

Letters21 October 2014Low-Dose Aspirin for Prevention of Morbidity and Mortality From PreeclampsiaJillian T. Henderson, PhD, MPH, Elizabeth O'Connor, PhD, and Evelyn P. Whitlock, MD, MPHJillian T. Henderson, PhD, MPHFrom Kaiser Permanente Research Affiliates Evidence-based Practice Center, Portland, Oregon., Elizabeth O'Connor, PhDFrom Kaiser Permanente Research Affiliates Evidence-based Practice Center, Portland, Oregon., and Evelyn P. Whitlock, MD, MPHFrom Kaiser Permanente Research Affiliates Evidence-based Practice Center, Portland, Oregon.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5020-5 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Roberge and colleagues suggest that alternate analyses of our data reveal important effects of the timing of initiation of low-dose aspirin therapy for preventing preeclampsia, intrauterine growth restriction, and preterm birth. Unfortunately, meta-analyses of the available evidence are not well-suited for identifying such effects. Many of the included studies enrolled women initiating treatment across a range of gestational ages.Of note, the 2 largest included trials cannot be precisely classified, having enrolled participants beginning at 12 to 13 weeks of gestation, with 49% initiating aspirin therapy before 20 weeks of gestation in the MFMU (Maternal-Fetal Medicine Units) ...References1. Caritis S, Sibai B, Hauth J, Lindheimer MD, Klebanoff M, Thom E, et al. Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med. 1998;338:701-5. [PMID: 9494145] CrossrefMedlineGoogle 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. Askie LM, Duley L, Henderson-Smart DJ, Stewart LA; PARIS Collaborative Group.. Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data. Lancet. 2007;369:1791-8. [PMID: 17512048] CrossrefMedlineGoogle Scholar4. Duley L, Henderson-Smart DJ, Meher S, King JF. platelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007:CD004659. [PMID: 17443552] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Kaiser Permanente Research Affiliates Evidence-based Practice Center, Portland, Oregon.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2844. 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 Stéphanie Roberge , Suzanne Demers , and Emmanuel Bujold Low-Dose Aspirin for Prevention of Morbidity and Mortality From Preeclampsia Stéphanie Roberge , Suzanne Demers , and Emmanuel Bujold Metrics Cited byPotential role of the corpus luteum in maternal cardiovascular adaptation to pregnancy and preeclampsia riskA Novel Peptide Ameliorates TNFα- and LPS-Induced Endothelia Dysfunction in PreeclampsiaSpontaneous Preterm Birth: Is Prevention with Aspirin Possible?Maternal StrokeDevelopment of a Set of Lupus‐Specific, Ambulatory Care–Sensitive, Potentially Preventable Adverse Conditions: A Delphi Consensus StudyPregnancy outcomes following oocyte donationFirst Trimester Screening for Preeclampsia: An Asian PerspectiveMaternal and Fetal Outcomes of Pregnancy in Nephrotic Syndrome Due to Primary GlomerulonephritisThe Safety of Low-Dose Aspirin on the Mode of Delivery: Secondary Analysis of the Effect of Aspirin in Gestation and Reproduction Randomized Controlled TrialRelevance of the assessment of natriuretic peptide plasma concentrations in hypertensive pregnant womenMelatonin attenuates hypertension and oxidative stress in a rat model of L-NAME-induced gestational hypertensionDoes race or ethnicity play a role in the origin, pathophysiology, and outcomes of preeclampsia? An expert review of the literatureCys-peptide mediates the protective role in preeclampsia-like rat and cell modelsPreeclampsia and Renal Disease in Pregnancy: Obstetric PerspectiveClinical practice guideline on pregnancy and renal diseaseIntérêts potentiels des facteurs angiogéniques placentaires comme biomarqueurs dans la pré-éclampsie pour le clinicienThe International Federation of Gynecology and Obstetrics ( FIGO ) initiative on pre‐eclampsia: A pragmatic guide for first‐trimester screening and preventionNF-κB–responsive miRNA-31-5p elicits endothelial dysfunction associated with preeclampsia via down-regulation of endothelial nitric-oxide synthaseMelatonin modulates autophagy and inflammation protecting human placental trophoblast from hypoxia/reoxygenationAmeliorative effects of aspirin against lipopolysaccharide-induced preeclampsia-like symptoms in rats by inhibiting the pro-inflammatory pathwayFetal Growth Restriction: Recurrence Risks and CounselingMaternal Vascular Physiology in PreeclampsiaConcomitant preterm birth and severe small-for-gestational age birth weight among infants of immigrant mothers in Ontario originating from the Philippines and East Asia: a population-based studyEffects of low-dose aspirin on maternal blood pressure and vascular function in an experimental model of gestational hypertensionIncidence of superimposed preeclampsia among pregnant Asian women with chronic hypertensionRelaxin confers cytotrophoblast protection from hypoxia-reoxygenation injury through the phosphatidylinositol 3-kinase-Akt/protein kinase B cell survival pathwayAspirin prevents TNF-α-induced endothelial cell dysfunction by regulating the NF-κB-dependent miR-155/eNOS pathway: Role of a miR-155/eNOS axis in preeclampsiaObstetric and neonatal complications in pregnancies conceived after oocyte donation: a systematic review and meta-analysisAspirin Use in Women: Current Perspectives and Future DirectionsMaternal Serum Aneuploidy Screen and Adverse Pregnancy OutcomesGeneral AspectsToxicity and Drug SafetyEarly prediction and aspirin for prevention of pre-eclampsia (EPAPP) study: a randomized controlled trialA Lifestyle Perspective on Infertility and Pregnancy OutcomeUS Preventive Services Task Force Guideline Supports Low‐Dose Aspirin for Prevention of Preeclampsia 21 October 2014Volume 161, Issue 8Page: 613-614KeywordsDisclosureMorbidityPreeclampsiaPregnancyPreterm birth ePublished: 21 October 2014 Issue Published: 21 October 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. 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