Aspirin and Prevention of Preeclampsia

Brennecke, Shaun P.; Ma, Bi; Crowther, CA; Hague, W.; King, James F.; McCowan, Lesley; Morris, J.N.; North, R A; Pattison, N. S.; Tippett, Christine

doi:10.1111/j.1479-828x.1995.tb01827.x

Cited by 11 publications

(2 citation statements)

References 14 publications

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“…This specific pregnancy disorder can be the result of multiple mechanisms of disease [9,10,13,16,20,21,25,32–36,42,43,46,47,53,56,57,59,64–66,70,78,80–82,84,87,88,91,102,105,111,112,116,120,123,129,134,136,144,154], is adaptive in nature [2,15,44,96,97,113,135] and has a long subclinical phase [19,22,63,67,68,98,100,122, 125,140,145]. Due to its syndromic nature, several attempts have been made to classify patients with PE into distinct subgroups in order to improve un derstanding of its pathophysiology [148–150,153], predict maternal/fetal complications [4,27,89,124,126] and to develop individualized preventive or therapeutic interventions [11,23,128,138]. …”

Section: Introductionmentioning

confidence: 99%

Placental lesions associated with maternal underperfusion are more frequent in early-onset than in late-onset preeclampsia

Oggè

Chaiworapongsa²,

Romero

et al. 2011

Journal of Perinatal Medicine

248

145

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Objective Preeclampsia (PE) has been classified into early- and late-onset disease. These two phenotypic variants of PE have been proposed to have a different pathophysiology. However, the gestational age cut-off to define ‘early’ versus ‘late’ PE has varied among studies. The objective of this investigation was to determine the prevalence of lesions consistent with maternal underperfusion of the placenta in patients with PE as a function of gestational age. Study design A nested case-control study of 8,307 singleton pregnant women who deliver after 20 weeks of gestation was constructed based on a cohort. Cases were defined as those with PE (n=910); controls were pregnant women who did not have a hypertensive disorder in pregnancy (n=7,397). The frequency of maternal underperfusion of the placenta (according to the criteria of the Society for Pediatric Pathology) was compared between the two groups. Logistic regression was used for analysis. Estimated relative risks were calculated from adjusted odds ratios. Results 1) The prevalence of lesions consistent with maternal underperfusion was higher in patients with PE than in the control group [43.3% vs. 15.9%; unadjusted odds ratio 4.0 (95% CI 3.5–4.7); P<0.001]; 2) the estimated relative risk of maternal underperfusion lesions in PE was higher than in the control group; 3) the lower the gestational age at delivery, the higher the relative risk for these lesions; 4) early-onset PE, regardless of the gestational age used to define it (<32, 33, 34, 35 or 37 weeks) had a significantly higher frequency of placental lesions consistent with maternal underperfusion than late-onset PE (p<0.001 for all). Conclusions 1) The earlier the gestational age of preeclampsia at delivery, the higher the frequency of placental lesions consistent with maternal underperfusion; 2) our data suggests that demonstrable placental involvement as determined by pathologic examination differs in early- and late-onset preeclampsia; and 3) this phenomenon appears to be a continuum, and we could not identify a clear and unambiguous gestational age at which lesions consistent with underperfusion would not be present.

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Section: Introductionmentioning

confidence: 99%

Placental lesions associated with maternal underperfusion are more frequent in early-onset than in late-onset preeclampsia

Oggè

Chaiworapongsa²,

Romero

et al. 2011

Journal of Perinatal Medicine

248

145

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“…After 6.5 years of follow-up, however, adjusted aspirin use was associated with a significantly lower all-cause mortality (hazard ratio [HR]: 0.86; P = 0.04) and cardiovascular-related mortality (HR: 0.75; P = 0.01) in those women taking aspirin 17. In addition to recommendations regarding the use of aspirin for the prevention of CVD and associated complications, numerous guidelines also recommend low-dose aspirin for women at risk of preeclampsia;19–21 but again, there is considerable variation in its use for this indication 22…”

Section: Introductionmentioning

confidence: 99%

The role of aspirin in women’s health

Verheugt¹,

Bolte²

2011

IJWH

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BackgroundThe aim of this review is to discuss the role of aspirin for various conditions in women.MethodsA nonsystematic review of articles published on PubMed® that examines the role of aspirin in women.ResultsAspirin is associated with a significant reduction of stroke risk in women, which may be linked to age. However, despite this evidence, underutilization of aspirin in eligible women is reported. In women of reproductive age, it may also have a role to play in reducing early-onset preeclampsia and intrauterine growth restriction, and in the prevention of recurrent miscarriage in women with antiphospholipid antibodies; it may also reduce cardiovascular risk in associated systemic conditions such as lupus. Aspirin may reduce colorectal cancer risk in women, but its role in breast cancer warrants further data from controlled trials.ConclusionsThe risk–benefit threshold for aspirin use in women has been established for several conditions. Reasons why women are less likely to be prescribed aspirin have not been established, but the overall underuse of aspirin in women needs to be addressed.

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