ABSTRACT
Objective: There are significant racial/ethnic disparities in development of preeclampsia and perinatal morbidity and mortality due to preeclampsia. Low-dose aspirin (LDA) is the only strategy proven effective for preeclampsia risk reduction among high-risk patients. This study aims to determine if there are racial/ethnic differences in use of LDA for preeclampsia risk reduction among patients who meet criteria based on ACOG/SMFM recommendations. Study Design: This is a secondary analysis of a retrospective cohort study of all pregnant patients who delivered at 33 US hospitals in 14 states in 2019 and 2020. Patients were included if they had an indication for LDA for preeclampsia risk reduction. Exclusion criteria were missing or other race/ethnicity, missing LDA use, and positive SARS-CoV-2 test. Indications for LDA were defined per ACOG/SMFM recommendations: >= 1 high risk factor (history of preeclampsia, multiple gestation, chronic hypertension, pregestational diabetes, kidney disease, lupus) or >= 2 moderate risk factors (nulliparity, obesity, age >= 35 years, in vitro fertilization). This study was performed before the recommendations were updated in 2021. All data were ed from the medical record by trained and certified perinatal research staff. The primary outcome was LDA use during pregnancy. Multivariable logistic regression adjusted for clinical site. Result(s): A total of 6,853 patients were included: 26.5% non-Hispanic Black (NHB), 47.6% non-Hispanic White (NHW), 4.0% non-Hispanic Asian (NHA), and 21.7% Hispanic. NHB patients were most likely to use LDA (38.7%) followed by NHW (29.6%), Hispanic (27.5%), and NHA (24.7%), p< 0.001. NHB patients had 1.5 times the odds of using LDA compared to NHW patients (95% CI 1.33-1.69);this persisted when adjusting for clinical site (aOR 1.44, 95% CI 1.26-1.64). Conclusion(s): Among pregnant patients at high risk for preeclampsia per ACOG/SMFM guidelines, overall rates of LDA use were low. NHB patients had increased odds of LDA use compared to NHW patients. Future research should seek strategies for increasing LDA use among all patients with high-risk pregnancies. [Formula presented] [Formula presented] Copyright © 2022