Low dose aspirin in pregnancy are there any benefits

ABSTRACT

Although the question of major prophylactic benefits of low-dose aspirin in preventing pre-eclampsia or intrauterine growth retardation in pregnancies of mothers who had had such a history has been convincingly negated by the CLASP study, there has remained a question whether pregnancies of primiparae (the group most at risk of such outcomes) might benefit. This study was designed as a randomized controlled trial to address this possibility and other hypotheses arising from the CLASP study. The hypotheses addressed concerns whether low-dose aspirin prevented in or delayed the onset of the hypertensive disorders of pregnancy, including pre-eclampsia, and eclampsia, and whether preterm delivery or low birthweight rates were reduced. In addition, the study was designed to assess whether enrolment, early rather than late, had the most beneficial effect. In parallel, possible adverse effects on mother and infant were monitored. A total of 6275 primiparae were enrolled from 12 weeks gestation in community clinics in Kingston and St. Andrew in Jamaica; 97 percent of them were followed throughout pregnancy. There were no differences in the development of markers of hypertensive disorders, the prevalence of pre-eclampsia or eclampsia except for oedema, which was more prevalent in those on placebo. Mothers on the drug showed no differences in mean diastolic bloodpressure at any stage of pregnancy - they were not less likely to deliver preterm or have a larger foetus. They were, however, significantly more likely to suffer from bleeding disorders antenatally, intrapartum and postpartum. It is concluded that low-dose aspirin has no place in the management of normal pregnancy (AU)