Subsequent pregnancy outcome after mid‐trimester termination of pregnancy for preeclampsia

Eerden, Leonoor van; Groot, Christianne de; Zeeman, Gerda G.; Page-Christiaens, G. C. M. L.; Pajkrt, Eva; Duvekot, Johannes J.; Vandenbussche, Frank P.H.A.; Oei, S.G.; Scheepers, Hubertina C.J.; Eyck, Jim van; Middeldorp, Johanna M.; Bolte, Antoinette C.

doi:10.1111/ajo.12691

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…In addition to the randomized controlled trials included in the current meta-analysis, a number of observational studies, including three retrospective (123)(124)(125) and one prospective cohort studies, (126) have reported on the relationship between early administration of low-dose aspirin and the risk of preeclampsia. All studies included women with history of previous preeclampsia and/or other pregnancy complications such as preterm delivery or fetal death.…”

Section: Comparison With Previous Studies On Pre-conception or Early mentioning

confidence: 99%

“…All studies included women with history of previous preeclampsia and/or other pregnancy complications such as preterm delivery or fetal death. The results are conflicting, in which three studies have reported that aspirin has no effect on the rate of preeclampsia, (123)(124)(125) while one study has demonstrated a reduction in the risk of the disorder (no treatment group 23.1% [3/13] vs. aspirin group 8.3% [1/12]). (126) Limitations of the study A major limitation of this meta-analysis was that not all trials reported on the rate of preeclampsia and that some studies did not differentiate preeclampsia from gestational hypertension.…”

Section: Comparison With Previous Studies On Pre-conception or Early mentioning

confidence: 99%

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Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Chaemsaithong

Cuenca-Gomez

Plana

et al. 2020

American Journal of Obstetrics and Gynecology

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Condensation: Aspirin given at <11 weeks' gestation in high risk women does not reduce the risk of preeclampsia and gestational hypertension but may reduce the risk of preterm delivery. Short title: Early aspirin administration and preeclampsia PROSPERO registration number: CRD42019125006 AJOG at a Glance: Why was this study conducted? • To perform a systematic review and meta-analysis to evaluate the effect of lowdose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. Key findings • The administration of low-dose aspirin at <11 weeks' gestation in women with a history of recurrent pregnancy loss, women who had undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome was associated with a non-significant decrease in the risk of preeclampsia, gestational hypertension, and any hypertensive disorder of pregnancy. • Early low-dose aspirin reduced the risk of preterm delivery but had no impact on the risk of fetal growth restriction. • Except for preterm delivery and any hypertensive disorder of pregnancy, sensitivity analysis demonstrated similar observations; confirming the robustness of our analysis. What does this add to what is known? • Administration of low-dose aspirin at <11 weeks' gestation to high risk women does not reduce the risk of preeclampsia, gestational hypertension, any hypertensive disorder of pregnancy and fetal growth restriction but might reduce the risk of preterm delivery at <37 weeks of gestation. ABSTRACT OBJECTIVE DATA: Pre-conception or early administration of low-dose aspirin might improve endometrial growth, placental vascularization and organogenesis. Most studies have evaluated the potential benefit of pre-conception or early administration of low-dose aspirin in women with a history of recurrent pregnancy loss, women who have undergone in vitro fertilization or women with thrombophilia or antiphospholipid syndrome. These women are at an increased risk of placenta-associated complications of pregnancy, including preeclampsia, preterm delivery and fetal growth restriction. STUDY: We performed a systematic review and meta-analysis to evaluate the effect of low-dose aspirin initiated at <11 weeks' gestation on the risk of preeclampsia, gestational hypertension, or any hypertensive disorder of pregnancy. Secondary outcomes included preterm delivery at <37 weeks' gestation and fetal growth restriction. STUDY APPRAISAL AND SYNTHESIS METHODS: We searched in MEDLINE via PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.Gov and the World Health Organization International Clinical Trials Registry Platform (WHO-ICTRP) from 1985 to November 2018. Entry criteria were randomized controlled trials evaluating the effect of aspirin administered at <11 weeks' gestation in preventing preeclampsia and/or hypertensive disorders in pregnancy or improvi...

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Section: Comparison With Previous Studies On Pre-conception or Early mentioning

confidence: 99%

Section: Comparison With Previous Studies On Pre-conception or Early mentioning

confidence: 99%

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Chaemsaithong

Cuenca-Gomez

Plana

et al. 2020

American Journal of Obstetrics and Gynecology

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“…Decreased trophoblast invasion, required to establish pregnancy, contributes to the development of preeclampsia ( 5 ) and inhibits vascular reconstruction in the uterine spiral arteries ( 6 ). Preeclampsia is a complex disease and its course is difficult to predict, therefore the termination of pregnancy may be recommended as a method of controlling disease progression ( 7 ). The etiology and pathogenesis of preeclampsia remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Effects of forkhead box protein M1 on trophoblast invasion and its role in preeclampsia development

Cui

et al. 2018

Exp Ther Med

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The present study aimed to investigate the expression of the forkhead box protein M1 (FOXM1) in the placenta of patients with preeclampsia, and its effect on trophoblasts. A total of 28 patients with preeclampsia and 30 patients without preeclampsia (controls) who underwent cesarean section and were admitted to the Affiliated Hospital of Qingdao University between June 2013 and September 2016 were enrolled in the present study. The expression of FOXM1 in placental tissues was examined by reverse transcription-quantitative polymerase chain reaction, western blotting and immunohistochemistry. HTR8/SVneo cells were used to measure the in vitro expression of the vascular endothelial growth factor (VEGF). The results demonstrated that FOXM1 expression was downregulated in the placental tissues of patient with preeclampsia (P<0.05). Following the silencing of FOXM1 expression, the proliferation of HTR8/SVneo cells was suppressed. The results of flow cytometry demonstrated that proportion of HTR8/SVneo cells in the G0/G1 phase and the proportion of apoptotic cells increased. The expression of the apoptosis regulator BCL-2, as well as the expression of VEGF mRNA and protein expression were also downregulated following FOXM1 silencing. FOXM1 may therefore promote the development of preeclampsia via the VEGF signaling pathway.

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Racial Disparities in Pregnancy and Birth Outcomes

Ciciolla

Armans

Addante

et al. 2019

Handbook of Children and Prejudice

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Subsequent pregnancy outcome after mid‐trimester termination of pregnancy for preeclampsia

Abstract: The course of subsequent pregnancies after mid-trimester termination for preeclampsia is uncomplicated in 53% with a recurrence rate for preeclampsia of 29%. The mean gestational age at delivery was 11 weeks later and birth weight 2000 g higher than in the index pregnancy.

Cited by 4 publications

References 20 publications

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Does low-dose aspirin initiated before 11 weeks’ gestation reduce the rate of preeclampsia?

Effects of forkhead box protein M1 on trophoblast invasion and its role in preeclampsia development

Racial Disparities in Pregnancy and Birth Outcomes

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