Relationship between risk factor profile and prescription of low-dose aspirin for preeclampsia prevention

Abstract

The purpose of this study was to assess obstetrician-gynecologist utilization of low-dose aspirin for women at increased risk for hypertensive disorders of pregnancy. Further, the study evaluated prescribing practices in relation to speci c risk factor pro les in order to identify which women are at highest risk of not receiving recommended therapy. Methods:This was a retrospective cohort study reviewed and approved by the local Institutional Review Board. Electronic health records were reviewed to identify risk factors for preeclampsia. Women were eligible for aspirin prophylaxis if they had at least one "high" risk factor or multiple "moderate" risk factors.Associations of interest were addressed using Pearson Chi-squared tests and multinomial logistic regression.Results: 970 patients were included and 301 women (31%) met criteria for low-dose aspirin prophylaxis; of these, 92 (31%) were given this recommendation. Women eligible for prophylaxis by presence of multiple "moderate" risk factors alone were least likely (0-6%) to have a low-dose aspirin prescription. Conclusions for Practice:Low-dose aspirin is an underutilized tool for preventing preeclampsia. Women with a combination of "moderate" risk factors are most likely to not receive indicated aspirin prophylaxis. Efforts should be made to encourage broader uptake of the recommendations for aspirin prophylaxis among obstetriciangynecologists. Signi canceWhat is already known on this subject? Low-dose aspirin has been shown to reduce preeclampsia risk in pregnant women. This preventative measure has been recommended by prominent organizations including the American College of Obstetricians and Gynecologists and the United States Preventive Services Task Force. Yet despite widespread support of this recommendation, uptake is not universal among obstetric care providers. What this study adds?This study identi es those who are most likely to experience a missed opportunity for aspirin prophylaxis, thus providing a suggestion for where provider education or other efforts to increase adherence to this guideline may be most impactful. DeclarationsFunding: There was no nancial support obtained for the conduct of this research or preparation of this article for publication.Con icts of interest: The authors report no con icts of interest.Ethics approval: The project was reviewed and approved by the local Institutional Review Board (IRB) prior to commencement of the project.Consents: Waivers of informed consent or consent for publication were obtained from the IRB due to the retrospective nature of this chart review and since no patient-identifying information will be published.

Missed opportunity for aspirin prophylaxis for preeclampsia prevention: a cross-sectional study from Sub-Saharan Africa

“… 19 Low-dose ASA remains an underused tool for preventing PE. 20 We found this to be very true in our study. Among the women who had an indication for ASA prophylaxis in this study, less than 1% were provided with ASA accordingly although more than half (195 of 395 women) of the women enrolled in this study had an indication for ASA prophylaxis.…”